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,

My twins were monoamniotic so I had to have a planned c section, which became an emergency one at 33 weeks! A total walk in the park regarding recovery... Very little pain and no problems "bonding". I put that word in inverted commas as I'm not quite sure what it means. Yes mine were in incubators so I couldn't hold them whenever I wanted but they were my children and they were alive and now ten years later it couldn't make less difference. I really wonder at the importance we place on "bonding", as if there are millions of women who fail to feel like their children's mothers because of the way their children entered the world!? It's a means to an end!

I delivered our twins at 26+1 via emergency c-section.
16 weeks in NICU and no issues with bonding or breastfeeding (still feeding both at 27 months old albeit only twice a day)...

May I add, it's your choice as to whether or not you are induced at any stage.

It's not up to the consultant to 'let' you do anything. It's their job to give you the risks and benefits of any and every intervention offered, and for you to decide what's right for you and your babies.

I must admit I was a bit when he mentioned bonding. He presented it as if it’s a cold hard fact that c section mothers don’t bond as well with their babies. I really don’t feel like that’s going to be an issue. I went through three years of infertility and spent all my savings on treatment to get these babies. You definitely couldn’t say they aren’t wanted!

I feel that either way has its advantages and disadvantages. I actually find the idea of being induced quite terrifying. I’ve read that many stories about it taking days/failing/really painful labours. Flisspaps it was only afterwards that the penny dropped that I don’t have to agree to induction if I don’t want it. Although obviously I want to do whatever is safest for the babies...

LuMarie at “not his vagina” a very good point indeed. I can’t help wondering if he’d be quite so eager to squeeze two melons out of the end of his penis!

OP sounds like you are keen for an elcs. You know what, at your next appt, say that and make them write it in your notes as your preference. If your consultant won't support you ask to see someone else.

This matters because whatever happens on that day, YOU need to live with the results. Not him. Or his wife You may have a medical emergency which in practice robs you of choice, but up till that point, it is your choice and you should do what you think is best for you and your family.

A tip for dealing with that type of blackmail is to ask for absolute risk ie so you're saying my baby is twice as likely to have asthma, what's the absolute risk? As if the original risk with a VB is 0.01% then twice that is still pretty bloody small - if it's 23% with a VB and thus 46% with a CS that is clearly a different matter.

Disclaimer: all figures thoroughly made up!!!

Like a previous poster I also know a twin mum who delivered her first twin vaginally, and the second was an EMCS. Recovery was horrific for her. The c-section scar was 'traditional' too i.e. vertical, not bikini line.

I've had two c-sections; one emergency, one planned. Breastfeed both in recovery immediately after theatre. Bonded strongly. Kept breastfeeding for the very long-haul with no need for formula top ups etc.

My planned section was MUCH easier than my emergency. I was prepared for it and back driving, with permission from my insurance company, within two weeks.

Hello midwife here,

It all depends which way your babies are facing, especially the first one. Head down and engaged, if number two is head down too then that's even more positive. There is no reason why you can't go for a vaginal birth. Xxx

You might find the current AMA thread by the comments consultant gynaecologist helpful, OP.

Consultant is hardly giving you a balanced view.

Twins by emcs as T1 was breech. It was the safest way for all three of us. I know a couple of twins mums who had a vaginal and then a csection for T2.

No issues with bonding, or breastfeeding (9months). I don't feel I missed out or that I didn't really 'give birth'. Mine are teens now, and how they exited by body is the least interesting thing about them.

I've never heard of the excema and asthma link, one of mine had very mild excema, but then so do I, so not sure that's c section related.

I do however have a rather unattractive overhang.

ShovingLeopard I’ve had a look for the thread you suggested, but I’m afraid I can’t find it?

MrsMac Twin 2 is breech and has been since my 24 week scan. I know he/she is still breech as I’m in quite a lot of discomfort from the hard little head lodged under my ribs! I won’t be getting my next scan until next week due to switching hospitals.

I don’t think consultant gave a balanced view either. Although he said it was my choice he was very clearly in favour of a vaginal birth.

I’m seeing my midwife next week, so will discuss it with her. I’m scared of the prospect of being induced and also very scared at the likelihood of forceps/ventouse being used if I have an epidural. Atm I’m leaning more towards a planned section, but might agree to try vaginally without epidural if I go into labour early. I feel quite miffed that my choices were presented as either induction and epidural or section.

JohnnyMcGrath I will try your absolute risk approach. Especially in regards to to chances of me needing intervention if I have an epidural. It was definitely glossed over.

I had a scheduled c section at 37+4 as both mine were lying transverse

Had trouble latching one baby other completely fine

The nhs will virtually always tell you a vaginal birth is better, but I know a number of people with lasting issues from vaginal births, and none from c-sections.

Triplets? All breach? All weigh at least 9lbs and have super pointy double jointed shoulders? Definitely vaginal will be a lot better 🙄

Fuck my life... and trying to guilt you into it by telling you you won't be able to bond with your babies after a c-section. It makes me so cross!!!!

I hope it goes well for you whichever you choose!

I have twins. I really really wanted a VB but ended up an induction and emergency section.

It wasn’t scary, it was fine.

I bonded with my babies without any problems and they were ebf for 18 months.

I do have an overhang but you can’t see it when I’m dressed. Tbh your body will always be different post baby. Not necessarily worse but definitely different regardless of VB/section.

Looking back the section did make the first few months with the babies harder than it would have been otherwise. I got an infection in my scar, I couldn’t drive, getting up in the night to feed was painful etc.

