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Trying to wrap my brain around this twin birth thing

post #1 of 22
Thread Starter 
OK, say Baby A is head down and I have a vaginal birth. I push him out and then... my imagination is having trouble filling in the rest. I'm assuming I can't hold him and nurse him right away because, God willing, Baby B will be on her way out. So what does it look like in the delivery room when you're having twins?
post #2 of 22
I got to hold my baby a for about five or ten minutes. I nursed her for a little while until the contractions were too tough for me to concentrate on anything else, handed her off to my husband, and then my baby b came out. But, I have heard stores where baby a hung out for thirty or forty minutes with mama before she had the urge to push out the second.

But, what does your provider say? Are they going to let you hold you first baby if you can, or are they just going to focus on the getting the next one out?
post #3 of 22
Thread Starter 
I don't know. My midwife said to come up with a birth plan/idea of what I want and then we'll talk about it.
post #4 of 22
I asked my dr to please give me a "script" for how this might go because i couldn't figure it out either!

My Baby A is head down; B is breech. She said that typically the interval is short between births because she does do a breech extraction of B. If he's already descending, then she will wait. But it was clear from our talk that for twins that share a placenta (as mine do) she's more comfortable if we don't wait too long. I got the impression that for di-di twins she might proceed less conservatively. For 2 vertex presentations, she said she would wait and proceed just as if B was another separate birth-- no special interventions.

I dunno... on the one hand, I don't like the idea of directed pushing or any kind of manuevering. On the other, she IS one of the most experienced drs around here in breech vaginal births and twin births and I truly do respect that. She also said that in 10 years of practice she has only once had a vaginal delivery of A followed by a surgical delivery of B-- and that was for an abruption, not positioning/breech issues.
post #5 of 22
Thread Starter 
My midwife actually has twins, so I really trust her. Each baby is in its own sac and has its own placenta, so that's good.
post #6 of 22
At my birth, I consented to be in the OR during the birth. I push and birth laying on my side and there isn't much room on the surgical table. I was lucky because they had recently installed wider, padded surgical tables in the birth center OR's.

My boys both had some breathing problems shortly after birth so I saw them by picture on the cell phone first. There was 28 minutes between them but it felt like it went much quicker. Then they were wisked away to NICU for a few hours.
post #7 of 22
Annette, I"m due right with you and in the same boat. I'm not sure what to expect either.

I know a delivery in the OR doesn't mean you labor in the OR. You labor in L&D and when ready to push they move you to OR.

Then you'll have anesthesiologist there just in case of a crash section. Your doc plus a nurse for each baby. I'd look into hospital policy as well. Even full term my hospital still wants NICU present. Ummm hecks no. IF we deliver at hospital (Which its not the plan)... NICU can wait outside the OR. People inside the OR will be kept at a minimum. The only thing I'd ask about is pushing in other positions and how it would be possible in the OR. Since those tables really are small.

For us even having a homebirth the idea of having another after having the first just isn't wrapping around in my head.
post #8 of 22
Thread Starter 
Moving when I am ready to push would annoy the crap out of me.

I think they told me they have an "in between" room that isn't a regular L&D room but isn't the OR either. I think. Everything is fuzzy lately.

From what I understand the "cast of thousands" at a twin delivery is fairly standard here as well.

One way I'm really blessed is that our practice hired a new midwife. I have really clicked with her and she's had a twin vaginal birth/breastfed twins herself.

The placentas confuse me as well. So, I have a baby, have a placenta, have a baby, have a placenta? That just seems so redundant to me.
post #9 of 22
From my understanding. You can do it have a baby then placenta, then baby then placenta. Or you can have baby, baby, placenta, placenta.

I'd be sure to ask specific NICU policies. Our hospital requires twins to visit NICU even if full term and appear healthy. (grrr). I would also ask about 3rd stage policies for twins. Midwife or not some places specify active management for twins. (Immediate cord clamping, pit, etc).

For us we're just hoping to stay home. If we have to deliver there I'm planning on WHOOPS it happened to fast to move to OR. Or birthing in the room directly next to the OR for a fast transfer if necessary. If we deliver there early then obviously we'll just go with what we have to. But full term with no complications there I'd be putting up more of a fight.

