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Facing pressure to induce twins at 39 weeks

post #1 of 22
Thread Starter 
Hi, Ladies,

I don't post often, but have been lurking throughout this pregnancy. I didn't even know it was possible to carry twins this long until I started reading your stories, so they've been truly inspirational! But now I feel like I need some information and I'm having trouble finding it myself. On Tuesday, I had an appointment with "not my usual" OB and to my great surprise she pushed me into scheduling an induction for this morning (I'm 39 weeks today). I was surprised because we had never spoken about this possibility before and these OB's are supposed to be more open to more natural childbirth...even with twins. So anyway, I was so dumbfounded that I went ahead and scheduled it, but called the next day (after I came to my senses) to cancel it. So last night around 6:15 I get a call from the doc basically telling me that if I didn't induce today, I was going to end up with a section this weekend because they aren't on call and she's "not sure" how comfortable the OBs who are on call are with breech extractions (Baby B is breech...or was 3 weeks ago...Baby A dropped and I'm pretty sure Baby B is now approaching transverse and moving in the right direction). Anyway, I'm not giving in to the scare tactic...I'm just really mad that I'm getting it at this point! I did not carry these babies to 39 weeks just to have a completely artificial labor and delivery shoved down my throat! I would rather have a normal labor and delivery for Twin A and end up having a section for B than to forgo all normalcy all together! And who says I'm going to go into labor this weekend? Are Saturday and Sunday any more likely than Thursday, Friday or even Monday?? Sorry...just irritated!

Anyway, sorry for the rant (I feel like it's okay here ), the information that I'm looking for is about the possibility that Baby B will turn and follow her brother out the door during labor. I'm pretty confident that she will given her change in position since he has moved out of the way a bit, but I'd still like to have an idea of what I'm likely to be facing when I walk in the door. I've read that the chance of having a "combination" delivery (which is what I'm considering the worst case scenario right now since Baby A has been vertex and low for several weeks now and they're going to be hard pressed to talk me into a section for both!) is about 3-4%, which is comforting and implies to me that most breech Baby B's turn or can be turned during labor, but I can't find any good statistics. I'm a biologist, so the numbers are sort of important to me! Anybody have any links or anything for me?
post #2 of 22
What I was told is that once baby A is out it is easy to turn Baby B. One of my OBs was not comfortable with the idea I wouldn't have an epi (I ended up with a knife but that's a whole 'nother story) but all the others didn't care.

Basics: if you have an induction you are far more likely to have a surgical birth.

I don't have any numbers for you - someone will. Check out "The Thinking Womans Guide to a Better Birth" for good info.
post #3 of 22
Good numbers are really hard to find. I've heard the 3-4% chance of delivering both ways too, but I'm not sure I trust that number. The possibility is held up as a scare tactic by everyone at my hospital, but when I asked no one could remember when it was last done. (I ended up having my twins naturally at home.)

The chance of Baby B moving after Baby A is born is great. Especially if given time to do so. How long will they "let" you go between babies?

And I agree with you that I think I'd rather have a vaginal birth for Baby A, even if I ended up with a c/s for Baby B. For a bunch of reasons. But it's unlikely. And there's no telling whether you'll go into labor on Saturday or Sunday. Are the twins your first?

Way to go resisting the bullying and induction! Your babes will be more mature and better positioned if you let them come in their own time. Baby B may have turned already!

My pedi was the only healthcare provider who wished 40 weeks for me an my twins. Hope yours get all the time they need.
post #4 of 22
Thread Starter 
Thanks, Ladies! It really helps me to hear that Baby B should either turn or be turnable. I know nothing is guaranteed and that I have to be flexible, but I also know that this is my body and these are my babies and we're all entitled to some say in this process!

The twins aren't my first, but they are my first with these docs as we moved midway through this pregnancy. I set about learning a lot about the risks of intervention after the birth of my son, which was loaded with them but turned out just fine in the end (thank goodness!). My biggest regret with him was that I didn't go into labor on my own (I was 41 weeks, he was my first, and I didn't know enough to argue with the doc about induction, although I did know I didn't feel right about it).

