Starting to freak out about delivery

At my appt today my dh/MFM and I had a long discussion about the delivery. Twin A is presenting vertex and bigger than Twin B who is breech. At 31 week u/s Twin A was estimated to be 3.9lbs and Twin B 3.0lbs. My MFM Dr. says he feels confident with a vaginal delivery. He said Twin A is in perfect position and will pave the way. He will go in (yikes) :huh: and do a breech extraction of Twin B. He said in 20 years he has never had to do a c-section following this type of delivery. he said he has had to do more c-sections post vag delivery of first twin when both were vertex (5 total). He said that as long as I don't go into labor next week when he is on vacation he will come in even if he off call to deliver my twins. He also said all the MFM drs in this practice are also comfortable with this and half of the regular OB drs are comfortable with this. Otherwise its a c-section. He left the choice completely up to me and dh. I am on the fence about this. I am so worried for Twin B. Could care less about me and c-section recovery, but he has almost sold me on the vaginal delivery. What do you guys think? Anyone with experience with this presentation...I am sure there are lots of you out there!

 

My babies presented the same way. I delivered vaginally and was very happy I did. It is definitely a weird sensation to have the Dr. go in and get the baby but both were delivered safely and no c-section needed. The Dr did need to use foreceps to get Baby B out because she got stuck on her way out. And she had to have a hip ultrasound due to breech delivery. But everything was fine!
I'm very glad I delivered vaginally and if you trust your doctor I would take his advice!
Good luck!!

 

I was soooo nervous about delivering twins!
mine were presenting the exact same way as you -- Baby A vertex and Baby B was breech. I really wanted to have them vaginally and discussed all options with my dr... he felt confident in delivering Vag and doing a breech extraction if need be.
So the day of the delivery Baby A is born at 12:20 with just one push... he then "goes up" in and attempts to turn the breech baby - the baby's water breaks and so he did a breech footling extraction - he just grabbed her little feet and out she came - just 4 minutes after Baby A and one push from me.
I would highly suggest an epidural if you're going to attempt this - as a breech extraction (or attempting to turn baby B) will be VERY PAINFUL! I have had 2 of my babies at home w/o drugs (and was sort of anti-epi...uh.. not anymore!)
I really thought once the epi wore off I would be in such agony from all of that man-handling -- but that wasn't the case - in fact I didn't tear or have an episiotomy - and as you can tell from my siggy - my twins were not little!
It's compltely natural to feel anxiety and worry about the delivery but I wouldn't change things with mine and before I knew it - the whole thing was over and my little girls were in my arms!
good luck!

 

Both of mine were vertex, but my OB had said he was trained in breech extraction and would do that if I wanted. He also had never had to do a c-section after doing that type of delivery. My OB really wanted me to have a vaginal delivery since we had no help. He said recovering from a c-section and taking care of twins would be really difficult. So I would have done the breech extraction. But you have to do what feels right to you.

 

I fought to have the kind of delivery you are describing and I am soooo glad I did. Twin B (breech) was over 1 lb bigger than Twin A (vertex). Technically they don't like to do a breech extraction of a much bigger 2nd twin but I had delivered my 9 lb boys vaginally and was confident it would not be a problem. I had a very fast delivery with my twins. Baby A came out in 3 pushes then he reached in and grabbed Baby B by her feet. They were 3 minutes apart. Recovery was great and I am very thankful I avoided a c/s. Turns out Baby B was 1.5 pounds bigger than her sister and still it wasn't a problem.

I agree with the PP though, get an epidural. I had no pain during the delivery and only a small tear.

 

Mine presented the same as yours baby a was vertex and baby b (which was bigger) was breach. We also had the choice but the dr recommended trying a vag birth. I was induced at 37wks5days, and was in active labour for about 19hrs before deciding to switch to c section. I tried vag birth and it didn't work out, ended up with c section. I was most worried about having both births to recover from (vag and csection), but baby A just would not cooperate to do a vag birth. I still had the choice after 19hrs of labour to keep trying, but honestly I was literally exhausted and was happy to have the csection to have it over with.
There are many of us on here that have had csections, and we all survived the recovery! Good luck with your decision

 

It sounds like your doctor is confident and know what he's doing. When the time comes and you are in the middle of it, trust me you won't care how they come. Once they get here you won't care how it happened (you're just so in love with them). If you can avoid a c/s, avoid it! I attempted a vag delivery and never dialated after 13hrs. The section was more painful than I expected but not unbearable. If you trust your doctor I would just go with what he says and take it a minute at a time. They will most likely deliver you in the OR anyway so if something does happen you're right there and they'll get baby b out in no time. Those doctors and nurses (there were 3 doctors, 4 nurses and an anastesiologist) in the O/R they move fast!!!! I was the 3rd set of twins they had delivered that day! As pp said, that epidural takes care of everything, I got one about an hour and half before I went into surgery because they were pretty sure I wouldn't dialate anyway and I couldn't feel a thing after that.

