Twins - vaginal birth or vbac - give me your experiences....

[tiggersreturn]

I have type 1 diabetes and with ds I ended up with an EMCS after a failed induction (8cm failure to progress, ds OP).

Since the start of this pg I have been told that there is no way that I have any option other than an ELCS (when I thought it was just 1 I was quite keen to try and vbac)until my last 2 appointments in which 2 obs have said if twin1 is head down at the right time then they don't see why not. But that we'll discuss in more detail at about 32 weeks (I'm nearly 26 weeks now)

Perversely now it looks like it may be a possibility I'm beginning to get cold feet. All I really want at the end of the day is 2 healthy babies and very much secondly a not too damaged/traumatised mother who is capable of looking after a 4 year old and 2 babies.

My thoughts at the moment are that if my body does decide to start labour of its own accord (I have a cut-off date of 37 weeks owing to diabetes) then I would be prepared to try providing hospital agrees to:

1. Confirm that no. 1 is definitely head down
   
2. Allow me mobile monitoring and not strap me to the bed
   
3. Not force any drips on me until strictly necessary (I have to have insulin/glucose one past a certain point)
   
4. Explain exactly what they'll do if twin2 turns the wrong way at any point during the process.
   

I'd be grateful to hear other people's experiences of vaginal birth or vbac with twins.

How did it end up?
What did you think made it work?
What made it go wrong?
What would you do if you were doing it again?

[Sapphirefling]

Are your twins identical ?

[tiggersreturn]

DCDA

[kingfix]

I had a vb for my twins, but have not had a CS before.

I chose to have an epidural because I was concerned that they might need to intervene with the second twin and I wanted to minimise any drama if so.

So I did have a lot of monitoring and a drip throughout BUT it was still the best labour of the 3 I've had.

In the end, the second twin did turn from head down to breech but with a bit of manipulation was born vaginally too.

I was glad I followed my midwife's advice to get the epidural in early as it was uncomfortable getting the line in and hard to sit still through contractions. I was surprised I could still feel to push and felt more in control, rather than less.

Good luck with whatever you decide.

[3ismylot]

I had a vaginal birth with my twins following a vaginal birth with a singleton so dont have experience of a vbac Im afraid.
I was induced at 37 weeks (my choice) and had a very quick labour (47mins)Twin 1 was born head first and they tried to keep twin 2 head down too but he had other ideas lol, they said as he was 2nd they would let me deliver him breech and he actually came out feet first and was absolutely fine
Go with your instinct and if you would feel better with an elcs then have one x

[tiggersreturn]

Thanks for the replies. I guess I'll just talk through the options with the hospital when we get closer to the date and see what they're offering in terms of management and whether it sounds like it could conceivably work or if it's certain to set me up for an EMCS in which case I may as well opt for an ELCS. I can't be induced because of prior EMCS and I'm not sure what the view is on manipulation given that ECV is out with prior cs.

[thingamajig]

I had my identical twins vaginally very quickly and easily. They came at 35 weeks, but the whole labour only lasted 2 hours. I did not have any epidural or other pain killers or feel that I needed them. DT1 was head down, DT2 transverse, they both came out head first.
I wanted to have as intervention free a birth as possible but I never managed to get any straight answers about their twin birth policy. So I was glad that I only made it to the hospital with twenty minutes to spare and they didn't have time to mess me about.

[tiggersreturn]

thingamajig - were your dts your nos. 1 & 2 or had you given birth before?

[accessorizequeen]

Hello, my dts were born VBAC. I had ECS with ds1 as he didn't engage, vbac with ds2 with gas and air. They told me exactly same things as you but did offer to induce me 3 times once I got to 37 weeks. I refused as I was induced with ds1 and hated it. Got to 39.4 weeks, both head down, waters broke, labour started within the hour and I had epidural on advice of my consultant as soon as I got to hospital. Which I was begging for, having 2 was freaking me out! Within an another hour dt1 born. Dt2 got stuck, they manipulated her to get her out but was close to crash section if they couldn't. I was monitored from the beginning same as with 1st vbac but I managed fine. Best of the 3 births, and v v v pleased I went for it!

