Birthing Twins- vaginal AND section?

[ThankfulMama]

I am really praying that this PG proceeds smoothly and am looking ahead to birthing (not as in I'm hoping to get there soon, but as in I want to be well read and thought out beforehand).  I really really want to birth the babies naturally.  In fact, I am scared of a section. I had a beautiful natural labor and delivery with DD at 39w6d and was so very blessed.  I hear people talk a lot (mostly on other sites, I think) about not wanting to recover from both a vaginal birth and a section.  I'm a bit perplexed about this--I would much rather have the babies vaginally and I just can't understand why people would say this.  Wouldn't it be much better to have at least one baby vaginally than both via section?  Maybe I am missing something???  I felt great after birthing DD--its the section I'm terrified of.  Really really --I can't imagine epidural, incision, not being able to hold them right away, drugs, etc.  It sounds like a nightmare.  Anyhow, I'm just wondering if there is something I should know about this in the event that I face a section. . .

TIA!

[rinap]

Originally Posted by ThankfulMama 

Wouldn't it be much better to have at least one baby vaginally than both via section?  Maybe I am missing something???  I felt great after birthing DD--its the section I'm terrified of.  Really really --I can't imagine epidural, incision, not being able to hold them right away, drugs, etc.  It sounds like a nightmare.  Anyhow, I'm just wondering if there is something I should know about this in the event that I face a section. . .

I was very lucky to be able to have a vaginal birth for my twins. And I worked really hard to make that happen.

And I decided the small risk  of having both was worth it.

But while I totally understand not wanting a c-section, it wouldn't be better to have both a vaginal birth and a c-section. Because then you have the epidural, the incision, the blood loss, the drugs, not being able to hold them *AND* the exhaustion from labor, possible tearing, etc from the vaginal birth. You basically have to recover from two wholely separate processes. And that's far harder than recovering from only one. And you don't get the vaginal birth advantage of no drugs in your system (though the first baby skips the drugs) or being able to hold either baby.

(also, at the hospital I delivered at, I was required to have the epidural before the delivery...they didn't give me any drugs,  but I did have the puncture)

[ThankfulMama]

Thanks for the reply.  I was thinking that the first baby would at least have the option of going down the birth canal and no meds and that might help that babe with breathing and BFing, etc...  When you say you worked hard to have natural birth, do you mean advocating for yourself or doing certain things to increase your likelihood?  If so, what?

ETA Oh, and whats the real deal with a spinal?  Can't it be done quickly instead? trying to find info here...

TIA

[rinap]

The question on the spinal will have to be for your doctor/hospital/anesthesiologist. It wasn't an option that was available to me.

Yes. That does mean the first baby gets to go down the birth canal. My babies had trouble breastfeeding even though they went through the birth canal, though.

I mean:

1) Advocating for myself

2) Having my husband and a doula there to advocate for me

3) Picking my OB very carefully to find one who prefers vaginal birth

4) Doing everything in my power to delay the birth to as close to term as possible

5) Eating mad amounts of protein and fat to build big healthy babies

6) Exercise (this one didn't work as well; I went on bed rest well before term, so my exercise was limited to what I could do in bed)

7) Dealing with the emotional baggage that went along with having less control than I would have liked.

[EonJourney]

I had a c-sect at 36 weeks and the recovery was easy. I dreaded the c-sect but I survived and the twins breasfed immediately. 1 had nicu time and both were super sleepy but we persisted and now 3 weeks later I breastfeed both at the same time with no problems. I hiked 2 hrs 9 days post c sect w/no pain too.

[ThankfulMama]

Thanks mamas.  I appreciate the time you took to respond.

[queenofchaos]

Sad to say, but your healthcare provider (whatever the title) has a huge impact on the birth.  There are a lot of variables that go into birth and it's double with twins.  Plus there's considerations that don't exist with singletons.   

I was very blessed with a doctor that had experience with breech births, and multiples births.  Baby A was vertex, and B was breech.  If A had been breech it would have been automatic c-section because my dr wasn't comfortable with delivering with the first baby being breech, even if the 2nd one was vertex.  However, I was fully prepared for the possibility of Baby A being born vaginally and Baby B being born by c-section, given the position of my babies. I can totally understand you wanting a natural birth and being scared (I had 6 kids before the twins and all vaginally, surgery scared me to death.), but I would listed carefully to your dr.  Be careful not to push too hard for something he/she feels is not reasonably safe.  You may to do some shopping around until you find the person who suits your needs and desires most appropriately.  See if there a twins group in your area and find out from those moms who the go to dr is.

