Giving birth to identical twins

[Starfish1980]

I am due to have my twin girls in a fortnight, mono-di. I have been told that the hospital will book me in for either induction or c section between 36 and 37 weeks. I have my appointment to set a date this Wednesday. At this stage twin 2 is presenting and head down, the other is breech but has moved around each week! I know the hospital will suggest an induced natural labour if they stay as they are but will recommend an epidural in case they have to turn the breech twin or provide an assisted delivery. If they were both head own they may let me try for induced labour with no epidural. I am wondering whether to ask for an elective c rather than face an induction and assisted delivery, if i have to have an epidural in any event.....v confused.
I would appreciate any voices of experience on this huge decision, just ish i knew which was going to be best!

[Margetts]

When I had my twins both were in the right position, I was induced at 40 weeks and opted too have an epidural. After 15 hours my son who was the second twin went it to distress and I had an emergency c-section. I wasn't that bothered as I had 2 healthy babies and that was all I could hope for.
I was fit and healthy before the delivery, still swimming at 37 weeks and recovered well from the c-section.
I didn't even mind not being able to drive for 6 weeks as it gave me time to bond with the babies and establish a good breast feeding routine.
What ever you choose in my opinion the main thing is a good outcome for the babies.

[Avondale]

Not sure how helpful this will be but can tell you my story.
I was induced at 37.5 weeks with twins and elected for epidural as had had that with my previous birth. Both were presenting head down. I wanted to avoid section if possible as thought I would have enough on my plate in the following weeks without having to recover from operation as well!
Labour was pretty straightforward, although was completely bed bound as had a heart monitor for each twin as well as monitor for the contractions as had been induced. It's very uncomfy but hey, it's labour?!
Twin 1 was born fine but twin 2 spun round in all the new room he now had and was then presenting breech. His heart also slowed right down and they told him they needed to get him out NOW! they pulled the emergency cord and delivery room suddenly filled with loads of staff. I was told I would need emergency section. Obviously I would agree to anything at this stage but asked if I could keep pushing as that was just my natural instinct. I managed to give birth (vaginal breech!) before they got me into operating room. Twin 2 AGPAR score was 4 but after a few minutes, we were all fine and came home 4 days later.
If I could do it again, would I have asked for an elective section? I'm not sure still! I haemorrhaged badly so was pretty unwell afterwards anyway despite not having had a op! But I do still remember the feeling of giving birth which was amazing. And I'm really not the sort of person who was bothered about that. I just wanted them out!
It depends how much help you will have afterwards too and if you have older ones who may need lifting etc. Will you need to drive in the first six weeks etc?
I would just listen to the docs, ask all your questions and keep an open mind.
Aww, I hope it all goes well for you. It's so exciting and just that little bit extra special having twins! Please come back and tell us how you got on xxx

[Starfish1980]

Thank you, it is really useful to hear your experiences. I have been pregnant before but lost them early on, just want to get these little blighters out safe and sound now! I do have my mum close by and my husband can take two weeks off once we are all home. I suppose the docs have done this far more often than i have so will take their advice, be marvellous to have a crystal ball!,

[Jemm16]

I gave birth 10 days ago to non identical twin boys by elective c- section. I was booked in for induction at 37+2 weeks and both boys were head down. I was given propess and then monitored for 24hrs. Initially everything went well and I started to get contractions and within a few hours was 1.5 dilated. They decided to keep the propess in for longer rather than break my waters as I wanted an epidural and would have had to stay in bed. However, the contractions then stopped and I began to swell down below and any examinations were very painful due to twin 1s head being very low. The doctor wouldn't break my waters as it was night time and not enough staff and I had got myself in a state and needed sleep. So 36 hours after the start of the induction I asked for a c- section as I couldn't cope with anyone examining me ( even with gas & air), I was exhausted, couldn't keep any food down and was worried about babies as they took it in turns to have the occasional blip when being monitored. The midwife and doctor were wonderful and supported my decision. I am now recovering with my beautiful boys and am moving around and have been out a few times (with help from my partner & parents). I did have a moment of - I am a failure as I couldn't give birth naturally but in the end the boys are healthy, happy and so am I. I didn't have much of a birth plan as there are so many things that can change and was happy to be directed by the midwife and doctor - however when I did request the c- section they listened and understood. Hope it all gives well for you xx

