Vaginal birth or c section with twins?

[Lipsticktraces]

I’m 28+4 with twins. I saw my consultant yesterday and was told that they don’t want me to go past 37 weeks.

We discussed birth options. I had been 100% sure I wanted a c section, but now I’m not so sure. Consultant told me that there is no advantage to babies if I have a c section and that it makes bonding/breastfeeding harder. My other option is induction at 37 weeks and an epidural. Consultant did make it clear that it is my decision and hospital will go with whatever I want to do.

Really don’t know how I feel now. Would really appreciate others thoughts/experiences. I’m 39 and this is my first (and definitely last) pregnancy,

I sooo wanted a vaginal birth but had emergency section at 38 weeks as one baby was breech. It was fine - and I bonded fine, and breastfeeding was fine. I am incredibly glad now, 20 years later, than I had a section. I think I had some mad idea about the mystery of giving birth, in a pool, and finding my real self through labour... hah!! now I realise vaginal deliveries can result in tears, piles, incontinence issues blah blah, I'm really delighted that my little scar was the only thing I took away from it.

I would say, either option is fine - do what is best for your babies of course. You are in for the adventure of a lifetime, twins are fabulous - good luck

Ive had 4 sections and never had a problem bonding or breast feeding.......

If you get the choice I’d go vaginal. Either way isn’t easy but at least with vaginal all the pain’s before during and not so much in recovery.

I had a vaginal birth with my Twins.
I was induced @ 37 weeks too.
1st baby was super easy, my 2nd baby turned after I delivered 1st so i had to have an epidural and go into theatre for them to try and turn her.
She was delivered at a funny angle (leg pulled over her head and slightly twisted) but she was fine no problems. I'd do it all over again it was amazing.
I've personally had no c-sections myself but my friend has and she hasn't had any problems bonding.
Do what's best for you 💐

I had an emergency c-section after a 12 hour labour with my first and a planned C section at 34+4 with my twins. In fact when i found out I was pregnant second time around I asked if I could have a c section and was told that I should go for a vbac (so when I knew I was having twins I requested a c-section and it would probably have been granted even if we hadn't had to get them out so early). I breastfed with both pregnancies. No issues with bonding either (and the twins were in scbu for the first 2 weeks and were being tube fed expressed milk!)

My sister wanted a vaginal birth with twins and she ended up with the first baby coming out vaginally and the second by emergency Caesarian. Be aware of that risk!

Given the choice of induction or c-section I would probably take the c-section. If you went into labour early, I'd be more inclined to try vaginally then.

I've had 2 x emcs and the only breastfeeding issues I've had were related to latch not supply and with dd, I bonded with her whilst I was watching her coming out of me, all sticky up hair and a grumpy expression on her face. She was on my chest within 4 to 5 minutes of being born and that included delayed cord clamping and a rub down by a midwife.

Plus like hopingandprayingthistime's sister, the wife of a friend delivered twin 1 vaginally and twin 2 by emcs. Having had my first by emcs after a long labour and failed forceps, that's not something I would wish on anyone.

Both my c-section recoveries have been quite literally a walk in the park though, very little pain, no need for pain killers and pushing a pram 3 miles a day within a fortnight which obviously influences me a bit.

I had one by c section
Then with twins decided I wasn't doing that again!

The consultant tried to force me into another one but I said no thanks and see how it goes.
It's up to you OP - either way make sure you have plenty of help and rest at home afterwards

Good luck

I was induced at 35w due to growth issues with T1. I refused epidural. Personally I feel the benefits of epidural are way overstated provided both twins are cephalic (head down).

I would not choose a VB with epi as it massively increases the risk of forceps and thus damage downstairs. For me, active mobile VB or elcs - but VB where you are on your back and cannot use gravity? No chance for me, worst of both worlds!

I had twins by planned section at 37 weeks. I really didn't know what to do about virginal vs section but my consultant said if i was his wife he would want me to have a c section. That made my mind up and it was really a positive experience. DP watched them come out (they lowered the curtain for him) and he got to tell me their sex. They ended up in scbu for 8 days but it helped me get into a routine with them and recover from the surgery. Good luck, do what feels right for you.

I had an induced vaginal delivery at 37 weeks. Twin 1 was head down and delivered quickly. Twin 2 was footling breech and delivered up to his neck but then my contractions stopped for 4 minutes. He did need help after and was taken straight to SCBU for brain monitoring, which was so hard. I didn't see him for 6 hours and almost kept forgetting I had another baby!

He spent 30 hours being monitored and then was back with me.
The induction was incredibly intense and everything happened very quickly but ultimately I am so pleased that I went for vaginal delivery. I didn't tear at all and was up and about within half an hour, which was such a blessing with babies on two different wards.