Oh, and I wanted to edit this to add, if you are planning to breastfeed, get in touch with your local LLL and also see if there's any moms in that twins group who Bfed, with or w/out c-section recovery.  TBH, I am not sure that the method of birth has as much influence on b/fing success as some might think.  Both my babes b/f like champs fresh out of the womb, but then a couple hours after birth, Baby A started developing some latching issues.  My DDs are 16 mths now, and I still can't figure out why, but of the two, she is the one that is a little more problematic in the b/f'ing dept than her sister.  Go figure!  

[ThankfulMama]

thank you!  Im praying I make it to term or very close and that both are vertex. not sure what the odds are of that. I think a vaginal birth with intervention scares me equally (forceps, vacuum) so im praying.  What are the odds of both being vertex?

[rinap]

The odds are very good for both babies being vertex (but probably a little worse than for singletons). The odds are also very good that if the second is breech, they will either turn after the first is born or be easier to turn.

But definitely on the advice to shop around for providers.

[ThankfulMama]

Thanks.  I wish there was a Henci Goer -like book for multiples.  I guess I can't recall if she addressed that in the Thinking Woman's Guide.  I need to revisit perhaps...

[rinap]

She doesn't really address multiples, and I had to be careful when reading it; it's really very negative on interventions, and I was feeling trapped enough. But it's a good book (if it doesn't make you dwell), and has a really good chapter on what you should do if you're going to have a c-section. I read that very carefully and it made me feel more prepared. (and luckily didn't need to use it, but it helped to have a set of positive things to focus on)

[ThankfulMama]

Thanks.  I feel so blessed to have these two babies but also so scared of the unknown. I really appreciate your responses,

[Miraj]

Hello! I wanted the benefits of a vaginal birth for my twins, and had back up plans for emergencies etc.  I birthed twin 1 vaginally without any help or drugs, just a small tear that I declined suturing.  Labour stalled so i waited nearly 24 hrs for Twin 2 before considering induction of labour. But twin 2 became transverse do I had a c/s.

No regrets here, apart from not knowing how yucky an epidural can make you feel! My recovery was complicated with slow milk issues (possible link to surgery, epidural or blood loss), but the recovery from the vaginal birth was no issue. 

[ThankfulMama]

Thanks!  It helps to hear that.  Meds make me nervous and I HATE feeling numb so an epidural sounds just awful for any reason.

[OGirlieMama]

This is an oldish post but I'm not on here much lately, and you're still pregnant, I assume, so it might be useful. My twins were vertex-vertex when I went into labor at 29 weeks (after two weeks on the high risk antepartum unit with bouts of PTL). I birthed baby A vaginally, and baby B folded herself in half. I heard "I feel B's head. And hands. And feet. And they're all in the same place." She wasn't in severe distress but had a few decels and they told me she needed to be born by c-section, even though it wasn't emergent then, it would soon become so. I consented and definitely think it was the right decision.

Both babies had respiratory distress syndrome, as is common at that GA. But Baby B had more severe RDS and required oxygen for the first 6 months of her life. We'll never know if that might have been better had she been able to make it down the birth canal, so it's impossible to draw any firm conclusions, only inferences.

My recovery from the c-section was quite painful, and according to friends who've both pushed and ended up with a c-section (with a singleton) and then had a scheduled c-section, the recovery was much easier with the latter. I still wouldn't trade my vaginal birth for anything, both for my baby and for me, especially because I'm not doing this again! The one upside is it makes for one hell of a story, and possibly makes people think twice before inviting me to baby showers. ;)

[mylilmonkeys]

Originally Posted by OGirlieMama 

This is an oldish post but I'm not on here much lately, and you're still pregnant, I assume, so it might be useful. My twins were vertex-vertex when I went into labor at 29 weeks (after two weeks on the high risk antepartum unit with bouts of PTL). I birthed baby A vaginally, and baby B folded herself in half. I heard "I feel B's head. And hands. And feet. And they're all in the same place." She wasn't in severe distress but had a few decels and they told me she needed to be born by c-section, even though it wasn't emergent then, it would soon become so. I consented and definitely think it was the right decision.

Interesting.  That's exactly what my B did.  The midwife told me she had "jack-knifed."  We weren't in the hospital, so one of my midwives had to reach all the way up behind her butt and guide her out, forcing her head under the pubic bone with her forearm on the way down.  She just wouldn't budge otherwise, and both placentas had come down over my cervix after A, decels, etc.  A scary, scary ordeal, but we all made it!  And yes, I have a pelvis you can drive a truck through.