vaginal birth with MO/DI twins

I know many of the BTDT moms visit over here.. I am having mono/di twins.. my MW and OB plan to do a vaginal birth as long as baby A is head down.. they will deliver baby B breech.. but.. it seems most people are told that mono/di twins should not be delivered vaginally.. so I would love some success stories for mo/di twins being born vaginally.. if you have one..

 

No experience as yet.... but we are all systems go for a vaginal birth - I have mo/di girls on board and can't wait to deliver them naturally.... we are lucky Baby A is head down and Baby B keeps changing her mind - My Midwives and Obstetrician haven't even entertained the idea of not having a vaginal birth.

Good luck - I am sure there are some lovely ladies who will share their story with you... and when I finally do birth - will share my story with you.

 

I had di/di but the placentas were fused so they were functioning somewhat as one. Both babies were head down at the time of delivery and the delivery itself went well. I did have pretty severe hemorrhaging post birth but I'm not sure if that was related to the vaginal delivery or if it was just an unrelated complication.

 

I'm sure you'll hear from people who did both but here is what my dd was told by both her ob AND peri: with mo/di twins the risk of TTTS exists right up until the babies are delivered and that it was in the best interest of the babies to do a c/s.
She had healthy baby boys born via c/s at 36w 1d.

 

Hey Mel,

I have tried to get some idea from the TTTS Foundation board what the parents over there think. Here's a link to a thread that also includes some research links: http://p198.ezboard.com/ftheofficialtwinto...icID=1949.topic

You might also check the Twin Wiki stuff here to read what parents here at Twinstuff said about mono/dis and TTTS and delivery procedure (how and when).

Also, next time I e-mail Dr. DeLia (the TTTS laser surgery pioneer doctor) I'll ask his opinion on how that decision should be made.

I'm interested in this subject too as you well know since my doc has pretty much said I'll be having a section around 34 weeks. . . I've always been more comfy with a natural, vaginal birth.

 

I had a C/S with my Mo/Di girls ... BUT my Maternal Fetal Specialist said that if both babies were vertex (head down) then she would absolutely do a vaginal birth, if A was head down and the same size or bigger than B and B was not vertex then we could try breech extraction (or sometimes the baby flips on her own once A is out), but if both were breech or B was bigger than A (even if A is vertex) then you should absolutely have a C/S. So, I think it is very possible, depending on your situation ... which you won't really know until the big day They can always change and move positions!

I ended up with a C/S b/c I had pre-e ... not b/c of the position ... but A was vertex and B was transverse ... and my MFS said that she is glad we did a C/S b/c she had a little trouble getting B out and she doesn't think a vaginal birth would have been successful for both. I did have a friend with vag for A and C/S for B and she said it really wasn't ALL that bad!

 

TY everyone. I plan to read up more on this..

Emily.. I hadn't checked that board as my girls have no sign of TTTS at all yet.. but I enjoyed reading and will be reading the articles tomorrow.. I bookmarked them. Thankyou. I guess I just want to understand all the reasoning behind having mo/di twins delivered c section even with no TTTS signs...

 

Delivering mono/di twins by c-section due to TTTS concerns has just really come up in the last 2 years or so. A few doctors are saying that c-section is the safest route while other doctors say vaginal. I'm not sure there's any research to support either position.

We were planning to deliver my vertex/breech girls vaginally. Unfortunately, I was induced early and my body didn't progress at all before we came down with more complications and we had to do a c-section. My girls were diagnosed with TTTS at 19 weeks and a vaginal birth was always an option for us. I was at a very highly ranked children's teaching hospital (Stanford University's Lucille Packard Children's) with the top peri as my main doc and her and the other peris were all fine with a vaginal birth for me.

I am a big vaginal birth advocate but, personally, I don't think I'd do a vaginal birth with vertex/breech babies unless Baby B was smaller than Baby A though.

 

I have to admit I was kind of scared to have a vaginal birth with my Mo/Di girls, but we did it! I had lost a set of ID twins to TTTS previously, so we very much erred on the cautious side. I spoke with Dr. DeLia over the phone on several occasions as I would update him on my pregnancy and get his opinion on different things. I was scared about acute TTTS happening at the end, but Dr. DeLia still thought it best to try to deliver vaginally since we had had no signs of TTTS. I'm very much about doing things the "natural" way, but even I kept questioning if we were doing the right thing. My girls were both vertex towards the very end, but if baby B had stayed breech, my doctors still advised trying for a vaginal birth (and Baby B was the bigger one). As Baby A was crowning I was wheeled into the OR and they immediately got things set up for using the Ultrasound to monitor Baby B. Baby A took only a couple pushes and she came out. The doctor could see my concern and he talked me through everything...because I wanted to make sure Baby B was doing okay, etc. They were monitoring her the whole time on the ultrasound machine and she didn't flip. Once her head was in the birth canal one of the doctors held her head there so she wouldn't get "sucked" back up. They were born 5 minutes apart.

With my other deliveries I didn't have an epidural and didn't want one, but the doctors strongly encouraged me to have one this time. For one thing, it helped me relax and be better able to pay attention to what was going on. Also, if there had been an emergency, they could have gotten Baby B (or A) out quickly.
Hope this helps!


Edit: Feel free to PM me with any further questions!

