VBAC with twins

[Twinsagain]

I'm pregnant with twins for the second time. First set were born in 2017. My consultant has warned that VBAC is not recommended because it's likely I'll have to be induced and there's a risk of scar rupture. Does anyone have any experience with this? I'd much prefer VBAC over elective caesarean but don't want to make the wrong choice.

Hopeful bump

Hi there. No personal experience from some I'm afraid (although I did try for a Vbac (single babies not twins).

Induction methods vary between hospitals and my local ones don't induce labours for Vbac due to scar rupture. However,twins normally arrive a little early anyway don't they?

Why did you have a c section the first time around?

Did you have a bad first experience with your section?

Thanks for replying, both.

I had an emergency c section after twin A got stuck during labour - I'd been pushing for quite some time and he just wasn't going to come out!

Twins usually do come early of their own accord but I had to be induced due to pre-eclampsia so there's a risk of the same thing happening again.

How far along are you? Second twin pregnancy, a previous c section, baby getting stuck and pre eclampsia history. I would be surprised if they encouraged a vbac.

Of course totally your choice, no one here or at the hospital can tell you what the right choice is. Did something happen with the EMCS?

Congratulations OP!

An elective section is a very different experience to an emergency one. But I can understand why you would rather avoid a major operation with 2 babies to care for. Remember there is always the chance of delivering baby 1 vaginally and needing a section for baby 2.

I had a Vbac with a single baby after elective section with my twins.

Honestly, I wish I’d had another c-section. As PP have said, elective is completely different to emergency. Mine was actually lovely, whereas my Vbac ended in episiotomy that was awful and the healing experience was harder than my section.

Congrats on more twins!

I attempted a VBAC with induction after an emergency section with my first.

It did cause a total uterine rupture that was only detected as I was wheeled into theatre and cut open. I was only in theatre due to slow progression of labour (5cm in 20 hours) but if I hadn't have been in there then it's likely we both would have haemorrhaged.

For my insistence on a VBAC I ended up exhausted from 24 hours of labour and no sleep (albeit with epidural) straight into caring for my newborn. Something I wanted to try avoid.

Managed to have a third baby via ELCS and that was my calmest and most healing birth.

Does your hospital have a vbac clinic? If so make an appointment, i found it incredibly useful, both with my vbac vs. Elcs decision, and to know what they didn’t and did allow in the vbac process, as all hospitals are different.

For example- do you want an induction? You can choose to have an elcs if you don’t labour spontaneously, or only certain induction procedures.

Pain relief- hospitals have different rules. Some won’t allow certain pain relief as it may mask a rupture or other problem.

Some hospitals allow “trial of labour” where a cs will be performed if certain progression targets aren’t met.

Your hospital should have clear guidelines on best practice for vbacs. They should also have specialist midwives to talk you through all of your options and the risk/benefit. Request to see them asap so you have time to digest, think, and make further appointments to ask questions etc.

The aim is for you to make a fully informed decision on the options available for you and your babies.

Thanks all so much for your replies.

I do wonder if I'm being stubborn about just wanting a VBAC and not seeing the advantages of an ELCS. I think I just want the opportunity to give birth vaginally as it's what I wanted last time. I also dislike the scheduled nature of it - I'd rather let nature do it's thing as far as feasible and not be booked in to give birth on a certain date at a certain time.

I had a good recovery last time so I've got no reason to specifically be against ELCS if that makes sense.

I'm only 18 weeks so got loads of time to think about it and my consultant said it's too far away to make any kind of choice yet.

May I ask do twins run in your family? I'm fascinated with the idea of having 2 sets of twins.

I have no experience of VBACs, but have had 2 beautiful peaceful ELCS because of breech babies and obstetric cholestasis. I recovered perfectly from both and breastfed straight away with skin to skin immediately, if that's what you wanted to do , but I appreciate that isn't always the case for everyone and it is a serious operation.

Twins do run in my family - without being too outing, I'm having the 4th set this time

It’s such a difficult decision! I do have friends abs family that have had natural deliveries with twins but they weren’t Vbac. And although they were straightforward it’s always slightly stressful waiting for the 2nd from what I heard from them.
There was a lady in hospital when I had my baby and she had natural delivery with twin 1 and c section with 2.

I think in your case it would have to depend on how the consultant and hospital would support you in trying for a Vbac. If it’s strapped to the bed/induction/pressure to get it done in a certain time frame etc I’d be tempted to go for a c section. But,it’s your birth not mine.
What the lady above suggested sounded good,Vbac clinic at the hospital.

Induction with vbac with twins is crazy, in my view. Why risk it? I had a wonderful ELCS with twins - highly recommended.

Had twins delivered by planned c section at 37 wks plus a few days....at that point was no room for them to move and both transverse so wouldn't have attempted vaginal birth anyway. Consultant thought she was giving me bad news when said wouldn't advise vaginal birth but couldn't have been happier as all stories I'd heard about twins involved scary delivery of second one. Went very smoothly & personally wouldn't want to risk twins delivered vaginally although think approx 50% are.. Good luck whatever you choose!