The most annoying thing about having had a section was not being allowed to lift anything heavy for 6 weeks and nothing very heavy for 12 weeks.

One baby in a car seat is heavy, two babies in two car seats are definitely “very heavy”!

I managed around the restrictions but it did make logistics a bit tricky occasionally.

The section itself was fine though and in the end was necessary for my babies’ safety so I have no regrets.

Here's the thread I mentioned, OP. It's about obs/gynae generally, rather than about twins, but I thought you might find the OP's views on risks of CS v VB interesting.

www.mumsnet.com/Talk/AMA/3303150-I-m-a-consultant-gynaecologist-AMA

Thank you ShovingLeopard interesting that she says vaginal birth is riskier for the baby than a section. I was told there’s no difference

My reading, going back three years, is that the risks and benefits are different, but that overall there is less risk to the current baby with CS. The risks I was particularly interested in were the more catastrophic kind, which are lower with CS. However, it does make the risks higher for subsequent babies, because of the scarring to the uterus. This is why they suggest no more than 3 CS. They will be happier if you are planning no more than one subsequent baby.

I do think within the NHS there is a huge issue around informed consent in childbirth. VB seems to be pushed (for financial/ideological reasons?) very heavily, and women are not informed of all the risks and benefits to the various birth options, or given real choice. You are the one who will undergo the birth, you and your babies will live with the aftermath (hopefully happy and serious injury-free). Not the consultant. Or his wife. So the choice should be yours. His role should be to offer unbiased information, not propaganda.

Meant to say that I thought that thread would be interesting for you to see the other view. She does say to ask her anything.....

The bonding stuff is an invention and the breastfeeding evidence is a bit patchy.

I think I'd go CS simply because I've done both that and VB, it wasn't that awful, and because I really wouldn't fancy the prospect of huffing one out then possibly having to have an EMCS with the next. Which with breech is obviously a possibility. I'm also not in love with syntocin, though I appreciate that with twins you aren't in a position to wait until things kick off naturally.

I have also never had twins so feel free to disregard on that basis! I only read out of interest, but felt compelled to respond to your account of a consultant who's peddling such utter nonsense. That is actually so very dodgy that it would be making me at least wonder if I ought to see someone else.

ShovingLeopard I too am very concerned regarding catastrophic risks for the babies. I just want them here as safely as possible. Consultant also spoke as if a section makes any subsequent pregnancy harder? That’s irrelevant to me though as I’m not planning anymore babies . The chances of me conceiving naturally are extremely low and I have zero desire to ever go through more IVF. Plus I’m nearly 40, so just getting these two here safe and sound will be enough for me.

That AMA thread is fascinating. I did put a question on, but think she may have missed it. Hardly surprising. I’m quite horrified at the number of women asking her medical questions. It’s a sad reflection on the state of women’s health in this country

GameOfMinges may I ask what your experience of being induced was please? I’ve been reading some less than great accounts from people. I find the idea of induction scarier than the idea of a section. That’s another thing I feel consultant rather glossed over. He pretty much described it as “You come in. We give you a pessary, break your waters, put you on a drip, epidural and then BOOM...you have two babies” I suspect there might be slightly more too it then that...

OP I am not Game but I was induced and it pretty much was like that, minus the epidural and drip.

They admitted me at 2pm on the Sun, faffed about for fucking ages whilst I hypnobirthed and tried not to get into a state. Pessary in at 1.35am. DH went home and I had a little sleep on the delivery suite bed thing. Woke up about 6.15, MW asked to monitor me, nothing doing. Went for a walk and decided that people walk up stairs to bring on labour, so I should do that. By 7.30ish still nothing doing, so headed back to delivery room. Brief monitoring, nothing doing except one sudden massive twinge in cervix. Decided to shift me to the big twin delivery room for their 8am shift change so lumbered over there. MWs monitored me one more time around 8.15 to check I deffo wasn't in labour then went off to do paperwork. I went to the loo in the en suite, felt like I needed a poo, and delivered DS instead! Got back into delivery room with DS and summoned help, they got me on bed and scanned to check DD was still head down - she was - they asked to break her waters and then told me to push - she shot out. They gave me an injection to deliver the placenta, and that was that.

But a couple of things there

I had had a baby before so my body "knew what it was doing"

When they inserted the pessary I was already 2cm dilated

I moved around a LOT - I did 30 flights of stairs!!! - which definitely helped - not possible with an epidural

My hospital let me give birth on delivery suite so I could go for walks etc - check this as some make you do twim VB in an operating theatre where you cannot just walk in and out to get some alone time but are under constant gaze of staff - some.women inc me find they need to be alone a big

If the pessary hadn't worked as it did they gave it 24hrs, tried a second one, at 30 hrs went to drip, and then saw how things went

Non induced twin VB is totally possible and you might well go into labour spontaneously at 33w or something so prepare for that

Don't even consider bonding or breastfeeding as c section mamas haven't got issues there! The issue would be c section is a surgery and painful and you need to rest afterwards and unless you have a really good support team around it would be very difficult with two babies to look after? Research aftercare? And I bet Facebook has lots of twin groups who have lots of insight too :)

Sorry OP I wasn't induced, I had syntocin in a stalled labour that had started naturally. At that point in proceedings it was the safest way to do things, so I don't regret the decision, but I'd have felt differently had labour not started at all, cervix unfavourable etc. The contractions were more painful and unfortunately I wasn't given the epidural I'd asked for either.