VBAC with twins?

Is anybody's doctor encouraging a VBAC with twins? Mine says only if EVERYTHING lines up perfectly -- both head down, right size, spontaneous labor (no induction) -- and he would raise no objections to just planning on a c-section. In addition to my previous c-section (where they also removed a fibroid from the exterior of the uterus), I have also had laproscopic surgery to remove endometriosis and an ovarian cyst -- do you think that makes a stronger case to just go for the c-section?

 

I can't personally vouch for it since I"ve never had a c/s, but have you seen this video??? It's fantastic! If it is important to you, I would definately shop around for a provider that will work with you and your goals. It's never too late to change doctors to get the birth you want. (barring a life/death complication).

http://www.youtube.com/watch?v=7E-wULAaD50

Good Luck!

 

I'm going to break my own personal rule and offer an opinion on your situation, but with the STRONG caveat that this is just what I would do in your situation and I still believe firmly that you should do whatever you and your doctor feel is best for you and your babies. Having said that, with your history, there is no way that I would risk the VBAC. You must have a particularly high risk for uterine rupture. I had a laproscopic myomectomy to remove fibroids last year (no prior c section or anything) and even in that case my doctor would be extremely hesitant to risk a vaginal birth. Your uterus has experienced alot of cutting and trauma - that is a lot of scar tissue, so I would think the risk would be a bit too high (and it sounds like your doc kind of thinks so too but doesnt want to totally rule it out). And while you could always shop around for a doctor that would be more willing to do the VBAC, I'm not convinced that you would have much success given the other factors in your medical history.

Best of luck to you!!

 

My doctor seems to be the go-to guy for multiples in my city -- even the doctor at the level 2 ultrasound spontaneously volunteered that "he's the best". He actually trained in the program run by the guy who wrote the paper that started the whole VBAC movement, so I know he's not biased against it. And he didn't completely rule it out, just gave me the parameters that he would feel comfortable with. He related some interesting history -- turns out that the doctor who wrote the original VBAC paper later went into law and made a fortune suing other doctors for VBACs that went wrong! Can anyone say conflict of interest?

I do trust his judgement and am leaning toward just planning the c-section, but I was curious to hear what advice everyone else was getting.

 

Sounds like you're in really good hands. And I'm not surprised about the doctor who became a lawyer. Hee hee!!

 

The high risk OB gave me the ok to VBAC. In our case it was better to attempt a vaginal delivery vs. a repeat c-section. Though I still have certain "demands" to meet. Baby A has to be head down(B doesnt matter), cant have more than a 10% weight difference and labor has to start on its own (will not induce). So I pretty much have the same guidelines as you do but I also asked for my personal percent of rupture based on my history and the fact that it was twins I had a 3% chance for rupture. I asked the same about a c-section and was told risk to the babies were around 7% and risk to me was around 5-6% (this was for a repeat c-section not an emergency one). Those are my personal percents but I healed VERY well with my first c-section. I would ask your Dr. what your chances are for both and go with what is the lower risk to the babies and your health.

 

Hmmm...I'm sure a vbac is possible . I have to say that I personally have no interest in a vbac. Going through hours of painful back labor only to end up with a c-section was so incredibly stressful and such a bad experience - my entire l&d experience is a bad memory. I want this time around to go smoothly, so I will be having a scheduled c.

 

This is by no means anything more than my personal opinion, but there is no way I would do a VBAC with twins (or after my c-section with twins). The talk of my office today is a 31 million dollar verdict last week in a VBAC case. The mom really really wanted a VBAC, signed all the waivers, looked great on the monitors. They induced, and her uterus ruptured. The baby was deprived of oxygen and has severe CP. Everything about her case was apparently textbook - a great situation for a VBAC, and a freak complication. Unfortunately, it's a freak complication that they can't foresee and that there is virtually no wiggle room with. And with twins, you already have enough risk for freak complications.

 

Totally irrelevant, but it's not actually a conflict of interest.

 

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Oh my goodness! I watched this clip and balled my eyes out, my husband came into the room paniced thinking something had happened, it was so beautiful. I so hope I can have a vaginal birth with these two. It's a shame that so many doctors suggest c- sections because they are scared of being sued. My best friends OBGYN is going to retire in 5 years and she was gutted when she found out that he decided not to deliver anymore up until his retirement, for the fear of getting sued. She had a wonderful birth experience with him and her son. But he said this close to him ending his practice it is not worth the risk to keep delivering. At the end of the day, yes I would love to experience another vaginal birth and bring these babies up onto my chest like with my son, but the most important thing is to bring two babies safely into the world. I will accept my midwife and doctors advice since here they are very pro vaginal birth, so if they do suggest a c-section I know that it is really needed and not a convience thing on their part.