Expecting twins, first birth - CS or VB?

[Pazza]

Hello, I'm expecting twins - EDD May 22nd

The EPAU nurse, doc and midwife all say CS is safer for twins for a first birth ... but can take a bit longer to recover from?

Not one of my friends had a good VB experience in hospital, so feeling panicky. Any advice would be really really welcome.

Pazza xxx

I had twins as a 4th birth and never had a CS. I would be very surprised if you needed to plan a C section for twins but may be there are special medical reasons in your case. Although my sister had twins first and after 20 hour bad labour did have a C section in the end. I still think she wanted to try not to have to have one however and was glad of that chance.

C sections are major operations. I would avoid one if you possibly can. VBs are much quicker to recover from. I think look at material on line or in books not go by what your friends say.

My twins were born at 40 weeks and labour started naturally.

I had twins first (and last!) birth and didn't have CS, it wasn't even mentioned as anything other than an emergency procedure

inamuckingfuddle - how did the first birth go?

I'm confused as to why all the medical staff have just said 'oh go with an elective CS' as if it's just obvious that's the thing to do. Xenia - there's no special medical reasons, I'm healthy.

I think I might rather have a planned CS than a long and painful VB that ends in CS anyway or episiotomy or both. At least I'd know what I'm getting in to! ALL my friends who gave birth in hospital ended up with an episiotomy (without being given a choice) and being in loads of pain for weeks after.

Cheers, P

There is absolutely no reason to plan a CS just because you're having twins and certainly not at this early stage. It could be you end up with 2 or one breach baby in which case the option will be given to you for your and their safety.

When i was expecting my two i read up a lot, as you do, and it can depend on your consultant as well as the hospital you chose as to their opinions on it. End of the day, it's YOUR choice not theirs and having twins you're gonna be exhausted from day one without having the added trauma of recovering from a CS.

i went VB, no.1 was head down and no.2 was feet first - however that was at 29 weeks so they weren't exactly big and there is no way i went to 10cm before i popped!

Pazza I think lots of women have CS for twins because even if the first one is nicely engaged and is born "easily" the second one has quite a chance of being in a non ideal birthing position. This is what happened to my mum when she had twins - the first one was engaged and the second one came out folded up, bum first! I think if that had happened these days, she may have had the VB for twin #1 and a CS for twin #2 meaning you have both the stomach and vaginal areas to recover from birth.

Furthermore, I believe that in general, an elective CS is easier to recover from than an emergency CS.

I have a friend who opted to have her twins delivered by CS recently and she was happy with this choice. If this is what the docs recommend for you, I would do it.

My niece had twins naturally in May, as a third labour. She said it was the easiest of her three labours and her babies were massive at 6lb 5oz and 8lb 6oz.

Well Pazza, mine were born at 35 weeks, spontaneous labour, although I was due to see the consultant the next day anyway as he had concerns about twin 1's growth rate. DT1 was in good position, but ended up needing forceps, DT2 was footling breech. They weighed 4lb 2oz and 4lb 6oz but no SCBU thankfully. I can't say I enjoyed it but I could at least move afterwards!

I had an elective c-section as one twin was breech. You won't need to decide until you are 32+ weeks or so and the twins have chosen their positions. If both are head down, or the first one at least, is head down you can go natural.

I guess I was more worried about having to have an episiotomy and/or emergency c-section so chose just to go for the surgery and get it over with! Having said that it was hard to recover from whilst looking after twins and I was left very ill and anemic.

Let me know if you want to email me for a chat.

It's easier for the hospitals in some ways to plan a C section but I think most women who have had twins naturally are grateful they had the chance to try. Even my sister who did have a C section wanted to try on her own to start with.

Twins births can be more complicated but that doesn't mean you need a C section at all. I really don't see any good reasons for it.

And C sewction births are not easier than VBs. They are much harder and much worse in terms of what is being done to your body, risks and the recovery period afterwards. There seems to be a popular myth that they're an easy pain free birth option which is a load of rubbish and you can have pain free VB with an epidural if pain is what you're worried about.

My twins were 6 pound 8 and 7 pounds 8.

I think the bigger risk which I was worried about was they come far too small and are very little and in special care. In some ways whatever birth you have if you can keep them in there to 38 weeks that is a huge plus.

Hi Pazza I am having twins due on 2 Feb 2008. Congrats on yours, imagine you only recently found out there were two!

I have been asking similar questions over on the multiples board as the ladies there are very knowledgeable . I was dead against even considering a c section unless I had a medical reason to need one, but my consultant is quite pro c sections and I started wondering if it was just easier. I have a son already who will be less than two when the twins arrive, so am worried about how a c section will impact on my time with him as well.