 

My SIL's twins presented the same as yours are. She successfully delivered both vaginally with no complications. GL with whatever you decide!

 

I would go for the vaginal. My OB had the ultrasound machine pointed on twin B while I delivered A to make sure he turned the right way. I would trust the DR. I was very very nervous about delivering my twins also but I was glad I did vaginal b/c I was up walking around 2 hours after I delivered them (after the epidural wore off) and was able to go see my babies in the NICU.

 

another vote for the vaginal delivery. same scenario, only mine were the same size (only 2oz different at birth)- BUT- I have to say, it can be done w/o an epidural- at the time baby B was born, I didn't have any IV's, epidurals, shots, etc- it was completely me & the angels working to get those babies out. The absolute worst part was the delivery of baby B's head- and the silly midwife is telling me to give her one more big push and I thought, sorry, no push left- you'll just have to pull her out. Thankfully, it's about the time she popped out.

my biggest obstacle ended up being my recovery. they think now I had some placental accredia? (sp??) where the placenta grows into the uterus a bit- and because of it, I couldn't stop bleeding. we managed it- but not well-- I was seriously anemic for a good 6 weeks then kept bleeding and was just feeling low for another 6 weeks. I'm not sure if a c/s would have made a difference- if they could have managed the bleeding better then-- or if it would have made it worse (made it unstoppable). but the end of the story is good- I'm here and so are my girls and we're all well- just seriously sleep-deprived.

my biggest blessing- I had a birth doula- she was amazing and was able to talk me through the whole thing- they are invaluable in my opinion.

good luck whatever you decide, I pray there is a happy ending no matter which route it takes to get there.

 

QUOTE(monodigirls @ Aug 12 2008, 10:44 PM) [snapback]927378[/snapback]
At my appt today my dh/MFM and I had a long discussion about the delivery. Twin A is presenting vertex and bigger than Twin B who is breech. At 31 week u/s Twin A was estimated to be 3.9lbs and Twin B 3.0lbs. My MFM Dr. says he feels confident with a vaginal delivery. He said Twin A is in perfect position and will pave the way. He will go in (yikes) :huh: and do a breech extraction of Twin B. He said in 20 years he has never had to do a c-section following this type of delivery. he said he has had to do more c-sections post vag delivery of first twin when both were vertex (5 total). He said that as long as I don't go into labor next week when he is on vacation he will come in even if he off call to deliver my twins. He also said all the MFM drs in this practice are also comfortable with this and half of the regular OB drs are comfortable with this. Otherwise its a c-section. He left the choice completely up to me and dh. I am on the fence about this. I am so worried for Twin B. Could care less about me and c-section recovery, but he has almost sold me on the vaginal delivery. What do you guys think? Anyone with experience with this presentation...I am sure there are lots of you out there!


I had a vaginal delivery, with breech extraction of Baby B ... totally natural (with the exception of having to deliver in the OR), no epidural, etc. I was totally comfortable with this .... Our babies were 6 oz in wt difference

The story is on my blog ... link in the signature

Good luck!

 

Go vaginally if they are allowing it.

My twins were in position from 4 months on, A was head down and B was breech. I delivered my A in 1 push and B came out in 3 pushes. After A was out the doctor reached in to grab B's feet to lead her down more. The twins were born at 4:46 and 4:49pm. The Peri said he and others in the practice actually prefer to just deliver breech instead of trying to turn the baby around, causing possibly prolapsed cord and thus a c-section is needed.

 

Well, I'll be the voice of dissent here. Or at least another perspective to think about.

I'm a twin. My mom's doctor was very confident in his ability to perform a breech extraction of baby B (my brother). I was born vaginally, very easily, no problems with my delivery whatsoever.

38 minutes later, they did an emergency c section to get my brother out. He and my mother both almost died--while the doctor was reaching up to pull out my brother, his cord prolapsed and my mom also started hemorraging. The section was done so quickly that her scar (vertical) is about 8 inches long and jagged. Many many years later (he was her doctor for another 16 years after our birth), her doctor confessed to her that my brother's failed extraction was the scariest moment of his entire career.