[Tommychoochoo]

I gave birth to non identical twin boys. One was head down the other one was breech and had also moved around a lot. I went into labour at 34 weeks and it went so fast. By the time I got to the hospital (less than an hour after my waters had gone) I was 7cm. There was no time for an epidural twin 1 was born fine an hour later. Twin 2 turned side on, when they tried to turn him ( by putting a hand up)they could only get his arm and can't turn by the arm, I got rushed for an emergency c section. He got 2 on the agpar score and spent a long time is scbu. I really wish I had planned better and looked at all options, I was really young, it was my first pregnancy and did what the doctors told me to do. I think you should do what you think is best. Although a c section is horrible, my sister chose to have her twins this way and all went to plan.

Good luck and hope all goes well, my dt are now 6 and I love having twins. Be prepared to be stopped every 2 seconds by strangers asking millions of questions from are the identical to was it Ivf.

[twintwo]

Hi I have identical twin boys. They were born by elcs at almost 38 weeks. We made the decision with the consultant about half way through the pregnancy, he was not keen on vaginal birth for identical twins at all and I was worried about the risks to the second baby. We'd had a few problems during the pregnancy and I just wanted their birth to be the safest option. The section itself was fine, very calm and surreal experience. I was up and about the next day, babies were breast feeding and doing well we went home on day 5. I recovered quickly (much quicker than my first sons vaginal birth which left me in pain for months) and was able to enjoy those first few crazy weeks with twins!

[MultipleMama]

I had momo twin boys at 37 weeks, vag birth, no meds. But was booked in for c-section at 39 weeks. Dts2 was breech but was the first one out and didn't require any intervention. Their heart rates were good and decided unless they were stressed or looked to be taking too long they'd hold the c-section.

Fortunately for me both boys came out healthy, safe and screaming and latched on straight away.

My plan was to have a vag birth from the start but have the elcs on stand by if the twins showed any signs if being in danger.

[MultipleMama]

I didn't want c-section unless it was an absolute must as I had 2 other dc and the recovery would be too long not to push a buggy! Sounds a little selfish but if at anytime twins became in danger then of course I'd welcome c-section.

My recovery was quick as I didn't need stitches etc and back doing mum things a week later. Ultimately it depends on you and what you feel is best for all 3 of you.

[toomuchpink]

I was concerned about having an epidural when I gave birth to my twins, as I had my first using gas and air. I asked for a mobile epidural which still allows you to move around on the bed. It was excellent. I was told I could only have this if staffing allowed on the night, which it clearly did. It was the right decision to have an epidural as it took a while for me to give birth to twin two and I was taken to theatre. However, with lots of encouragement I avoided a c-section. From what I have seen of people recovering from c-sections it is much worse than the fatigue of labour and lasts longer, but everyone is different. If I had a choice I would not choose one myself, but I would go for a mobile epidural every time.

[ladythatlunches]

I was told (16 months ago) I couldn't deliver my id twins myself and had to have a c section. Both twins were head down. And I previously have 3otherr dc that were quick easy deliverys

[thingamajig]

I'm surprised you were told that, Lady. I had my ID twins 2 years ago vaginally. They came at 35 weeks, though, and the birth was so quick the doctors didn't have a chance to get involved. This suited me very well, as I wanted things as natural as possible. I had my first at home and felt that going into hospital was a major concession in itself (obviously very advisable with twins).
My dt1 was head down and dt2 was all over the place (or impossible to find) a few days before birth, she must have turned round, and has been following her sister closely ever since. At the time, in my hospital (they all have different opinions) this was fine if you wanted to try a vaginal delivery.

[ladythatlunches]

They told me there was no way I could deliver them myself as there was a huge risk to twin 2.

I hated the c section it was awful.