Not a twin mum but done it both ways. First born was emcs and was an awful experience after a long labour, baby back to back and failure to dilate the last 1cm. V birth with no.2 (baby correct way round) I'm 2 weeks post partum now and cannot believe how much better I feel. Yes, there was a tear but nothing compared to pain and exhaustion of c section recovery. I am breast feeding for 2nd time also, much more positive experience this time after v delivery. Main thing with section is you cannot sit up in bed by yourself to get comfortable to feed and can't twist into baby's crib to lift them on your own for weeks. Was 25 with my first and scar is a horrible saggy pouch despite being toned size ten pre pregnancy so I'd be worried about that being worse with a section at 39. At 28 after v birth my tummy has snapped back to much quicker already (still got pouch for section) and just wish I'd been able to have my first naturally as well. Already back in my size ten jeans! Took about 4 months after section. Everyone's experiences are different and nothing guaranteed though. You're always gambling with whatever option you choose. Personally I'd try for natural birth and you may get lucky with both twins arriving that way. All the best for when the time comes!

Thank you for the responses everyone. Really interesting to read about everyone’s different experiences.

I was quite surprised when consultant said about the bonding issue. He pretty much stated it as an undisputed fact. My friend had her first baby last month by EMCS and has bonded/breastfed with no issues.

johnnyMcGrath I did express my concerns regarding labouring on my back, forceps etc. Consultant said all going well I would be able to move around, etc. Not really sure how that ties in with an epidural? It was pretty much presented to me as an epidural being the automatic thing if I decide to labour vaginally. There wasn’t even mention of me potentially trying without in case I need an EMCS.

DarkestBeforeDawn my consultant actually said that he would want his wife to have a vaginal birth every time.

Whilst he did stress it was my choice I do feel he was a bit simplistic regarding vaginal birth. He pretty much glossed over induction, epidural etc as if they were no big deal!

musicalmama I must admit that I’m rather vainly worried about c section overhang. I was a size eight before this pregnancy with a toned stomach that I totally took for granted until it vanished. Whilst I accept it might never be quite the same again I would like to keep carnage to a minimum. Then again I’m terrified of what a potential forceps delivery might do to me as well. Luckily DH told me earlier that he’ll always love my fanny either way

Thanks again everyone. You’ve given me a lot to think about.

At the minute twin 2 is (very painfully) breech, so not sure how that might affect things if he/she stays that way?

Vaginally.
2 vaginal one c section. I dont feel i gave birth to the last, rather someone handed me a baby. It was elective. Ime vaginal births are followed by a euphoria which c sections cannot give. Obvs others may argue different but there is something about all that pain and then holding your baby. I wish id had a vaginal with my last.
I have no overhang though, and i was up and about 2 weeks later and healed.
I regret my section maddively and breastfed all of them.

Not had twins but have had an emcs after an extremely long labour. Could move pick up baby etc easily the pain after was nothing compared to pain and exhaustion from the week of slow and active labour.
I am a size 8 and gained very little weight during pregnancy and don’t have an over hang. No bonding issues but milk didn’t come in until day 5 though that could have been dye to exhaustion and lack of food for the week. If I have another I would want an elcs

My twin 2 was breech throughout and my consultant was not concerned at all and actually was really pushing me to have a vaginal delivery. He was only ever interested in T1 being head down. He did recommend that I had a epidural in case they had to do any manual turning of T2, which did frighten me!
I did have an epidural but only just in time and twin 1 was born a few minutes later.

In the end, they were happy for me to deliver T2 in a footling breech position

I had my twins via Cs at 36w but I didn't really have a choice as one was breech. However I had no problems bonding with them and breastfed them successfully!

My advice would be c-section, there is too much risk with a 'normal delivery' for twins.

I have had 2 vaginal births (one induced) for my singletons and I had an EMCS with my twins at 31 weeks.

My consultant had said it was my choice but when I said I would have a section I got the impression that she thought I had made the right decision.

My main reason for the c-section was that I know someone who delivered twins naturally and didn't have a happy ending. I won't go into details but it left me in no doubt that I wanted a c-section. Also, while my twins were in neo-natal there was another twin delivery that never went to plan that was not expected at all.

Good luck OP xx

OP if you care to look it up, the relevant NICE guideline is Clinical Guideline 129. It states that epidural is strongly advised but if a woman is not keen other pain relief options should be discussed.

You have the right to refuse any intervention.