I guess you need to figure out what is important for you and your hubby and start with that first. With twins your going to really have to pick your battles as there is so much that they want from you i'm sure its about impossible to get 100% your way the whole time.
post #10 of 22
I've only had twins once so I'm not expert but this is what I did (or what they did I guess!)

Baby A- vertex. Birthed, held for a while, but I didn't nurse her right away because I wanted time before contractions started up again. Baby was transverse but I had a person on each side of me while birthing Baby A and they sort of maneuvered her into a better position. I was mostly ignoring them. After about 30-40 minutes they suggested I nurse Baby A if I was ready to start on the next. So I did. She nursed and immediately I started having contractions. I held her until I wanted to push (and yell!) and then I handed her off so I wouldn't scare her with my sounds. She was born very quickly after that. I thought it would be more painful, after having just done it with baby a, but it felt rather soothing in all honesty. A bit like salve on a wound. I think the time difference was 47 or 57 minutes.

I held her for a bit and then my partner handed A back to me also. This was good for a bit until I asked them to check my bleeding. I had been chatting with a nurse who recognized my name and we were talking racing stuff/people/places, etc and no one realized just how much I was bleeding. So I had some help with the placentas and then quickly got some pitocin shots, iv set up for pitocin and something placed up my bum to help with bleeding.

I had feared being pushed to have them too quickly. The time I had was perfect for me. I dreaded having two more children. My birth plan was that the babies would be born and DP would take them. I didn't even want to hold them. Well, that all changed pretty quickly. I pulled Baby A up to my chest and think I said "It will be okay. We can do this." about 50 times. It helped having a solid healthy 8 1/2lb baby to hold. The actual birth of the twins was far easier than the pregnancy or the labor.

As for the crowds. Yup. My other kids were born with a nurse and a MW. These girls had- MW who didn't have enough births at the hospital but was our MW, her MW mentor who I HATED and actually asked to leave at one point after she commented on my breath (after 40+ hours of labor mind you!), the OB they worked with because I wouldn't go to the OR but was in a regular L&D room, two nursed for each side of my belly, a nurse for each baby, and a nurse for me (actually two because of shift change.) Oh, and the maternity ward director, because I was the first person to birth twins outside the OR. That's 10 people. Plus me, dp and then two babies. It felt like a crowd.

Really, if you've had other drug-free, vaginal births, this birth won't feel much differrent. But don't get me started on labor....
post #11 of 22
Thread Starter 
Well, for me it might all be a moot point.

The babies have their two little heads together. Baby A is footling breech and Baby B is transverse. They're in there like a little number 7. They're estimating A to be 4.5 pounds and B to be 5.1. Even given the fact that US weights can be off, there's not a whole lot of room for them to move around in there.
post #12 of 22
No, no, no. Don't think like that.

My girls were 8 1/2 and almost 7lbs and were moving around until the last minute. I had a failed induction before actually going into labor, so that last week I felt like I lived at the hospital. The babies were being watched pretty closely. A was always A and vertex, and B was always B but A kept moving from her belly facing forward feet toward my right armpit (Gosh, all those terms drain so quickly when you no longer need them!) to her facing backwards with her feet on the other side. B was mostly transverse with her head on my right side but her body was flopping all over. And this was seen during the 3 days of failed induction just a few days before birth. I didn't feel any of it happening either.
post #13 of 22
They might change position, it seems like mine were flip flopping quite a bit towards the end of my pregnancy.

My OB was adamant about delivering both placentas after baby B made his exit. I had two placentas but there is still the possibility that they could be fused and trying to deliver A's would be dangerous. The cord was just hanging out while B was born. My duo were 36 minutes apart, once A was born my OB used a portable ultrasound machine to see if B had flipped or not (he was tranverse going into the delivery). He did move head down and using external pressure he was guided down lower.

