Twin birth

[Thetirednessisreal]

Hi I’m 34 weeks pregnant with twins

I was all set for a natural birth was told it would be around 36 weeks

At my meeting yday the consultant told me
That they would wait until 37 weeks to induce me. Now I’m worried my twins are already over 5.5lbs so by then they will be 7 or over. I was also told they have to be careful inducing previous c section mums due to the scare.

Induction team rang me and today to book me in and are looking like 37+4 to induce I think this is too late and also the second twin is breech. I don’t have an appt again until 36 weeks but I am now wanting a section due to this new info can I ring for an appt with my consultant (it’s a busy nhs hospital)

In your shoes OP I wouldn’t even be considering a natural birth. I would be insistent on a c section as early as safe to do.

I had a vbac 37 weeks with twins and twin two was born breech (my midwife had experience with breech which is vanishingly rare now).

I had a horrible induction with emcs for my first baby and swore it was either no interventions or pissing around or strait to c section for me.

In all likelihood you will go into labour before they have chance to induce you - twins don’t hang around waiting for their moment like singletons do.

I’d say keep cool and hope to go into labour naturally. If you reach 37+ I’d refuse inductions and go straight to section.

It’s inductions that are dangerous in vbac because you’re imposing contractions on a scarred uterus.

Very best luck 👯‍♂️

MCDA (Mino chorionic) means one placenta which is the risky part. If the placenta slips out with one twin it can cut off the blood supply to the other twin resulting in brain damage, death etc.

Risk of that would mean a definite c-section for me, regardless of past history. And I am generally intervention-and-needle-adverse.

I was also heavily persuaded to have an elective for my twins at bang on 37 weeks. I did fight it, god knows why as it was a very calm experience. In the end DS1 was breech so I had no choice. For my next birth, I was desperate for a cs as DS3 was massive but I was refused. I have a bad prolapse now due to that I think.

YANBU. You have to be really firm OP. Ask to see your consultant and tell them in no uncertain terms that you want an elective. Take someone with, preferably a male, to stand up for you. They think we women are stupid and don't want to do a cs due to costs.

I was heavily being pushed to a natural delivery with my twins despite twin 2 being breach. I had a horrendous delivery with dc1 and was not having it. I actually ended up changing consultants at 34 weeks to one who agreed to a section. Mine were 6lb and 7lb at 38 weeks. And my c section recovery was far quicker than my difficult vaginal delivery recovery which was important with toddler and twin newborns.

My hospital weren't happy for me to be induced with my second due to a previous c/section (over 3 years previous) they said they'd let me attempt vaginal birth if I went into labour naturally but induction was too risky.

Scans showed my second to be 11lbs 9oz at 37 weeks...they refused vaginal birth as this point!
He was 10lb 5oz at birth, 37 weeks, c-section.

Look up your hospitals policies, mine shows reasons you might request request a c-section.

“In this country, we are told the risks of different approaches”

Not always: I wasn’t.

Agree though that other healthcare systems, eg US, also have problems such as the profit motive.

In this country, we are told the risks of different approaches and we choose the one that best fits our values/needs. We aren't instructed by a profit making machine and nor do we want to be.

If only that were true! This OP, for example, hasn't even been given any other option than induction with VBAC of twins much less told of risks of different approaches or offered choices. This may not best fit her needs at all. All too often, 'busy' hospitals or those with higher CS rates will indeed literally instruct women that they are having VBACs or inductions they may not want and which may not be best for them and their baby or babies.

I’ve made an appt for next week to request a c section. If I go into labour naturally that’s fine but it I have to be induced I’d rather the section

Okay, in the OP, it says:

"I was all set for a natural birth was told it would be around 36 weeks"

That to me says they decided on a vaginal birth but as there is a date specified, my assumption would be that the OP had already decided on inducing labour.

Then at 34 weeks, she was told that a) it would be 37 weeks (term) and b) the risks of induction as a previous section were (re)explained.

As I write it like this, I wonder who agreed the initial plan of a "natural birth" around 36 weeks and how they explained how this could be achieved (induction) and whether the risks were explained then.

Anyway, the OP was concerned that the extra week would mean that the babies would be bigger and increase the risk of labour to her/the babies and that the 2nd twin is breech which is an additional risk to a twin pregnancy. Either way, I thought she had consented to induction. I know the balloon can be used with VBACs and works better with people who have had a baby already.

The balloon gets your cervix open enough to break waters without using the hormone which is the real risk for VBACS. (Doing my doula training).

