vaginal or c-section with twins?

[rubyred84]

interested to see what decision others would make based on the below statistics of my hospital (figures are twin births in 2014 of 100 women)

50% had elcs for medical or personal reasons

25% attempted vaginal delivery but ended up having a c section for both babies

11% delivered one baby vaginally and needed a c section to deliver the second

12% delivered both babies vaginally with intervention/assistance

2% delivered both babies vaginally with no intervention ( yes...just 2 women).

hospital is very pro vaginal delivery (but not at all forthcoming with these statistics which worries me).

I did post this in the multiple birth section but thought I might get more response here. no judgement please, just honest answers based on the stats

are they your first children?

apologies, yes I should have said, these are my first children.

I would choose ELCS, definitely. If you try vaginal you have only a 1/3 chance of not having an emcs.

Having both a vaginal and emcs birth on the same day would be the worst of both worlds for me!

The exception would be if I wanted a large family, as the risks with repeated c sections go up. In that case I would ask why women are needing emcs for both/ second twin, to find out whether anything can improve my chances of delivering both vaginally.

But it depends what you think is a good birth. To me an ELCS is almost as good an outcome as a vaginal birth, but an emcs is a significantly worse outcome. others will place more importance on delivering vaginally and may feel that ELCS and emcs are pretty similar outcomes.

You need to take into account how your babies are lying. If they are both head-down, or T1 head down and T2 breech then your chances for SVD are higher than if they are in any other position.

I think those stats are quite woeful
I had twins 20 something years ago, they were not my first. T1 was head down T2 was slightly transverse. Hospital were keen for me to have an epidural which I declined to great consternation. Was very active in labour, upright throughout, delivered kneeling. I would guess that a lot of those assisted deliveries/EMCS were associated with use of epidural and/or recumbent positions. It depends what is important to you. I was happy to risk an EMCS for both or 2nd twin, to give myself the best chance of delivering vaginally.
I recovered well and both dts bf well from the start.

to be honest it is most important that we are all well and safe, that is my priority. I'm trying to speak to the supervisor of midwives to discuss further as obviously it matters how many of these women already had children, and also the type of twins. but I must say that at the moment to save any distress I am leaning towards c section.

I must say, I am annoyed the hospital hasn't freely communicated these stats, and despite these figures are still pushing for a vaginal delivery. I know a c section is by no means the easy way out at all, and recovery is harder, but when it is more than likely I will end up with one anyway, I don't see the point in trying.

How many weeks are you and how soon do you have to decide? The decision could be out of your hands depending on the position of the presenting twin etc. I would try not to stress about it and to see how the pregnancy goes...

I would ask for a breakdown of figures in the attempted vaginal birth Labours to see what the outcomes are with twins in your positions. Also are the stats worse for first time mums? You may find that the hospital don't gather this data unfortunately.

Ask what would prompt emcs of the second twin. If second twin is breech do they perform emcs or breech vaginal?

I had an ELCS for one baby and was v happy with it. I just needed DH to help for the first two weeks, but recovery was much better than I expected.

What are your plans for future children? I was told that after three c sections the risks go up.

Based on those figures? I personally would fight tooth and nail for an ELCS!

(I had my singleton via ELCS because he was small for dates and the consultant didn't want to put him through the stress of an induced birth. Surgery went well, it was an intensely moving experience for me, the recovery was fine, you can hardly see the scar now.)

Have you discussed this with your consultant? I would be in the 2% as my twins were born after about 5 hours of labour at 33+4. I had opted for an induction at 38 weeks if they hadn't come by then. The figures were very different in my hospital. I think 50/50 c section/vaginal and then a 5% chance of having to have a c section for twin 2 after vaginal for twin 1. Your figures would worry me. This was my second pregnancy which may or may not have made a difference but I think in your situation I'd go for an elective or change hospitals.

Hypothetically I would go for an elective section. My experience of twins is that my sister had twins - she tried to deliver naturally but ended up having one vaginally and the second by emergency section. She had a really bad time.