As far as holding them after delivery, my baby A needed some encouragement to pink up and breathe, so after I saw her she was whisked away with the pediatrician and a nurse. Once baby B was born I saw him for a few minutes before I had to start pushing to deliver the placentas, then I was in the OR for an hour getting some repair work done. I sent my husband off to be with the babies in the next room while this was happening.
post #14 of 22
My DS changed position on the last day before he was born. We had an ultrasound at 36 weeks 5 days, and he was frank breech. 24 hours later, on the OR table, he was discovered to be transverse. It didn't much matter, really, since I was a c-section candidate for like a zillion reasons anyway. But it does prove that they CAN and DO move very late, even when they're already pretty big. They were just over five pounds, and 6 1/2 pounds.
post #15 of 22
Yup, mine were flipping around till the last minute too.

My twin birth story is here:

http://www.mothering.com/discussions....php?t=1214085

I didn't know what to expect either, but it was awesome.
post #16 of 22
Thread Starter 
Thanks!

I know they still have room to move; I think I was just feeling kind of "GAH!" because I really thought one was heads down.

It doesn't help that my husband has said he would almost prefer I have a c-section. And before anyone crucifies him he isn't pushing me or even pretending like he has a say in it. I think he's worried about me, especially the possibility that I could end up having a section even after one baby is born vaginally. And he's really concerned about me bleeding, which has been an issue before. Most of all, I think in his mind a section would be more controlled and controllable. I'm really not there, and would certainly (a) not have one unless I had no choice and (b) not have one just to make him happy.
post #17 of 22
My girls were born at home less than 5 minutes apart.

I held my baby A for less than 2 minutes before I felt the need to push again - it was the very next contraction after Anna was born. She had a short cord so they cut it and the wanted me to get out of the tub because I was bleeding a bit too much but that contraction hit me and I couldn't.

I was pushing so hard with baby B, Emma, but she wouldn't crown. Midwife reached down and Anna's placenta had detached and had slipped down next to Emma's head and she couldn't be born. The placenta was pulled out of the way and Emma came right out.

The placenta's had been fused, we could tell afterwards. Emma was born and her placenta had come right out with her. She also had a short cord.
post #18 of 22
AFAIK, most twins end up with a fused placenta, if there's more than one.

My twin vaginal hospital birth went like this:

1. I labored in a "high-risk" room (no bathtub; more contact with staff)
2. when baby A's water broke I felt ready to push, and I was immediately wheeled to an OR (incredibly annoying to be moving when I wanted to stop and push!)
3. there were 25325352 people in the room.
4. baby A came out vertex and I saw him briefly, but I was still in hard labor with baby B, so I couldn't really focus. Plus they were born at 34w and needed NICU time.
5. My water broke with baby B, and his foot slid out. All 2335325325 people in the room yelled at me to push, and I pushed him out, as a single-footling breech.
6. I saw them both for a few minutes before they went to the NICU.
7. I birthed a GINORMOUS placenta.
8. I "recovered" for a while, and then went to the NICU to see them and hold them and nurse them.

I can't believe it's been nearly 8 years now!

Btw, I think my ignorance was bliss. If I'd known what I know now, I would have been stressing about everything. My mantra was just that I wanted a vaginal birth. I was a single mom of twins, and I knew that recovering from surgery AND being a single mom would be too much.
post #19 of 22
I was doing the same thing before the boys were born. I would try and try to envision it and just had no mental image to go on. I looked up birth videos online but all them had an angle to them were the babies just emerged from beneath the mom like magic. I have never wanted to see an up close camera view of a birth so bad before.

For what it is worth this is my birth story: http://www.mothering.com/discussions....php?t=1273507

But from what I have been reading things are SO different based on how the babies are positioned, hospital policy and all that sort of stuff and if you throw preemie into the mix you get a bunch of other things going on...

Sorry I couldn't have been more of a help. I will be thinking and praying about you and hoping that your little ones come in a way that you hope and plan.
post #20 of 22
Thread Starter 
Thank you for sharing that-- I was actually reading it earlier and thinking "Wow, how amazing!"

And yes, you said it exactly. I just can't get a mental picture. To be honest, I can't get a mental picture of what having two babies will be like either. This is just all so outside my experience.
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