I wasn’t told the risks of induction after a c section. I was just told the risks of a c section. Then at my last meeting they told me the risks of induction .

Also with twin 2 being breech they told me that would be no problem to turn as they will be small ‘like6lb’ well they def won’t be small lol so that has worried me too

And aside from this, you are within your rights to have a CS given it's a MC twin birth and you have had a previous CS. So if you want a CS, then don't hesitate to make that clear and yes, bring your spouse or a friend for support. If they are a 'busy' hospital it would very much concern me the level of consultant support if you go for a VBAC, tbh, access to epidural and the like.

You can have an elective caesarean for no reason at all according to guidelines. Admittedly hospitals don't always concede that.

Contact BirthRights if you feel your choices are being limited by protocol. Even if their recommendation is on best (statistical) evidence, it doesn't mean you have to accept it.

You are also allowed to change your mind so if they try to pull the 'but you agreed to it in the past' lark and try to persuade you, you don't owe them justification. 'I changed my mind. I no longer consent to induction for this birth.' And repeat it. I strongly recommend you take someone with you as it sounds like they bamboozled you a bit.

All too often, 'busy' hospitals or those with higher CS rates will indeed literally instruct women that they are having VBACs or inductions they may not want and which may not be best for them and their baby or babies.

When my MW friend read this in the mail or whatever she said it is far less time consuming to do caesareans for people who would otherwise be induced. They would save money if everyone who was up for induction or was otherwise high risk like VBACS just had an elective caesarean. It might flood the PN wards but they'd be using so few of the labour rooms for people in labour, they could keep at least a few there. So the risk with a busy hospital and a high risk labour is that they will push you into a predictable elective caesarean rather than an induction/VBAC. As everyone has said, they are safer in terms of risk of emergencies during the surgery.

@ChilledBee Whoah, overreaction much? The OP asked for others' experiences and I shared mine. My obstetrician trained in Ireland and practiced in U.K. for years, and I'm pretty sure the only beneficiary of my choice to have a C-section would be the hospital not her personally. That's assuming that a quick elective would actually be more profitable than an induced labour and fixing any complications from that. I'm not in the US.

I was not "instructed", I was advised. Specifically against induction after a previous C-section. This hardly seems a controversial viewpoint. Based on the risks I am happy to follow the advice. I am far from convinced that in the U.K. I would have been presented a balanced view (or indeed a consistent one since you don't always see the same doctor). The obstetrician did say I could try for a vaginal birth if I went into labour naturally without induction but I decided I preferred the c-section in that case too. My choice.

Midwife of 23 years here. I had mcda twins. Usually my hospital induces them at 37 weeks but because I work there and know the consultant I was induced at my requested 36 weeks. I did not want to go any longer due to the increase in risks beyond 36 weeks.
Luckily they were both head down and my previous 2 labours had been extremely quick and easy normal deliveries so I was happy to be induced.
If I had had a previous cs and one was breech I would have demanded a cs.
As it was they got acute ttts at the end of labour!

As it was they got acute ttts at the end of labour!

Oh no! Hope they were OK.

Link to TAMBA information is here;

twinstrust.org/let-us-help/pregnancy-and-birth/preparing-for-birth/birth-plans.html

Normal recommendation for twins sharing a placenta is caesarean birth at 36 weeks. But of course guidelines are only guidelines and a woman's preferences and thoughts are equally important.

@pasanda this happened to us! One was really red and the other pale! I'm a neonatal nurse so freaked out!

Have they given you steroids? Make sure you get them. I’d ask to speak to them as a matter of urgency asking for an ELCS instead of induction. The only thing with twin births (I have twins) is that often your body gets to the point where it really can’t hold them in anymore. Obviously the ideal is that they stay inside as long as possible but the two conflict and if your body can’t cope with them getting bigger, they will come! In my personal experience of twin births and other twin mothers I know, it’s very unlikely you’d get to the stage of induction or elective caesarean. They usually come when there is no room left and all your internal organs are squished and it’s a matter of the birth you get, not the birth you want. There’s little you can do but go with the flow with whatever hand you’re dealt.

Mine were 6lb 9oz and 6lb 6oz at 35 weeks and they’re grand, 3 years old now. Twins are also good at developing all the faculties babies need to survive outside quicker than other fetuses.

So yeah, sorry about the waffle, my basic point is ask for an ELCS but be prepared that twin births rarely stick to plans.

Oh, and sleep as much as you can now.

I'm so impressed by all these well grown healthy babies! Mine was a 6lb10 singleton at 42 weeks! I have a super-narrow pelvis though, so probs the right size for my capacity!