Twin vaginal delivery - advice please

[Yorkiegirl]

Message withdrawn

OK here goes!
I'm 34 weeks pg with (probably) non id twins. Both are head down at the moment and I've been advised that if twin 1 stays vertex I can try for a vaginal delivery. I would prefer not to have a CS as I already have two older children and the prospect of a scar and four kids is not appealing. If twin 1 delivers ok vaginally and twin 2 stays vertex and is not distressed, what amount of time can elapse before a CS becomes necessary? Their placentas are fused and each has their own sac. I should maybe post in the multiples area but all seems quiet over there.

Had identical twins @ 27 weeks

Twin I head down

Twin II kept turning but ended up being feet first

Time between them 7 mins

does that help?

I'm pestering throckenholt to answer, she was in same situation...

Hi bubble99

I'm sure there are midwives here who will answer this really well. I used to be a midwife and will answer from memory.
In most cases, if the first twin is head down the second twin is likely to turn to the same position - if not before labour then sometime after the delivery of the first twin. Most doctors wait patiently if all is well with twin 2 - I've seen waits of up to an hour before further decision was taken.
The last twin birth I did the second twin was breech but turned to a head down position 10 mins after delivery of the first baby and was then born easily 12-15 mins after her sister.

HTH helps a bit - it's been a while since I practiced and I'm sure some of the practising midwives out there will be able to give you more detailed (and any new) information.

Mandy

I should ask my mum! I was one of non-identical twins although she didn't know that before we were born. We were born at 36 weeks with 10 minutes apart - she only had gas and air, I don't think epidurals were widely available then.

Wow! Rocket twin 2's. Another issue with twin deliveries is apparently post partum blood loss. Because there are two placentas am I likely to have a heavier bleed immediately after delivery? would there be less chance of heavy blood loss with a CS? Thanks in advance.

Mine were about 20 mins apart - but I think an hour is fine - and probably longer - I have heard of people who have twins born on different days and I think that wasn't just either side of midnight. If the baby is not in distress and labour is still ongoing I think no reason for a c-section. If the cervix starts to close up and labour stops (ie your body thinks it has given birth and forgets the second baby) then you have problems

try asking on the forums at www.twinsclub.co.uk - or I will ask for you and report back - can't do it tonight though - probably tomorrow.

Hi bubble,

Yes this can be true, however, I'm assuming you're giving birth in hospital where there will be a ton and a half of expensive medical equptment and doctors and midwives and drugs to sort it out if there is a problem.
Two placentas will leave a larger raw surface area in the uterus which will bleed - expect your blood loss to be heavier for the first 24hours - it should settle down then though.
Although there are two babies - it doesn't necessarily follow that you will haemorrhage - the chances are that the drug they give for the delivery of the placents will stimulate your womb to contract down as it did with your other two. Am assuming you haven't haemorrhaged before. Also (it's all coming back to me now ) if your iron levels are good a larger blood loss will be okay - your body will cope with it.

HTH

Mandy

I am a twin and there's 15 mins between us (me being the older) so when sis called me names when we were younger I would tell her she was my afterbirth .

Also it was VBAC

hi bubble
My first two children were natural delivery. Like you my non ID twins heads were in the correct position ready for big day! I did not want a C section for same reasons as you ,( i had a two and four year old to look after) However complications ocurred at 37 weeks i ended up having a planned c-section. It really was not as bad as I thought.

I recovered fairly quickly and still managed to breast feed in comfortable postions, I was up on my feet in no time, I had lots of help at hand, which was great especially in the early days. I hope it works out for you. BTW a friend of mine had twins viginally and 50mins between babies

just did a quick poll on twinsclub - about 10 people answered so far - all seem to have gaps of between 10-20ish mins between their twins. Will update if anything of interest comes up.

can't see any reason why you would need a C/S when you have delivered before. Usually second twin comes within 30 mintues. Haemorrhage would not be less likely with a C/S , is likely to be more infact. When we deliver twins we have a drip ready to start to make the womb contract more firmly if needed. Women having twins are advised to have an epidural incase twin 2 needs assistance. They don't have to have one though if they don't want to.

My friend's mum told me a lovely story about having her non-identical twins at home. It was in the late 1950's and twins had not been diagnosed. N had given birth to a boy and the midwife yelled down the stairs to the new dad "Congratulations, you have a son. Can you bring us all a cup of tea?" She went back to N, realised there was another baby on the way and, just 5 minutes after the boy, delivered a little girl. She yelled down the stairs again, "Well done, you've got a beautiful daughter and we really need that cup of tea!" The new dad appeared and said "Make your mind up; first it's a boy, then a girl, can't you tell the difference yet??" and was promptly presented with two babies.

Good luck with your babies, Bubble99.

lovely story

I'm concerned about post partum bleeding due to my pathetic Hb levels - 10.7 at booking and only 10.9 since taking iron tds. Am I likely to need a transfusion before delivery or am I close enough to the lower range of normal Hb levels for this not to be necessary? I've got an appointment with my consultant next week but it's been bugging me as to why I don't seem to be absorbing iron - any ideas? Am I absorbing normally but the twins are using it all up? No problems with bleeding after my previous two singleton deliveries.

Thanks throckenholt, I'll whiz over to twinsclub and read the replies. Suedonim, I've got a feeling these are girl/boy as well. I've got two boys already, a bit of pink around the place would be nice!

longest so far was 66 minutes.

I had a girl after two boys, Bubble - we almost suffocated in a blizzard of pink stuff. Lucky it's my favourite colour!

Thanks mears. I haven't had an epidural before, if I needed to have an emergency cs would that mean I could just be whipped into theatre? Any thoughts on low hb? Do many women need transfusing before delivery and if so at what point? Is there a lowest hb level that is safe to proceed a delivery with,in case of post partum bleed? Thanks in advance, you should be charging a consultancy fee for all this free professional advice!

Hi Mandy

Just curious, did you stop practising midwifery once you'd had a family?

hi bubble99 - it is very rare for a woman to need a blood tranfusion prior to delivery. It probably would only be considered if the Hb was less than 8g/dl. The epidural is recommended for the reason you gave - if a C/S or instrumental delivery such as forceps or ventouse is necessary then the epidural is 'topped up'. As I said earlier, the doctors and midwives are usually prepared at delivery with a drip to control any excess bleeding if necessary. HTH.

Thanks mears

Hi Bubble,

Yes - and got very fed up with all the in-fighting and politics within - other midwives will know all about this. Decided to be a health visitor instead and thankfully got a place to study. Then immedietly got pregnant - after many years of trying and failing. Being a HV fits in well with the family - and it's a job I just love - especially as my DS is only 2 - can so relate to the difficulties other parents have sometimes.

Mandy

Just checked a few facts with my mum - 20 minutes' gap between us, but second stage labour was very short overall - 10 minutes for first delivery, followed by what felt like a 20 minutes' pause, and second twin born within a couple of minutes of contractions starting again. No more blood loss than after previous births but first stage was more painful (maybe because we were premature). In our case placentas were also fused. Good luck and I hope it goes well.

Thanks muminlondon, if I have a similar delivery I'll be happy. I have a feeling I'm going to need to be induced. DH and I are in the process of setting up two daycare nurseries, there is so much to do over the next couple of weeks that I'm trying to 'hang on!'.
Mandy, that's great that you've managed to find a branch of nursing, MW and HV with child-friendly hours. Also good that you have insight as a parent. Although it's not fair to say that you have to be a parent to be a good HV or midwife - in the same way that you can be a good oncology nurse without having had cancer, but it must help. Do you also have to deal with the elderly?