Twins and C-sections

[WinkyWinkola]

Just out of interest, are twins almost always delivered by section these days?

If so, why?

I help run a large twins group, and IME, it's the most common way for twins to be born. The women in our group who did it vaginally are the exceptions. It seems to be either because it was deemed safest for babies and/or mum or because there were problems during labour, and therefore an emergency c-section was done.

I had an elective c-section because twin 1 was breech and twin 2 was transverse. "Elective" isn't really the right word though - I was told by my consultant that it would have to be a c-section when I was about 34 weeks, as it was unlikely that Twin 1 would turn by that point.

Why are you interested, OP?

No. Ours (4th and 5th children) were born normally - in fact the first at home he came so fast. I hired an independent midwife. They were brilliant. My twins were born at 40 weeks and came of their own volition. I was very pleased not to be induced at 38 weeks.www.birthcentre.com/index.html

In recent years it's been decided that labour is too risky for twins who share a placenta because of TTTS. It was different when I had my twins, who are nearly 9 - I had fortnightly scans during pregnancy checking for TTTS but they didn't see any reason not to give birth normally.

(As it turns out twin1 was born vaginally and twin2 by emergency section in my case.)

Not all identical twins share a placenta and obviously fraternal twins never do.

What is TTS?

My cousin had her first twin naturally, then an emergency cs for her second. Apparently this is quite common for twin deliveries which start naturally, because the second twin is often breech.

Mine were non identical. I was very lucky to have the births I had and I was happy to accept whatever was necessary to ensure their safety but they were born pretty robust 6 puonds 8 and 7 pounds 8 ers at 40 weeks, exactly on the due day which none of my other children were and we called them the happy babies as they were so cheerful and I think that partly because they stuck on in there getting nice and fatter until they were ready to choose to be born. I've never had a C section but I've always accepted that the aim is to deliver a live child which is not a given and whatever results in that - great but that it is for me always to take the decision which is women's right under English law by the way - so do your own research and decide.

I remember once I knew it was twins I asked my GP whose wife is an independent midwife was there still any point in having mine as I was going to have them in hospital as it was twins etc and he said even more so, much more point and he was right, same midwives throughout but NHS doctors on hand in case of complications and we were all home the same night all well. Lucky us but it's not always like that. Just realise doctors' views differ and do your own research.

Initially I had read that if they are both head down or twin 1 is head down and twin 2 is breech then vaginal delivery is possible.

However the consultant has also told me that it's not just the position of the babies that is the deciding factor about twin delivery - twin birth is more risky than having two single babies, if that makes sense. He also said that generally they don't like to deliver singleton breech babies vaginally anymore, so its a kind of lost skill and his view was that it would be just as problematic to deliver a second breech twin naturally.

This is disappointing, as I am hoping to have my twins naturally (and I have met people that have done this although in theatre) but even so it has made me more aware that its not just like having two babies in quick succession. Also in 10% of cases he says that one is delivered vaginally and the other is an emergency c-section, which I think would be really scary and maybe the worst of both worlds?

Anyway, am hoping for the best but coming to terms with the fact that the most important thing is that they make it out safely, even if that means a c-section with a host of helpers rather than the calm birthing pool I wanted at home...

superbean mine were DT1 head down DT2 breech, I had VB, with forceps for DT1, that was 6 yrs ago now though so it may have changed since then

I'm having an elective CS tomorrow for MCDA twins at 34 weeks. Acute TTTS can happen during a vaginal delivery and I don't think it's worth the risk. I also have other reasons for an early delivery but every pregnancy is unique.

There are many factors that can cause twins to be delivered by CS or early - some affect singletons too, some are unique to twins sharing a placenta. Be guided by your consultant but also do your own research. TAMBA and the Multiple Birth Foundation are good sources of information and can help you decode the doctor.