I honestly don't know anything about the docs who will be on call this weekend, so I don't know how long they'll "let" me go between babies. All of my NSTs have been great and the babies are definitely healthy, so as long as that remains the case at the time, I feel comfortable at least asking that they give her some time. Actually, this whole "I don't know if they're comfortable with breech extractions" line was news to me. I didn't specifically ask in the beginning, which I should have in hindsight. Baby B has been breech the entire time that I've been seeing these docs, so this line of threats really should have been applied from the beginning, because technically I faced the same risk every weekend for the last 3 months! I actually find the 3-4% statistic reassuring in the face of this "induce now or face a c-section" argument...I'm quite sure that inducing increases my risk of c-section by at LEAST 3-4%, so it makes my decision to wait a little easier.
post #5 of 22
Trust your gut! There is no telling when they'll come, it could be this weekend, or it could be next week. There are a few moms here who have gone past 40 weeks, if my memory serves correctly.
post #6 of 22
I don't have any specific statistics but the midwife I'm using has had a few sets of twins (I know it's not a lot) and she said that out of the three she was there to deliver, 2 of them Baby B had turned after Baby A was out. She said she has the mommas lay on the side where baby A is during or just after delivery of A so that gravity will help Baby B's head down into the right position.

As long as Baby B is fine, you should insist that they give you time. If Baby B for some reason started to suffer healthwise, then I would go for alternatives. If anything, have the doctors try an external version to help B turn before agreeing to anything else.

Thats is my opinion anyway.
post #7 of 22
My B flipped as his breech sister was born vaginally. I began to have contractions to give birth to him 2 minutes after they cut her cord-4 minutes after her birth and was born posterior vertex (which makes sense as he was facing my back and breech....as he flipped he dove and landed face up). I, too, gave birth at home so we were comfy with having both breech. Breech was no picnic, but then neither was posterior!
post #8 of 22
Thread Starter 
Everyone,
Thank you for posting your experiences with breech babies! It gives me some mental strength to know that you've all been here and have healthy babies to show for it! You're right...I just need to trust myself and it'll all be fine...I might be "that patient", but it'll be fine!

Rachel,
Thanks for posting the tip about lying on the side that baby A is on during labor/delivery and after...that gives me something I can do at least to help keep the situation under control if needs be!

Those of you who hb'd twins,
I'm so amazed! I'm totally not a hb'er...it's just not me, but to do it with twins in the face of the current medical attitudes about hb in general is truly amazing to me!
post #9 of 22
Stick to your guns, mama! That doctor's scare tactics make me so ANGRY! Keep cookin' those babies and be proud that you made it so far.
post #10 of 22
Quote:
Originally Posted by rachel65655 View Post
As long as Baby B is fine, you should insist that they give you time. If Baby B for some reason started to suffer healthwise, then I would go for alternatives. If anything, have the doctors try an external version to help B turn before agreeing to anything else.
I agree with this completely. Somehow, you need to keep your wits about you after Baby A is born, enough to be in control and to not let scare tactics force a C-S.

Remember, your cervix will be open, there is very little chance it will swell shut or reduce in dilation after a certain amount of time, so allowing Baby B to come, even if that baby comes breech, should be just fine.

I'll be sending strong mama birthing vibes to you. Please keep us updated on you and your babes.
post #11 of 22
So you're in Philly, which seems like it would have plenty of good docs around to turn the breech baby. Forget their bullying. You are the one who has to take care of the babies for the rest of their lives, so you want them well baked...
I had my twins at home, and I completely understand being blown away by this idea, as that would have been my thoughts just a few years ago. But instead, after being followed concurrently by a peri and my mw, I felt like the best choice for our family was a hb. Baby B took 3 hours to arrive after her sister, and she did do some flipping around while alone, but came out head down. I was so grateful for being able to birth my first twin vaginally, that I would have been at peace with a ceasarean birth (if needed) for the second. I think it meant so much to me to be given the "chance" to birth them myself. I was blessed to have them both vaginally, then tuck into bed and sleep. I, too, will be sending birthing vibes your way. Please remember, that like your first, these babies may just be on a different timeline, and I would definitely let them go as long as needed.
Blessings for a peaceful birth~
Elizabeth
post #12 of 22
I would ask them (and yourself)...