[butterfliesbelly]

Looking into this a lot and seems like the approach depends a lot on the hospital policy and practitioner's preference. Some of the most accurate data I've found is below but in general I've noticed a lot of scare-mongering mainly because how a person defines risk is so subjective i.e. my idea of a high risk is vastly different to my doctor's who prefers to take no risk whatsoever - which realistically in the case of MCDA twins (our case) or any labour is impossible. Also ask your doctor what the risk of c-section is because they tend not to mention this, also for inductions and epidurals. There is much evidence now to suggest the more interventions you are willing to start with the more likely you are to end up with = cycle of interventions. Obviously its a personal decision and you have to factor in lots of things but I'm a researcher on pregnancy and have spoken to lots of women who prefer not to ask any questions and then find themselves uncomfortable with the outcome. So ask ask ask for the evidence....this is a fairly life-changing experience for mum and baby(ies) so good luck!:

www.rcog.org.uk/files/rcog-corp/uploaded-files/T51ManagementMonochorionicTwinPregnancy2008a.pdf - these are the Royal College of Obstetricians and Gynaecologist's guidelines doctors are advised to work with. Here is a direct quote from page 7: "It is appropriate to aim for vaginal birth of monochorionic twins unless there are accepted, specific clinical indications for caesarian section, such as twin one lying breech or previous caesarian section" and "Given the recognised hazards of caesarian section to the mother, it seems inappropriate to recommend caesarian section routinely for all MCDA twins without proof of benefit. Our search has found no such objective evidence".

Another useful document with accurate info:
www.multiplebirths.org.uk/MC%20Pregnancy%20%20Version%2012%2017%205%2010.pdf

[MerryMarigold]

I had an epidural with my first ds and then an assisted delivery (forceps), dreadful tearing requiring surgery and extremely bad bruising to his head, which I believe has had an impact on his development. (He is now 7)

Twins - I had planned c-section as dd (presenting twin) was breech right up until the last few days when they did offer me a natural birth. Decided to still go with c-section. Was absolutely wonderful. I cannot tell you how amazing it was. I was so sad for my first ds's birth.

I think if you haven't given birth before, I would go for the c-section. If you have had a singleton and it went ok, then there is a high chance that it would be ok this time too.

[MultipleMama]

My boys were MoMo and was booked in for a section at 39 weeks. I qas advised to have a section because they were MoMo and there was a risk that vag birth would pull the cord and placenta if it wasn't long enough and risk the other twin.

T2 was in breech position from 33 weeks onwards. And unfortunately (for the drs) I didn't come into the hospital until I was 6cm dilated and hit 10cm fairly quickly and felt the need to push just after they prepared me for c-section. I gave birth unassisted and with no med.

I was happy to have the natural birth I wanted but because of the risks I would have had the c-section if it meant my twins had the best care and were safer.

Honestly it's a personal choice way up your options. If you have any doubts go with your gut.

[Twicethehugs]

I was induced just before 38 weeks with identical twins (both head down), ended up having CS due to foetal distress. But you don't know what will happen and will never know the alternative course! I think it helped that I went in with the idea that CS was still quite likely and when the decision was made all I cared about was that the babies were ok.

[itchyandscratchy26]

I gave birth to DCDA twins at 36+3 five weeks ago and had an elective section. I strongly wanted a section the whole way through as I feel it's safer. In the end the presenting twin was breech so it was taken out of my hands.
What a civilized way to have a baby (babies) I was up and about in 10 hours, home in 48 hours and driving at 3 and a half weeks.
I would do exactly the same again. The thought of induction and a possible instrumental delivery filled me with dread and worries regarding birth asphyxia etc.

[MerryMarigold]

itchy, I agree. Civilised is a good way to describe it. And the op was less painful, healed more quickly and was far less invasive than a big tear.

[hetsto]

Hello all,

I?m not sure this is the best place to post, but I?m looking for some mums-of-twins or mums-of-twins-to-be for a chat and any experiences.

We had our 20 week scan yesterday and after a lot of scanning around the sonographer told us we?ve got twins!

The babies are both on the small side but, more concerning is that are looking rather different to each other at the moment. They?re sharing one placenta, but are in separate sacks and one of them has less amniotic fluid than the other, so there?s a risk of Twin to Twin Transfusion Syndrome. We?ve got an appointment with a specialist at King?s tomorrow to investigate further and discuss options. Having said that, the fact that I haven?t had any adverse symptoms so far, and that both of them have reasonably strong heart beats bodes well. stay positive stay positive stay positive

I had my dating scan at 8 weeks and there was no mention of more than one baby at that point. Since then I feel like I?ve been growing at a rate of knots but otherwise haven?t had any particularly unexpected symptoms. Not that I really knew what to expect with my first! There?s a large part of me that is feeling really indignant and wondering how on earth they could miss a second life in there with current ultrasound technology, but I?m trying really hard to focus on the here and now rather than getting uptight about that.