I have decided to just go with the flow, and play it by ear for now. I have another scan in 2 weeks, when I will be 28 weeks pregnant, and will see what position the babies are in. If the lead twin is in a good position coming up to the due date I definitely want to try to have a VB. My worst fear is going through the pain of pushing one out, and then having to end up with a c section for the second.

I have a friend who had twins as her first children and opted for a c section for no medical reason, and it all worked out well, but she did say it was a long recovery and she was glad she didn't have any older children to have to deal with as well.

I had an (em) cs with first child, but a vb was planned with the twins. Unfortunately it didn't happen. Personally I would never chose to have a cs (although I have never experienced a vb).

If your hospital are pushing for you to have a cs I suggest you find out what experience they have with vbs for twins. If they have none (which maybe if they are encouraging women ot have css fro twins) then think about finding another hospital that has enough experience and will support a vb if you want one.

Thanks laydeez!

I'm hoping this early-stage panic mode will wear off soon ... your replies have been really helpful, there's obviously no easy/right answer but I feel much less out on a limb about it all now having read your opinions and advice!

Twinsandra - would love to email you. Did you lose a lot of blood then?

Egg - how long was your friend's 'long recovery'?

Leolady ... good idea - I'll try to talk to a few hospitals who have done twin VBs.

Cheers Pxxx

Ohh gosh not sure how long, I know you are advised not to drive etc for six weeks and I think she just found lifting etc hard for that amount of time. Having said that I went to visit when the twins were three weeks old and she looked fab and seemed really well, but of course i was only there for an hour and she may have gone back to bed once i left!

Come over and see us on the multiples thread here for a proper chat .

Congrats. Suggest you read all the modern/up to date stuff you can lay hands on so you can make a well-informed choice. Also talk to your midwife.

My twins were born vb at 29 weeks, no probs. 2nd baby was breech but they turned him after 1st baby was born! I was uncomfortable but was not in pain at all. Would suggest you avoid CS if poss - Xenia speaks a lot of sense.

Hiya.
Some hospitals have a CB policy for twins but there's no need for it.
Try to find a doctor with a different viewpoint just to give you a balanced professional view.
My twins were VB at 35 weeks and it took 4 hrs start to finish and was easy except the bit where son's strangely shaped bits above his ears came out(and in and out and in and out etc...).We call them his extra brains.

Same as cbcb, I had c/s because dt1 was breech from about 27 weeks but at no point was i booked in to have one.
I went into labour at 33 weeks and dt1 was still breech so had no choice but it should be a last resort really, not just cos you're having twins!

Pazza, are your twins sharing a sac? If they are then most consultants would recommend a CS as there is a risk of them getting tangled up together. That was the only reason that I can think of to force a CS decision this early.

Otherwise it will all depend on their positions when labour starts/approaches. If one twins is engaged and head down I think that would allow you to attempt a VB.

Hi

Thanks for all your messages, think I will take your advice and go for VB if T1 is head down when the time comes, either way I'm feeling much less freaked out by it all. I guess I am settling into the reality of it ... and now more distracted by expanding waistline!!!

Pazza xxx

I haven't read all the messages only the op. I have 8 year old non identical twin girls. Born vaginally with no problems at all I went into natural labour at 35 weeks and they were born within a few hours of labour starting. Unless there are complications there should be no reason for a c section x

Pazza, when I had my DTs it was a VB and I went to 41 weeks. Perfectly healthy pregnancy and beautifully healthy babies. If there was any issue at all of risk I would have been first to agree to CS but I had a great birth. Much better than my VB singleton birth previously!! I was assigned a consultant very early on and you will have many, many more checks and scans than would be the norm for a singleton pg. I would like to think that your consultant will have a big experience of twins and therefore have a more balanced attitude.

Congratulations! I wish you good health all the way and it is very, very special carrying twins (I thought so anyway). I hope you enjoy every minute.

We mums of multiples have a daily thread called D'y ever wonder........ pop in anytime, kettle is always on.

As a midwife I would say VB with twins is fine if all is well and labour starts naturally.

IME, medical staff start to interfere by inducing labour from 38 weeks onwards (some women beg to be induced as well).

Induced labours often end up in forceps and the second twin may end up in an awkward position.

In that case, I think elective CS is better.

If only medics could leave well alone.

We have three sets of twins in the immediate family, all went into labour naturally and all fine, all vbs.
In many ways, for a twin labour, you want things to be as calm, as comfortable as possible, so as to get labour working most efficiently (we are easily put off our stroke by hospitals and examinations and all that malarkey) yet some hospitals make you labour in theatre rather than a delivery room.
A lot will depend on position at the onset of labour, though, but if you do a good bit of reading (not What to Expect and their ilk!) you will get a better idea of what contributes to a calm and effective labour, and can hopefully insist on putting some of it into practice.