Am I okay?

Are my babies okay?

If the answers are yes (and you WILL get the dead baby crap...the big "what if" or "it could happen at any moment") then you can say NO!!!

They don't want you to sue them. They are surgeons. They do not see a twin birth as a normal and natural event. And I think it is awesome that you are 39 weeks!!

Sarah
babies born at 40w3d
post #13 of 22
And FWIW: Aile (baby B) was breech at 39 weeks and went head down at 40.
post #14 of 22
Not to scare you, but I just met a new twin mamma (we had the same midwife) and she was coerced into an induction by her docs (she was doing shadow care with OBs) at 39 weeks 5 days. They over pitted her and despite NO MEDS, they ruptured her uterus! They had to go stitch her up 2 days later she lost a lot of blood.

So ridiculous! Those babies should have been allowed to come naturally. IMO she is a stud to go through the entire induction and birth with no meds!

Don't let them pull the "still born baby" crap on you. They did it to me and I still regret it.
post #15 of 22
Thread Starter 
Thanks so much for the support, everyone! None of the docs have tried the stillborn babies crap yet...these docs have had a patient go to 41 weeks 3 days before according to the woman who does my weekly NSTs, which is why I was so surprised about them suggesting the induction. The babies move like crazy, so I don't really worry that I'm in danger of that anyway. Still hanging in there at 39w3d and glad to have more or less made it through the weekend. I feel like I've made my point by NOT going into labor this weekend, so I'm in a pretty good frame of mind. I've been feeling quite tired today (even compared to "normal") and have had a little cramping, so I don't think I'll make it to next weekend, but I guess one never knows! I see the doc tomorrow for a weekly appointment and another NST (and it's the doc I like) and am confident that all will be fine.
post #16 of 22
The way I see it, MANY docs "dangle the carrot". They ask if you'd like to be induced because, well, it's easier on them than being called at 2am. If you say "yes" all the better! If you say no, welllllll.......are you SURE? Because, you know, I cannot vouch for the staff you might run into this weekend.......dangledangledangle. And Lord knows a woman 39 weeks with twins is VERY unlikely to not say "hey, YEAH, get these kids outta me!"

You're a strong Mama and these babies will come when they're good and ready. Hang in there!
post #17 of 22
Quote:
Originally Posted by Intertwined View Post
The way I see it, MANY docs "dangle the carrot". They ask if you'd like to be induced because, well, it's easier on them than being called at 2am. If you say "yes" all the better! If you say no, welllllll.......are you SURE? Because, you know, I cannot vouch for the staff you might run into this weekend.......dangledangledangle. And Lord knows a woman 39 weeks with twins is VERY unlikely to not say "hey, YEAH, get these kids outta me!"

You're a strong Mama and these babies will come when they're good and ready. Hang in there!
I think you've hit the nail on the head! Even with my singleton, when I was found to be in early labor at my last ob appointment, the ob offered to admit me right then so I could have my baby that night. Thank God I knew enough to decline, as it still took another day of early labor before things got going.
post #18 of 22
And you should be prepared to have the NST NOT go well...or all of the sudden you have a low AFI (amniotic fluid index) where it was fine before....all of these things are highly subjective and tend to not lean in your favor when you are being pressured to be induced.
post #19 of 22
Thread Starter 
Just wanted to update after my appointments today. I did NOT get to see my preferred doc today as she was delivering a baby at the time of my appointment, but I did tell the doc I saw that I was not presently interested in induction unless a problem developed. He said he wasn't going to argue with me, so I feel good about it. My NST was great again, so we're back to waiting. 39 weeks 4 days and counting.
post #20 of 22
Quote:
Originally Posted by hmbill View Post
Just wanted to update after my appointments today. I did NOT get to see my preferred doc today as she was delivering a baby at the time of my appointment, but I did tell the doc I saw that I was not presently interested in induction unless a problem developed. He said he wasn't going to argue with me, so I feel good about it. My NST was great again, so we're back to waiting. 39 weeks 4 days and counting.
Good for you!
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