The reason for the preference for epidural is if anything goes wrong with Twin 2 in particular they can act fast, performing internal cephalic version (making a huge episiotomy, reaching hand thru your cervix and pulling baby into position) or emcs. However I asked for absolute figures on these sorts of complications and was told they occur in fewer than 10% of cases and some estimates said more like 5%. I had a history of giving birth quickly and easily with DD1 and decided the safest thing for my twins was to be active and get into positions following my body's cues. I turned out to be right as both babies were born within 20 mins without getting into distress or adverse positions.

Mobile epidural which is what your dr is talking about is where they initially give you less of the drug so you retain some sensation in your legs. This was not acceptable to me as it doesn't allow anything like full mobility.

It is very personal but having given birth to twins my overriding feeling is one of immense relief I didn't go for the epidural. From experience though, you have to fight and also accept the trade off that if things suddenly go badly wrong they may need to do a general anaesthetic.

I had a c-section and experienced absolutely no issues with bonding or breastfeeding. It wasn't as bad as I expected either. I had a couple of months of soreness and was left with a scar. My hoo-ha is totally intact and I have no problems with it at all. Meanwhile friends who have given birth vaginally have been left with a variety of issues including urinary and faecal incontinence, requiring reconstructive surgery and years of physiotherapy, and one poor friend still has difficulty orgasming due to nerve damage when she tore. Yes some women have vaginal births and all goes well, but some don't. Especially with twins I'd choose the c-section.

See DaisyChops my consultant told me there is no difference in successful outcomes for vaginal or c section birth babies. I had automatically assumed that they would say a section is safer for twins.

Tbh I feel like all the emphasis is put on what’s best for babies, but what is best for the woman giving birth is totally glossed over. Almost like you are irrelevant in the process iyswim?

JohnnyMcGrath The whole turning the baby internally was briefly mentioned and it’s not a thought that fills me with joy! In fact the thought of labouring without an epidural (or indeed labouring at all) terrifies me.

If I was having a singleton I wouldn’t even have chosen a hospital birth. I’d have gone to a birthing centre given the choice. I didn’t want a medicalised birth, but obviously appreciate that isn’t possible now. Oddly enough I wouldn’t be scared if it was a singleton. It’s just the thought of twins that petrifies me!

CanaBanana That’s terrible about your friends. My worst nightmares come true!

Consultant also said section babies are at higher risk of asthma, eczema etc. I will have to look into that. I’m seeing my midwife next week and going to speak to her. I feel so unprepared for all of this. I’ve not even been to any antenatal classes etc yet as we’ve just moved to a different part of the country, and I’ve transferred to a different hospital.

Thank you again everyone

My consultant would have been happy for me to deliver the twins but I said straight away that I wanted a section due to my friends twin experience. I found it frustrating that the medical staff did not offer an opinion. I mentioned something about natural labour and my consultant said to me "you don't need to worry about that as you are having an elective section" and I just got the impression by the way she said it that she also thought it was the best option. I might have been reading too much into it, I don't know, but there was no way I was giving birth naturally.

My twins were too young to breastfeed when they were born but I still felt that we bonded through skin to skin kangaroo holding and they were definitely aware of each other even in hospital when I wasn't there as i came home before them.

One twin does have quite bad eczema as time but it is manageable, and the other children I know who have worse eczema were naturally delivered.

Good luck with your decision, make sure you do what is best for you xxx

my consultant actually said that he would want his wife to have a vaginal birth every time

Not his vagina!

That would be the comment that would have me completely disregard his views.

I've never heard of bonding or feeding issues, with twins I'd go for the planned c-section.

There can be enough drama with single , I want safe and controlled with two.

Your consultant sounds as though he may be biased in favour of VB. It is not the method of delivery in itself that affects bonding, rates of PND, etc, rather it is whether the birth experience differs from the woman's preference, and how she is treated in labour and post-partum.

If a woman really wants a VB, but is pushed into CS/has to have an EMCS in traumatic, high-stakes circumstances, that gives a far greater risk of trauma, bonding issues etc than a woman who is happy to have an ELCS. Similarly, women who are pushed into VB when they really don't want one, and would rather have a CS, are also at higher risk of trauma/bonding issues. Being dismissed/belittled/ignored or abused in labour also increases risk, whereas being respected and listened to decreases them.

Fwiw, I had ELCS with a singleton. I wanted it, and was very happy with the experience, and had no issue with bonding or feeding. I do know a twin mum who gave birth vaginally to the first twin, and then had to have EMCS for the second. She had a third degree tear, with ongoing problems, and then got an infected CS wound. Truly the worst of both worlds. Personally, I would always go with CS for twins, but what is important is what you want. Make sure you are happy in your own mind, and then tell the consultant what you prefer.