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Caesarean or vaginal for twins? Deciding appointment tomorrow!

(19 Posts)
2015THL Sun 04-Jan-15 19:11:19

Hi

First time poster and I have had a good look to see if there's been a similar post but apologies if I'm repeating previous question!

I am almost 41 and 34 weeks pregnant with much prayed for and desperately planned for, IVF twins. They will be our first-we still can't believe our luck.

At my 32 week scan, both babies were head down but I had geared myself up for an elective c-section as they'd been transverse/breech for a while. I'm petrified that something will happen to the 2nd twin or that I'll deliver one vaginally and one by c-section. Also, the consultant shared stats (after I'd requested them) at the 32 week scan- 23 of 82 twin deliveries last year were planned c-section, 28 of 82 need an emergency one! 4 unfortunate ladies needed a c-section after delivering the first. Only 11 women delivered vaginally without forceps or suction. I would obviously prefer a planned rather than emergency c-section.

The consultant recommended vaginal but said I'd hold up a labour if I was this anxious. She said it was up to me, she doesn't want to force me for me then to have to have an emergency section anyway! But the midwife!! I know from a midwife friend that vaginal deliveries and breastfeeding have to be promoted if they are an option but she made me feel like I was being unreasonable to even consider a section.

We're seeing her tomorrow morning. Sorry about the massive post but can anybody share some honest twin birth experiences-good and bad to help me decide? My husband won't give an opinion other than 'there are pros and cons for both' but I know that!

Thanks very much.

slightlyinsane Sun 04-Jan-15 21:07:10

Hi, congrats on your twins, they are amazing. Before I share my birth story can I ask what type of twins you are having?

HalfPintPortia Sun 04-Jan-15 21:11:32

I would opt for a section. You will know the time and the place - very calming. MW will always promote vaginal birth - and try to make you feel guilty if you decide on a section.

My DSis had twins vaginally and regretted it. She felt that she was bullied into it and wished she had a different experience. Her first DS was born with no issues but the consultant didn't want to wait for her to give birth to her second DS and so forceps were used. DSis was "threatened" with a e-section if she didn't consent to forceps. She has had several operations to correct the damage. DSis was also unhappy with the amount of monitoring that she had during the birth. She felt that she was chained to the bed and at the mercy of the HCP. She suffered from severe PND and feels that she lost the first few months of her babies lives.

I hope this is not too negative - good luck with your birth.

MuffinMcLay23 Sun 04-Jan-15 21:47:31

I am assuming that they will induce prior to 40 weeks in which case I'd definitely have a section rather than induction.
Like a previous poster my sister had vaginal delivery of twins which was traumatic and damaging and she wished she had gone for a section. She still suffers from the physical after effects.
I've been induced (ended in crash section after three days) and I'd never agree to be induced again.
the section itself was fine - I recovered quickly, much quicker than lots of people do after a vaginal delivery. I also felt that the section was safe and controlled - frankly the three days of induction leading up to it were neither of those things.

slightlyinsane Mon 05-Jan-15 00:53:07

I have 7 month old id girls. I plodded through the pregnancy thinking I'd let the babies position decide how I had them. From around 16 wks they were head down and didn't change, so the consultant assumed that I would be having them naturally as I'd had 3 previous straight forward labours. I just went along with it thinking it would be fine if the consultant didn't suggest otherwise.
One evening my waters went and we made our way in to hospital, they did some checks and everything was fine, I wasn't feeling any contractions but they decided to monitor the babies for awhile. Turns out I was contracting and was moved up to labour ward so they could keep an eye on things.
I had a not so gentle consultant prodding and poking for sometime and a very lengthy uncomfortable scan while she checked both babies positions.
I had decided no matter what I was having an epidural just incase I ended up in theatre, I wanted to be awake for everything.
I was hooked up to a monitor the entire time and after a brief period of them not being able to find twin 1s heartbeat well enough over her sister they put a scalp monitor on her. My god that was unpleasant, the 3 times they had to do it. I was fully expecting to be bed bound hooked up so I'd made my peace with it before I went in.
6 hrs after arriving my contractions were painful enough and regular enough to have the epi put in, it took 2 attempts.
Once that was in place the consultant reappeared and examined me, really did not like her at this point. She discovered that twin 1 had her arm down by the side of her head, superman style, and when I was ready to push she had to be called so she could try and push it back up so she didn't get stuck. Because of the epi and the fact I was only 7cm she decided they would leave me an hr then check me again, she was off for a break. The mw wasn't overly impressed with her either.
I did chuckle to myself as she obviously hadn't looked at any of my notes, once going I progress very quickly. 20 minutes later and twin 1s head was out by the time the consultant arrived.
As twin 1 was making her entrance I had a mw hold twin 2 in place so she didn't change position, 5 minutes later I delivered twin 2.
On paper I had the text book delivery of twins couldn't of gone any better.
In reality we are beyond lucky that our girls survived the labour, thank god from my waters going to them arriving was only 8 hrs. Very flipping lucky they arrived at 36 wks by themselves.
My girls were born with undiagnosed twin to twin transfusion syndrome. This only occurs in id twins.
I'm not sure how long they'd been suffering from it, weeks, but the hospital missed it. I should have had a section and not put my girls lives in further danger from a natural delivery. I've been left angry, upset and feel immense guilt at what my girls went through.
I'm really sorry this is long but there's no short way to say, yes it's possible to have a straightforward twin labour but if you're having id twins you have got to have a section around 36 wks. The type of twin to twin my girls had is not often monitored for and classed as acute ttts which can occur anytime up to and during labour.
I think even after having a set of twins if it were to happen again (never going to happen) no matter what type of twins they were I would have a section, the what ifs are too many for me to make peace with another natural delivery. A planned section gives you the best of everything and your not hoping that the staff on at the time have enough experience to deliver twins.

slightlyinsane Mon 05-Jan-15 00:53:55

Bugger after all of that I forgot to say good luck xx

DarceyBustle Mon 05-Jan-15 01:11:19

Good luck and Congratulations!