 

I had an amazing team of of about 8 doctors at the hospital I go too. All but two said that they would deliver my mono/di twins naturally even if Baby B was breech. 5 weeks ago that is what happened. I labored for almost 24 hours. We didn't want to push things since I was only 32 weeks and every day counts at that point. After I went into active pushing ... Rory came in 45 mins. He stayed vertex my entire pregnancy. One minute later, sliding out feet first came Jonas.
After the delivery we found out that although there was no hint of it in any of my ultrasounds the boys did have TTTS that would have gotta worse if my pregnancy had progressed. Rory didn't get enough blood and Jonas got to much. They are currently in the NICU but hopefully will be coming home within the next week or so.

evie

 

I had Mono-Di boys a little over 1 yr ago. We weren't "sure" they were mono but from the first us we had a strong feeling they were. My midwife was all for trying vaginal birth. I was highly monitored during labor and had to give birth in the OR. I had an epidural and the OB was in the room (as was everyone else in the state - so it seemed!). All went pretty well. Baby A (our JoJo) was head down and ready to roll. I had to work harder than expected to get him out. Hard to do pushing flat out on the OR table. He was starting to sound some alarms and the midwife did a quick episiotomy and out he came. 12 minutes later out came baby B (out little Thomas). He was as red as a beet. I think we had 12 minutes of TTTS! Everyone involoved assured us that his body would deal with the overload and he would return to normal within a few months (as far as color). Nothing else was out of the ordinary during the L&D and now I have two healthy happy twin boys.

Hope this helps. I tried hard not to worry about the whole TTTS throughout my pregnancy. I read up a bit and the boys measured very similarly up entil the last check-up. Even then no one was alarmed at the slight change at that point.

I'm very happy we were able to deliver vaginally. It was quite an experience!
All my best,
Merijo

 

Mel,

I delivered my mono/di girls via C-section but planned for a vaginal delivery all along. Every doctor I saw was comfortable with vaginal birth as long as Baby A was head down. Unfortunately, she stayed breech and her sister was transverse (side ways). I'm sure it depends on the hospital and the doctor, but there are a lot of them out there who are very comfortable with vaginal births for mono/di twins.

Good luck!
Trish

 

QUOTE(Merijo @ Apr 18 2008, 12:38 AM) [snapback]726896[/snapback]
12 minutes later out came baby B (out little Thomas). He was as red as a beet. I think we had 12 minutes of TTTS! Everyone involoved assured us that his body would deal with the overload and he would return to normal within a few months (as far as color).


Our girls were 5 minutes apart, but baby B was also very red compared to Baby A. I'm just wondering for others who DID deliver vaginally, did this happen with yours as well? I'm very curious about this, because I do wonder if some slight TTTS occured once's Baby A's cord was cut...

Both my girls were healthy except for a little jaundice and one had some slight blood sugar issues. The redder one gradually got lighter skin over a couple of months.

 

I've done it. My girls were mono/di with TTTS. I was very closely monitored and I was an inpatient for 4 weeks so I could be treated for the TTTS (multiple fluid amniotic drains and continuous fetal monitoring). My water broke at 35 weeks. Baby A was head down and they knew they were close in size because of the TTTS. I delivered in the OR and my babies were watched the whole time by ultrasound. Baby A came out no problem but B's heart rate dropped because their cords were entertwined. They told me if I didn't get her out in the next push she would be born crash C section. I got her out and even though she was initally blue, she responded well to stimulation and bagging and only spent 8 hours in the NICU. She quickly went from blue to beet red because of the TTTS but that went away afer a month or so. Baby A didn't need the NICU at all. Yes, we had some tense moments but I trusted my OBs and peris 100% and I still believe they did what was best. Between God and good doctors, my babies are here and healthy. Email me anytime and best of luck!

 

I delivered my boys vaginally almost 6 yrs ago. There was suspected TTTS in my last trimester because of fluid issues, but I don't believe we truly had it. Twin A was head down and Twin B transverse and was turned to be delivered head first. They were 17 mins apart. Shortly after birth we noticed that twin A was redder than twin B-acute TTTS?. They had some NICU time to learn how to coordinate suck, swallow and breath. The color discordance disappeared after a few months.

 

QUOTE(twins make 9 @ Apr 15 2008, 05:36 PM) [snapback]723228[/snapback]
I know many of the BTDT moms visit over here.. I am having mono/di twins.. my MW and OB plan to do a vaginal birth as long as baby A is head down.. they will deliver baby B breech.. but.. it seems most people are told that mono/di twins should not be delivered vaginally.. so I would love some success stories for mo/di twins being born vaginally.. if you have one..



I have mono/di twins, and the only people who keep mentioning a C section are the folks I work with! Baby A is down, and Baby B flips between transverse and breech all the time. We're planning a vaginal delivery, with delivering Baby B as a breech extraction if necessary.

 

My di/mo twins were born almost 6 years ago, naturally... No c-section, no epidural... They had TTTS, but not serious enough to intervene... My docs never suggested c-sec, unless one was breech... But they were both born head first, and did fine... They were 19 minutes apart, but did show the typical signs of TTTS with size discordance (7-6 and 5-15) and one was beet red and the other ghostly white... The latter one was on iron supplements for the first few months, but no lasting effects... They are both healthy and fine now...