I?m not quite sure how I?m feeling at the moment ? simultaneously elated and terrified I think! We were totally unprepared for the shock and had been rather blasé about the whole thing up to now, not really worrying about anything major and thinking about lovely things like whether to find out the gender and names etc. This feels like another level? TWO BABIES?!

[Twicethehugs]

Hi hetso, I hope all goes well tomorrow with the consultant. My twins are identical so were closely monitored due to the possible risk of TTTS with a scan every 2 weeks. For now, I wouldn't read up on it on the Internet, just see what the consultant says first. You've got the shock of it being twins to deal with first! 8 weeks is early for a dating scan, I had one then and they weren't sure if it was twins but could tell clearly at the 12 week scan.

[hetsto]

Thank you Twicethehugs, lovely to hear from a mum of twins! Did you pregnancy go to plan? How old are your twins now?

Just thought I?d give a bit of an update after a long day at King?s today. I was scanned again first thing this morning and we then spoke to a lovely consultant (all good things people said about the staff at King?s proved completely true by the way!) who confirmed that one of the twins isn?t growing as quickly as the other and it looked like they had TTTS. We were pretty frightened but the consultant explained that we qualified for laser surgery to sever the blood vessels that the twins were sharing, and that we could have it straight away. We knew this was fairly high risk but the alternative was to wait and watch things get progressively worse, so it was a no-brainer really. The staff were all very reassuring; we went for a little walk and then were seen for the surgery later this morning.

It was amazing to be able to watch the consultant working on the babies from the inside; he severed 7 blood vessels from the amniotic sack of the largest twin and then drained some of the fluid from that sack. It was all over pretty quickly and then we just had to wait a few hours before they could scan me again to check whether the babies were ok. They?re still holding on in there with pretty normal heartbeats, so we?ll be going back next week to check their heart beats again and see whether the smaller twin has started to catch up. On a plus note, I?m less tight and uncomfortable now some of the fluid?s been drained!

We?re not out of the woods yet and the twins will continue to be monitored on a weekly or fortnightly basis for the rest of the pregnancy, but it feels like we?ve moved quickly in the right direction. I can?t believe how fast all this has happened; I?m in a total whirlwind of shock and uncertainty, but my OH has been wonderful, as have lots of other family and friends, and it?s lovely to be able to come on here and decompress too.

?We?ve got girls, so I?m off to think about names now.

[twinteresting]

Just posting to lurk on this one and read later.

[Twicethehugs]

Hi hetso, I'm glad to hear the treatment seems to have gone well. It must have been terribly stressful for you and your OH, at least you have some good support around you. Sending you my best wishes and I hope you have two little fighters and get good news when you go back next week. There's quite a lot of info on TTTS around e.g. from TAMBA and I think there's a support group on Facebook. If you want more info/support, it may be better to start a new thread and I'm sure people who've had experience of TTTS will come forward. If you've had enough info but need emotional support, I'm sure others would respect this too.

You asked about my twins, I have two girls as well who are 6 months old now. After thinking they were bound to arrive quite early, I ended up being induced at almost 38 weeks (then having a C section but hey ho!)

Take good care of yourself and good luck thinking of names for your girls x

[hetsto]

Thank you Twicethehugs! I?ve had a look at TAMBA and they do have a really helpful booklet on TTTS, so thank you for that. I think I?m going to stick with that and the information from the hospital for now though as I don?t want to send myself and DP back into tailspin from information over-load. Good point on the support though, I might start a new thread today.

Congratulations on your girls! We?ve been thinking about names and like Jessica Rose and Lily Eleanor for our little ones but I just plugged them into google and they seem a little too popular right now, so I?m not sure anymore! I?m struggling to find names that sort of go together but don?t ?match? as I imagine I?ll be saying them together quite a lot?