I had a elective at 37+1 (twin 1 was a transverse breech). It was very civilized and I was able to breastfeed in recovery.

My friend (also DCDA) had a vaginal delivery. Twin 2 was a footling breech and was "pulled out like a calf" but with no ill effects to either!

I don't think that suction/forceps are necessarily a disaster (had suction for DD1) and another way of reading statistics is that 59 had a trial of labour and about have had an emcs.
There is a much larger ESPRiT study that has a section on this topic. Will try to find a link

SoonToBeSix Mon 05-Jan-15 01:15:41

My Id twins had undiagnosed ttts ( taps) which was quite serious.
I had a natural birth,spontaneous labour at 34 weeks. The labour was no harder than my singletons. I was very relieved I didn't have a section there was no increased risk to my babies . I was glad I don't have the recovery of a section as well as visiting/ caring for my twins in NICU.
Hope your birth goes well.

DowntheTown Mon 05-Jan-15 01:19:06

I was all up for natural birth with my twins as I'd had a fairly smooth time with ds. Though was a little concerned about the scenario of labouring for ages with twin1, then emergency CS for twin 2.

My consultant said approx half of twin births at our hospital were CS and half natural. He gently said that considering I was past 40, and had gestational diabetes, maybe CS would be best. I was happy to take his advice.

Planned CS at 36 weeks was fab! I'd always thought natural best, and possibly is, but the CS was v calm, quite fun, and so smooth and quick. Twins absolutely fine despite 4 weeks early.

Having done both, both have their advantages, and both can be right for different reasons. For me and my twins, CS definitely a great choice. I was also lucky that my recovery was very swift, little pain, and driving again quickly.

Congrats on your twins and best of luck with delivery whatever you choose.

DarceyBustle Mon 05-Jan-15 01:30:06

ESPRiT

2015THL Mon 05-Jan-15 07:47:47

Thanks so much everyone, I appreciate your replies and your honesty! Thanks for all the good wishes too!

MuffinMcLay23 thanks for sharing your story- the induction aspect was glossed over during discussions and although I know these can go without a hitch, some friends and my sister have have traumatic experiences.

Slightlyinsane, they're DCDA twins, so separate placentas and fluid- I think the worry of ttts would finish me off! I'm glad all was well eventually with all of your deliveries and your babies were safely delivered. DowntheTown, your consultant sounds great-funnily enough my GP has assumed from day 1 that I'd have a section.

Midwife at 10am...

Thanks again.

2015THL Mon 05-Jan-15 07:56:14

DarceyBustle, thanks for the link- interesting reading.

MrsHoolie Mon 05-Jan-15 21:48:49

How did the appointment go?
I have had two single babies,both emergency c section.
If I was having twins and they were my first babies I'd go for an elective section.

mooboos Wed 07-Jan-15 11:18:34

Hi there, congratulations on your twins! My friend has identical twin girls (they are 10 now) and she had one vaginally but the second one turned and she ended up having an emergency section under general. She was extremely sore afterwards as you can imagine! She has always said that she would choose CS if she could do it all over again. I hope I haven't scared you and good luck with whatever you choose smile

2015THL Thu 08-Jan-15 21:16:01

Oops- sorry, I did type a reply on Monday but I must've forgotten to send!
Thanks for asking MrsHoolie- I was so nervous telling the midwife (not really like me at all) but she was fine! Then we saw a different registrar afterwards who made it clear she thought I was mad to go for ELCS. I stuck to my guns though and am booked in for the last week of Jan!

As soon as we walked out of there I felt such a huge amount of relief.

No mooboos, you didn't scare me, thank you for responding and for your good wishes! Your post just confirmed my choice for me. Your poor friend; a complete nightmare! Glad her daughters were healthy!

MuffinMcLay23 Thu 08-Jan-15 22:14:02

I think that's a good decision. I hope it goes well.

Pandora37 Fri 09-Jan-15 00:05:58

I work in midwifery and I think you've made the right decision. You would be strongly encouraged to have early induction at about 38 weeks. Of course, you are entitled to refuse but unfortunately with twins your labour would very medically managed and you would likely give birth in theatre, or nearby, regardless of whether you were doing it naturally or with forceps. If it was a second pregnancy I'd say go vaginal but with a first I'd say the chances of you avoiding intervention, especially with induction, is probably quite low. Having said that, I have met a first time mum who had both twins vaginally, and had a straightforward labour. They were a bit prem though so of course they went to SCBU and they were quite little which may have helped. I will be completely honest and say looking after first mums in labour with twins makes me feel very, very twitchy.

Having seen c-sections I wouldn't normally choose to have one but if I was a first time mum with twins I'd make an exception. I'm glad you've made a decision you feel happy with and stick to your guns!

nocoolnamesleft Sat 10-Jan-15 23:25:02

Given your age (sorry!) and a twin pregnancy...I'd have pushed for the same. But then, my job's looking after the babies, not the mother...

MrsHoolie Sun 11-Jan-15 00:01:15

Glad you are feeling happier now you're all booked in. smile

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