Twins- C Section or Vaginal Delivery?

[tb4122]

I'm 19 weeks with DCDA twins and not sure what sort of delivery I should opt for. My first was a water birth in the midwife led birth centre, dim lights, hands off car, delivered him myself straight into my chest for skin to skin etc and obviously they won't let me have that again this time.

I don't like the idea of a spinal injection, being paralysed and recovering from surgery with two newborns and a toddler. But I'm also worried about needing forceps or even an EMCS having delivered one baby, if twin 2 isn't in a good position. I also don't like the idea of a really medicalised vaginal birth with bright lights, constant monitoring and a room full of people. They have already recommended getting an epidural "just in case" and I feel that this will lower the threshold for interventions massively and I may end up with an episiotomy and forceps just because they can, whereas with a single birth we might change positions etc.

The c section feels like a more controlled situation in some ways but isn't really what I want in a lot of other ways.

Our spinal needles are 25g so tiny tiny tiny hence headaches aren't common (vs epidurals 16g)... headaches are far more likely when medical drs do lumbar punctures as their needles are 22g and cutting needles (whereas we use pencil points)

@Destiny123 thank you, that's been very helpful to my veterinary brain (vs my "I don't know what to expect and it's scary" mum brain!).

The website labourpains.org is fab written by obs anaesthetists about everything imaginable in terms of risks/what to expect etc

No worries at all, yeah im the same, it's cos we only ever remember the difficult cases in our minds not the 10 patients a day that are totally uneventful. Feel free to message me if helps in future

I've only had section births (by choice), but for me personally:

• no shivering
• no nausea

-I felt physically fine during the surgery. First time there was minimal rummaging, second time a bit more).

• I remember briefly daydreaming about lunch, which shows you how un-nauseous I was
• Blood loss was an estimated 250ml or less, which isn't much really.
• don't look in the lights or you'll see your reflection...
• talk to your surgeon, especially if you want specific music played, want them to give a commentary, or equally NOT give a commentary.
• I breastfed fine in recovery both times.
• the first time my feeling came back 6-12 hours later. The second, I could start wriggling my toes in recovery. I think I got a smaller dose that time.
• not being able to move was fine, people brought me stuff and I was there like the queen 😃
• recovery was easy and pretty much pain free.
• The first time after about a week it only hurt if I prodded myself in the stomach (to see if it still hurt 😂). The second time I had an on/off burning sensation across my scar for a few days. Like if you've been holding a bag of hot chips on your lap for too long. Not painful, but odd. I also felt a bit bruised, but it was pretty mild. I took painkillers just in case it started to hurt though. It hurt less than an average period for me.
• I was out and about within a couple of days, and I remember chasing my toddler round the garden at day 5.

Everyone has a different recovery, and many women take longer than this to recover. Many don't though.

If you've already had a good vaginal birth, your chances of easy one would be good with a singleton, I don't know about twins though.

So I don't know what choice I'd make in your shoes. For me, vaginal birth terrifies me, so obviously I'd go section, but you are different.

If you do have a section, embrace it though. Enjoy that you'll have a date, that you'll be going in to birth reasonably rested (as much as you can at term). Enjoy that you'll have no labour pain. Enjoy that people will be sympathetic as it's easier to talk about needing help after a section, then talking to your dad (for example) about your vulva being ripped... Enjoy that you've got an extra reason to sit on your butt and be waited on if you want to/need to, but also that people will think you're awesome if you do things, even though a woman with a more painful severe birth injury may be soldiering on in silence. Most of all, enjoy your babies and follow your body.

Hello! I have no prior experience but I am currently 34 weeks pregnant with MCDA twins and I am planning a vaginal birth :) I have had 1 really positive hands off birth already with my singleton older child so think my chances of a positive twin birth are good.

My lower twin is head down and the higher one is breech so the plan is to birth them like that. I am pretty set on a vaginal birth unless things drastically change in the next 2 weeks. Haven’t decided whether I want to decline an epidural or not yet. I am leaning towards not having one but would maybe consider changing my mind. It’s hard to know until you are in the moment!

I know a few people who have had successful twin vaginal births so they do happen but most twin mums I know have had a c section. Sorry I don’t have a lot of first hand experience for you yet but thought you might like to know there are other people also planning vaginal if possible :)

Hello @texenstar - Reading this as pg with twins and want vaginal and no epidural. How did yours go if you don't mind me asking?

Hi @tb4122- I'm having similar thoughts to you years on! Do you mind if i ask how your birth was? Very much hope it went well

Hi! I dont even remember writing on this thread! Twins are over 1yr now. Probably not the answer you want but my labour ended up in an emergency section under general anaesthetic and soon after coming around I ended up being put under general anaesthetic AGAIN due a PPH that needed controlling 🤦🏻‍♀️ it all sounds worse than it was in the moment though.

I went in to get induced at 37 weeks. Found out I had late onset preeclampsia. All fine. Just had a wait a bit to bring my blood pressure down. Had my waters broken and put onto the hormone drip. Progressed to 10 cm and started pushing. We then lost twin 2 on the monitor and couldn’t find his heartbeat on the ultrasound which is why we did a switch to emergency section. But they were both fine in the end thankfully :)

only thing I regret is the epidural. I agreed to have it done due to the insistence of the consultants. However, in the moment, the midwives thought I was doing fine with out it (I was but the whole point was incase twin 2 needed help) and it didn’t work anyway 😅 so I ended up with a spinal puncture which was the most annoying thing afterwards.

so all in all. I found the whole thing fine and manageable and it was only because of twin 2 having issues whilst twin 1 was still in that we had to switch to emergency section, otherwise, I think the vaginal birth would have gone great.

sorry it’s not the answer you probably want to hear but just want to reiterate that I still see it as a super positive labour and birth :)

Hi@texenstar- thank you so much for taking the time to write this! I appreciate it. My app doesn't show me the post button if message is too long

So I have to write this in several messages. Sorry about the pre eclampsia and glad you and babies were OK despite these complications.

Must have been scary to lose twin 2 monitoring I had to look up PPH wow. good to know that it was positive despite not going to plan.

Had you started at home or in the birth centre? Hope the first year of the twins went well?! Must feel like a long time ago now. Thanks again :)

Sorry you said that you went in to get induced - ignore my last question!

I had a vaginal birth for DT’s but was aware that if they hadn’t been in such a good position I would have had a c-section.

I had a perfect delivery - an early epidural, plenty of sleep and watched the Wimbledon final giving birth!

Amazing! Good to hear. Hope it was a gripping final :D guessing you were at home then? If so was your trust difficult about this in any way? And is there anything you did to get them in the right position? Ive heard about spinning babies