Has anyone had a VBAC with MCDA identical twins?

[sugarfiend]

I had my first appointment with the consultant today (20 weeks) and it was presented as a done deal that I'll have to have a c section.

He didn't actually go into detail about the risks, just said that there were risks with a natural delivery. I've already been reading around so know TTTS is a risk even during labour and there's a risk of twin 2 turning/ being breech.

Apparently they definitely won't induce me because I had c section with my first child (who is 2 now - born at term, tried to induce due to growth restriction, but there was meconium when waters broke so it went straight to a section).

I was most surprised when he said that even if I go into spontaneous labour (early) then unless I'm already 10cm dilated it would go to an emergency section rather than have me labour.

Before I'd found out it was twins I wanted a VBAC if possible. I know with twins I just have to see how things go and if it is the safest option at the time I'm not against having a c section as such, but I'm quite upset at the moment about how it was presented and didn't feel like my opinions/questions mattered.

Do I have any (realistic) choice? Does anyone have experience of this and is a c section really the only safe option regardless of circumstances further down the line?

I had my girls naturally and as labours go it would probably be described as a text book birth.
Saying this I would have to agree with your consultant. My girls were born with undiagnosed TAPS and we are beyond lucky they survived. My consultant was the complete opposite to yours and it was pretty much a done deal that I would be having a vaginal delivery, none of the potential problems were discussed with us. Had I been properly informed there is no way I would have had them naturally. There are other risks to do with the cords as well as the risk of acute ttts.
If you're on fb there is a group for modi twin parents where you can get more people's opinions, be warned a lot will advocate a csec. Have they told you at how many wks they wanted to deliver?

I'm sorry to hear your girls had TAPS slightlyinsane and hope they're OK now!

It's interesting that your had consultant pretty much the same approach despite the different opinion. I think I'd have reacted differently if I felt like I'd been given the full information and properly informed rather than told what to do.

I've heard of TAPS and looked at it briefly when I found out, but got a bit overwhelmed by all the different types of risks so stopped looking :S I was hoping the consultant would give more of an overview so that they seem like risks rather than inevitable (I found some of the resources a bit too much at the time). TAPS often seems to be undiagnosed until birth from the accounts I remember seeing, is that true?

I'm already anxious about the placenta as last time around it was very poor by the end and there is a family history of small, premature babies... which is another factor and I did already know I'll probably need a c-section and they would likely advise that so I'm confused at my reaction. I guess it is time to get myself properly informed!

He said they'd want to deliver at 36-ish weeks, but I think I'll be lucky to make it to 34 as based on birth weight and a 30 wk growth scan that's likely to be when it started to fail last time and it is also the latest my mum managed to get out of 5 (singleton) pregancies.

Thanks for the tip about the fb group - there are too many different abbreviations! I'll be joining that soon!

Have you had a look at Twinsclub? Their forums can be very helpful.

I had my twins via c section, due to their presentation. It was also assumed from very early on that that's how the birth would be. Good luck OP

TAPS is more commonly diagnosed postnatal as hospitals don't tend to check for it unless you ask them. Google can be great at times and leave you a jibbering mess at others. Join some other forums to help you get the info you actually need. Tamba is one that a lot of people use. I'm Happy to answer any questions about anything.
I think my reaction was similar to yours, I put it down to being told what would happen rather than having an informed chat.
Modi pregnancies are full of potential complications that make for a stressful time. At 20wks youve still got time to talk about it with your consultant and you might find the decision is taken out of your hands due to the presentation etc.
take everything a wk at a time and make sure you're being monitored correctly. Which hospital are you at?

I don't think I have come across Twinsclub Tonikkoroll, I'll take a look - thanks!

That's useful to know slightlyinsane - I'll make sure I ask about TAPS (it hasn't been mentioned by them at all. I'm at Arrowe Park Hospital (on the Wirral).

I'm feeling a lot better now, must have been having one of "those" pregnancy moments and like you say, I still have plenty of time to get my head around these things! I think I'll feel even better for doing more of my own research properly and getting my head around it - before discussing it with the consultant where I always feel like I'm on the back foot!

Hi sugarfiend

I'm in a similar situation but with a consultant of a different mind! Currently 26 weeks with MCDA twins. They will be my first birth experience. So first time mom and twins you can imagine my worries!

Well since finding out twins and doing research(googling) I had come to the conclusion that I would definitely be having a c section. Got myself in the mind frame/almost ready to deal with it. Mind you considering I was having fortnightly scans no one even bothered mentioning the birth etc.

However at my 25 week consultant appointment. Both twins are head down. I naturally asked when would I be booked in for c section? My consultant caught me offguard with "why?" After jibbering about safety and planned and secure environment for my first/twins. She then stated that as they were head down and if continued to be so there should be nothing stopping me from having a vbac and our hospital had a good track record/she would provide me with a report etc at my next appointment.
I left really worried and emotional as I am frightened of my first labour/birth as well as the complications of twins.

However I've slightly got my head around it and now taking each week as it comes as twins may change position etc.

Having said that... I see other consultants opinions such as yours who push for a c section and it leaves me wondering if I should push for the c section. It's so hard and the only stressful part at the minute...

Sorry to go off on a tangent but It seems odd that were both having MCDA twins yet two consultants seen to be pushing for opposite things :/

I forgot to mention the consultant said the maximum they'd let me get to is 37 weeks. But around 35/36 weeks would be their aim for arrival.

:)

Hi Lewaney3 - I think part of it is that I've had a c section once already but my consultant seems very pro c sections generally, I guess because of the risk of TTTS and TAPS too.

He went as far as to say that he'd prefer the recommemdations for all twins to be c sections - including non-identical... I probably should have asked him to go into more detail why but I'm not good when put on the spot and didn't feel I had enough knowledge to question him! And I was also aware that they'd probably recommend a c section for me - but thought there would be a lot more seeing how it goes before making that decision further down the line, not at 20 weeks.

I've done a bit more reading since I posted last week, and now understand why the previous section I had is more of an issue in terms of risks if they have to induce (but I don't think that really made a difference to the consultants opinion, just cemented it).

I don't think I'd be happy for them to induce me now, so will likely agree to a scheduled c section once they want to book that in.

That said, I still hope to see how things go, and if the twins are in a good position, are not in immediate distress and I go into labour early, I will probably be asking for a second opinion from another consultant before letting them rush me off for a c section at a couple of centimetres dilated.
I still have some more reading/thinking to do though.

It's so hard once you think you've figured it out, started to get your head round it and to prepare yourself for one path and suddenly someone says no, actually it will be like this!

I definitely agree with the just about getting your head around something and then being told no it should/will be this way!

I too have concerns about taps and tts but I just feel slightly on the back foot with my consultant as of course I'm not medically trained and I just end up jibbering away. I feel like saying there's all these risks! Let me have an elective c section. However there's another torn part of me that wants to listen to her who states there's nothing indicating a vbac is off the cards and more chance they would spend less time in scbu if delivered naturally through birth canal... Although I'm not too sure about that as id still be induced early

It's so hard and it's one of the things constantly on my mind! I'd be interested to hear an update if you get a second opinion :)