[thingamajig]

Twins are nos 2 and 3; I had a home birth with my first daughter, also with no pain relief (and she was back to back!).

[PeelingmyselfofftheCeiling]

Oh, so glad someone started this thread.

Lots of questions here:
How did you manage skin to skin (VB or CS) - did you do some between deliveries, or wait until both out?
That whole 'getting the 2nd baby to turn'... Are we talking external, forceps, or James Herriott-style hand up there? Presume that is unbearable without epidural?
Anyone have an epidural sited but not hooked up - am pondering it as a compromise?
Anyone labour in water in the early stages?
Where did you deliver - normal delivery room/theatre? Was there a cast of thousands? Did you get to bond with a midwife or was it very much 'consultant delivering YOUR babies' style?

Trying to get my head around this!

[accessorizequeen]

hello peeling! Shall try and answer, remember these same qu's going through my head.

How did you manage skin to skin (VB or CS) - did you do some between deliveries, or wait until both out? >>There was a lull between dt1 and dt2 so had some skin to skin. Actually forgot I had to have another baby doh. Twas really really lovely feeding them both at the end.

That whole 'getting the 2nd baby to turn'... Are we talking external, forceps, or James Herriott-style hand up there? Presume that is unbearable without epidural? >> A very lovely registrar hand up there in my case moving dd's shoulder out of the way. I had an epidural, don't think it was more painful than a sweep tho tbh.

Anyone have an epidural sited but not hooked up - am pondering it as a compromise? >> I asked for this, I had this option with previous VBAC and it got them off my back, everyone happy. In the end when my waters broke I wanted one immediately.

Where did you deliver - normal delivery room/theatre? Was there a cast of thousands? Did you get to bond with a midwife or was it very much 'consultant delivering YOUR babies' style? >> I was v.concerned about this. At the end with 2nd baby getting stuck I don't actually know how many people but 8 maybe? Didn't give a jot at that point. Early on just one midwife, then another stepped in, it was v.quick so not a lot of time to bond. I had met the registrar several times before with hospital visits so felt comfortable with her. It was a normal delivery room.

HTH

[tiggersreturn]

Hospital have now supposedly changed policy and want to force me into a vbac on cost grounds. I'm not best pleased about this. Also I have a feeling that stupid obs registrar (who thought my due date was 2 months later than it was) also got a go ahead from the consultant by telling him that I have GD instead of type 1 diabetes which makes a substantial difference to their policies. So now I have to make sure to see the consultant myself next time and try and get to the bottom of this. Thank you for all your responses and sharing your experiences. While I'm willing to have an in-depth conversation with the hospital on exactly how it would work if dt1 is head down and labour starts spontaneously the fact that nobody here has managed a vbac directly after an emcs for ftp with twins is not heartening.

[tiggersreturn]

Hi again. I have now got an end date booked which will be an ELCS (consultant then wrote ve and arm if favourable in notes but I'm refusing that should they try) but if they come of their own accord before then I'm very prepared to give it a go.

So now I just have to work out strategy of how to make it happen best.

Did any of you have hospitals insisting on cfm throughout and if so can they do that accurately for 2 heartbeats or do I have an argument that 2 people doing dopplers are better? Obviously I don't want to risk anything with the babies but equally I don't want to be strapped to a bed and stuck in the same position as before which really didn't help.

[DrownedGirl]

How did you manage skin to skin (VB or CS) - Lots between deliveries 93h gap) then passed twin 1 to DP to hold skin to skin
That whole 'getting the 2nd baby to turn'... Hand up there.. I had just gas and air for that. No worse than any other pat of labour.
Anyone have an epidural sited but not hooked up - having had a (failed) epidural for latest baby, I can see some disadvantages... you prob still risk the headaches, for eg and it would be hard to move about with it all hanging out. If you are consideirng this, best to discuss it though in detail
Anyone labour in water in the early stages? Yes
Where did you deliver - normal delivery room/theatre? Was there a cast of thousands? Did you get to bond with a midwife or was it very much 'consultant delivering YOUR babies' style?