When I found out I was expecting twins, I had my midwife write down in my chart that if either baby was breech, we would do a c-section. When I got to the hospital, I told my midwife again "if something happens and it seems I won't be able to deliver both babies vaginally, do a c-section."

 

My babies presented the same way, too. My docotor was not at all comfortable delivering vaginally because baby b was bigger. I had high hopes of delivering vaginally so kept pressing the issue and he said the decision was up to me. I would have done it vaginally if he seemed more comfortable but ended up doing c-section. At my 36th week I said to myself if I make it to next week I will do c-section otherwise I will do vaginal. I made it to 37 and 3 days and figured it was a sign to do a c section. Recovering from it wasn't too bad- it took about 2 weeks to feel good again but that first week was not fun with two babies. luckily i had help.
Good luck to you and whatever decision you make!

 

Mine were also presenting the way yours were. I had an awesome Dr who has a lot of experience delivering multiples. I went early, so we didn't have time to discuss delivery before my actual delivery!! But she did tell me that she was going to go in & pull out baby B, no pushing. I was fine with that!! So I pushed with Baby A for 3 hours & she didn't budge, so Baby A was delivered with foreceps & then they reached up and grabbed baby B. They were born 3 minutes apart. Now I did have tearing, but it was all healed by 6 weeks pp.

As a pp said, Baby B had to have a hip ultrasound as well b/c breech babies who are pulled out tend to get their hip dislocated. Thankfully my little girl was totally fine, but if she had a hip dislocated, she would have had to wear a brace that keeps her legs in the "froggy position".

 

QUOTE(isis @ Aug 13 2008, 12:46 AM) [snapback]927557[/snapback]
Mine presented the same as yours baby a was vertex and baby b (which was bigger) was breach. We also had the choice but the dr recommended trying a vag birth. I was induced at 37wks5days, and was in active labour for about 19hrs before deciding to switch to c section. I tried vag birth and it didn't work out, ended up with c section. I was most worried about having both births to recover from (vag and csection), but baby A just would not cooperate to do a vag birth. I still had the choice after 19hrs of labour to keep trying, but honestly I was literally exhausted and was happy to have the csection to have it over with.
There are many of us on here that have had csections, and we all survived the recovery! Good luck with your decision


Almost my story exactly (except I "only" had 16 hours of labor before the c-section, LOL!).

I would give it a try if I were you. It was worth it to me to try, even if things didn't turn out the way I'd like. Many times, I've been told, if the second baby is breech, he or she will turn as the first baby leaves and makes room.

Someone told me to remember that labor only lasts a day (at least for most of us!), that it's a small amount of time (even though it may not feel like it) in the long scheme of things. I really tried to focus on that when I worried about labor beforehand. Just pushed myself to envision the two wee babies after the work was done.

 

I had a similar sitution and I chose a vaginal delivery. I delivered A vaginally with no problem, then had to have a C-section with B. I have never regretted my decision. I would do the exact same thing again. Turned out B had a true knot that could have been a big problem with a vaginally delivery. So, I am actual thankful for my C-section.

 

Thank you all for your replies! Hearing all the positive stories is so reassuring. Before I was completely on the fence, now I do think vaginally is the way to go. Hopefully it won't be for a few more weeks!! I will keep you posted.

 

I was in the same position also. Whilst in labour the doctor also advised she hadnt had to do an emergency C in 20 years.
Twin 1 came out no problem and was it was magical. The doctor then tried to turn twin 2 however we had drama along the same lines as LadyBenz's mom, cord prolapse which resulted in a dramatic and terrifying emergency C section and we are lucky to have baby 2.
Terrifying as it was, I would still want to have a natural birth as cant describe how amazing it was and am now traumatised at the thought of C sections. Im sure though a planned one is without stress!
You cant see the future so it may come down to whatever sits comfortably with you - good luck and make sure to let us know what happens!!!

 

We were planning a breech extraction because we were in exactly the same presentation as you (vertex A, breech B, A bigger). I ended up being induced early for various reasons and didn't progress so we had to go with a c-section. Having now done both a c-section and an extremely long VBAC, I would do a breech extraction in a second over c-section. In the situation you are in, it's not exactly dangerous while a c-section can easily end up with complications. If your doctor would prefer it over a c-section, I would say that is a good indication about the safety because doctors often will go with the procedure that has less chance of risk because of fear of liability. They aren't risk takers. Good luck with your decision!