To epidural or not to epidural? - twin labour

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Hello wonderful ladies. You have been so helpful, I thought I would ask another question which is now playing on my mind. Pain relief in a twin labour if I am fortunate to have the birth the way I want, which is vaginally. What did you all have for your pain relief or would recommend? I know that it is recommended by some hospitals to have an epidural just encase an emergency c-section is required, and then they can just top it up, but I am worried this could slow things down or prevent me from pushing adequately. I had my 4 year old son just on gas and air and although I would have preferred less pain, I feel the immense pain spurred me on to get him out. Not sure what would be best for twins though! Any stories, tips or advice about pain relief would be much appreciated. Thank you.

Phone your hospital and ask for a copy of their twin delivery protocol - they may well push very strongly for you to have an epidural in case they need to turn/section for the 2nd twin.
Of course it is still up to you, and having said that I was lined up for a vaginal delivery on G&a, but did have to have a crash section which for me meant general anaesthetic.

my friend delivered twins with no pain relief, she did have a drip set up ready just in case etc but all was fine and she laboured naturally at 39wks and delivered both babies naturally :) so it is possible you may have to be absolutely clear on what you want and that you understand the risks etc ie needing a GA if they cant get an epidural set up in time in case of emergancy :)

I wasn't given a choice, not that I minded, having already had one with my first.

As it turned out it was needed because I had twin 2 by c-section.

Hi, I've support lots of clients who had twins (I'm a Doula) and they didn't use epidurals for their births. If you don't want an epidural, then there is no reason why you should have one. Your hospital should explain their protocol, but remember that protocol isn't medical necessity. They will also explain the risks (ie GA if one or both of the twins get into trouble and there is no time for a spinal block/epidural).

By not having a epidural, you'll be able to move about freely and get into the positions that work best for you during birth and labour. hth

Congratulations btw. It's very exciting having twins (I'm also a twin mum. My Wee Weapons are about to be 8).

Hi again, my hospital were quite insistent I had an epidural in case there were any issues. I was keen not to have an epidural. Had loads of problems with my hips after DD1 - was on my back for too long (had to have an epidural due to v high blood pressure). However, when I was in labour with the twins I just went with their advice. I did wait until I was 8cm (much to some of the midwives horror) but as I had it so late I could still feel everything and continued with the gas and air. I was pretty wired up to machines so even if I hadn't had an epidural I wouldn't have been able to move that much (on oxytocin to speed up contractions, a drip for fluid and heart rate monitors for both of the twins). I could move (just!) from the bed to the chair to the commode (oh the indignity, I swear the bloody commode chair was the worst part of the whole thing).

As for not being spurred on by the pain, trust me, the fact that you are attempting to have twins vaginally will spur you on to push harder.

I think it depends on the presentation of the babies & general circumstances really. I wanted to see how things went and was lucky that there was no pressure from staff (tho we didn't see much of anyone until I was ready to deliver to be fair.....). Apparently there is the option to have the epidural sited, but not used unless necessary. In the event both ours were head down, labour was induced at 40+3 & progressed fine & I didn't have pain relief. I wasn't very mobile though, but that was due to being huge (boys were 7lb 11 and 7lb13 plus all the associated guff). It's good to be open-minded about the options available though.

You may find this article helpful: www.slate.com/articles/health_and_science/medical_examiner/2012/01/the_truth_about_epidurals.single.html

Thanks everyone. I feel much more confident about choosing, already, and hopefully I will be able to discuss with the consultant on Friday too.

The discussion went during labour at 33+4 waters gone unexpectedly drs just discovered I was 5-6cm and in no pain, oh and it was a vbac:
ob: we need to get an epidural in
me: why?!?! I'm doing really well.
ob: in case something goes wrong and we need to act quickly.
me: I'm still not sure. I don't want to increase the risk of cs.
ob: It won't.
me: but it does increase the risk of instrumental deliveries.
ob: I'm going to write in your notes that it's medically dangerous to refuse an epidural.
me: How about you site it but don't put anything in?
ob: We need to do an initial dose to check it works.
me: Can you make sure I can still move with it?

Or more or less. They thought I was due to pop at any minute. I could move and stood up for a long time. I don't think it worked properly as most of dt1's pushing was spent with obs and anaethetist arguing over whether it worked or not and judging by the way I held the ob's hand (no g&a in theatre) i think I had her convinced.

My mistake was that they hadn't given me any details of what would happen in twin births so somethings were a shock.

I had a successful unassisted vbac for both although 2nd degree tear

I had an epidural but that was by choice, I also eventually had them naturally albeit with forceps for 1 and ventouse for 2. Quite a bad tear but I didn't notice as the painkillers were pretty effective after. The scar tissue up there was horrendous, I do not recommend having a smear test 4 months down the line. In all honesty, that hurt more than the birth!

Just loved my epidural. Forceps and a tear were involved but the birth was relatively pain free and I recovered quickly. It just gave me some comfort that i could go straight to theatre if necessary.
I did vomit straight afterwards but I don't think that was down to the pain relief - just shock!
B/G twins are 2 next month - loving every minute.
Good luck!

Hi,
Reading your question has taken me back because I had the same dilemma. Gave birth to my first on gas and air, so was not at all sure about the advice to have an epidural with the twins (now five mths). I think my first labour had gone so well I wanted to try to recreate the experience. In the end though, I accepted it was going to be different - but not necessarily worse. I asked for a "mobile epidural" and got one (though I was told it would depend on staffing on the night). It allowed me to shift position on the bed and to feel the contractions, but I was not in pain. It was so great it made me wonder why I had been so brave the first time. As twin2 took a long time to come down, I got taken to theatre and given a full epidural ready for a section for her delivery. With a lot of encouragement from the midwives, I did manage to avoid the operation though, and they just used a cup to help her on her way.
Sooo, for me the epidural was the right decision on all fronts.
Hope this helps and all goes well.