Normal room for twin 1, just midwife there. We had declined paeds so noone else was there to fiddle with the baby (unless there was a problem)

Twin II was turned manually then went into theatre to have ARom and drip to keep her down... was 3am so just theatre asst, 3 midwives, SHO, DP

I spent a lot of time in advance discussing plans and managed to get pretty much what I wanted

However latest singleton baby was much harder.. due to my BP shooting up... long failed induction, failed epidural.... so unfortunately you have to compromise, but I felt better knowing each choice was only after other avenues exhausted, not just because it was 'policy'

Esp if you end up with complications (I had bladder problems after the failed epi) it's important to know that there had been informed consent for the interventions...

[DrownedGirl]

3h gap, not 93!!

[DrownedGirl]

I declined CFM

Hospital not hugely happy. I did end up on monitor continuously though from about 1h before twin II born - as they turned her, broke my waters, delivered while on synto drip

But no need for twin I, used pool, no pain relief, just a perfectly normal birth!!

[DrownedGirl]

They like CFM not because it's easier to get two HB but because they think it gives more info about wellbeing of twin 2

They REALLY like to use a synto drip to hurry twin 2 out before they get into a bad position

[tiggersreturn]

Thanks for all that info. I'm not sure about the synto. Particularly as I've already had a csec so I'll need to discuss that with them. Frankly if it's going to be more likely than not that it'll end in another EMCS I'd rather go for an ELCS.

[PeelingmyselfofftheCeiling]

Thanks all. DG, what's ARom?

Tigger I kind of feel the same - like I could have an almighty fight on my hand trying to have some kind of say in the labour I want, and then risk having a VB AND a CS, so I nice calm ELCS sounds preferable, but recovery time with twins... no idea on the answer!

[tiggersreturn]

artificial rupture of membranes aka breaking your waters.

[DrownedGirl]

One factor re CS is whether you want any more children (as there is a small risk)

[tiggersreturn]

to complete the thread my waters went at 33+4 and both dts came by vbac although hardly "natural " birth. will do full story at some future point as currently in a scbu where we got re-admitted via dt1 was lethargic .

[accessorizequeen]

Congratulations on your new arrivals, Tigger. I hope all goes well in scbu.

[LalaDipsey]

Hiya
Very interesting thread as I am in similar position... 26 weeks pg with non id twins. DD born CS due to placenta praevia. At my first appt my consultant said there was NO WAY he would risk a VBAC as if he had to manipulate 2nd twin around there was risk of ripping my scar. At last appt (both twins head down in scan) he said .. mmm maybe vbac then.. pressure to decrease c-section numbers!!
I don't understand how something could have been NO WAY and is now possible???!!! He did eventually say let's wait and see nearer the time but it is worrying me know... I was fine with an ELCS and am now confused and a little worried about vbac for twins.
I also think age comes into it - those I know that have vbac with single pg who are in late 30's have many more probs than those spring chicken in their 20's!! I will be 37 when the twingles come and think my body will not be as good as it would have been 10 years ago!
Lala

[dreamfeeder]

*laladipsey8, I know what you mean. i haven't been able to get the thought of delivery, and wanting 2 healthy babies (and me!) at the end of it out of my head. My DH wants me to have an ELCS as I had a tough time and third degree tear last time. The midwife says this will definitely be an option given my birth last time but I feel like I'm wussing out of a vaginal birth, maybe through fear of the pain,m re-tearing for me with twin 1 then having a section for twin 2 (as I was in theatre within 15 min of delivering DD due to haemorraghing/tear the first time), plus its got to be a better recovery. Confused! And i'm a mere 13+3. (loads of time to worry think about it)