Scheduling section for breech twins

[abowin]

I am 37 weeks with di/di twins.  So far I have had a very uneventful pregnancy.  The only unfortunate thing being that baby A switched to breech at 28 weeks and has not turned back.  My OB would have been comfortable with a vaginal delivery as long as A was vertex.  Now I've gotten to a point where they want to talk about scheduling a section.  She initially suggested 38 weeks but after I asked whether I could wait a little longer said that she would be willing to schedule it for 39 at the latest.  I'm fine with 39 (although the thought of going 2 more weeks sounds like hell).  So, from my understanding the advantages of waiting a little longer would be that the babies might be more ready, they might be better at breastfeeding, and my body if it goes into labor before then might be more ready to breastfeed.  Possible disadvantages, according to OB are that I could develop pre-e or if my water breaks I might get a prolapsed cord (since they're breech and the head wouldn't block the cervix).  Then of course she brought up the whole placentas getting old thing which kind of sounds like bunk to me.  I mean, it just doesn't seem like I'm a lot more likely to develop these things at 39 weeks than 38.  I think my husband would like to compromise with 38 1/2.  Also, somehow my age factors into this as well (I'm 37).  I think if I don't develop any issues between now and my next appointment there is no reason to schedule it before 39 weeks.

What do you ladies think?

[kjoy2]

I agree with you!  If there aren't any problems, there's no need to create any.  The more cooked your babies are, the better it will be.  If your gut tells you to go to 39, do it.  If you go into labor before then, I'm sure you'd be able to get to the hospital and have a c-section before the *very unlikely* chance of a cord prolapse.  It sounds like you have your head squarely on your shoulders and you know what you think is best.  

FWIW, my babes were born at 42 weeks and the placenta did not look 'old' at all. 

I hope everything goes well with their birth, breastfeeding, and recovery.  Enjoy those babies.  

[Red Pajama]

Having had 38 week twins, and a 40 week singleton, I recommend 39 weeks as an excellent compromise.

[Shuli]

I was always going to have a c-section because the boys were transverse the whole pregnancy. At 37 weeks one went into distress so it was more of a planned emergency than a real emergency. The advantage of doing it planned was that my DH could be in the OR with me. If it would have been a non-planned, I would have had to go it alone - so there's an advantage to having it planned. We spent a week in the NICU with one and it was horrible - he was just small so that's why he was there. The longer you wait the better and the less after care both you and the babies will need. Just by the way, I started pumping two hours after surgery as soon as I left recovery and I had more than enough milk and EBF for 18 months, your body will know what to do.

Good luck!

[ladydodson]

i would wait until i went into labor for sure if just going ahead w/ the section. and being on the other side of my double breech birth, i would find out just how much breech experience your doc has and gauge it from there. its another variation of normal.

[SympatheticDad]

Originally Posted by ladydodson 

i would wait until i went into labor for sure if just going ahead w/ the section. and being on the other side of my double breech birth, i would find out just how much breech experience your doc has and gauge it from there. its another variation of normal.

The "breech is a variation of normal" statement sort of infuriates me because it is so content-free.  Twin births are already inherently higher-risk than singletons.  Vaginal breech births (of singletons) is associated with a higher risk of perintal and neonatal infant mortality than elective C-section (source: http://www.sogc.org/guidelines/documents/gui226CPG0906.pdf).  Please, please, don't go to the Internet for health advice on this.  Consult with your doctor and ask her advice.  If you don't trust your doctor, then find a new doctor who you trust.

[~Adorkable~]

wanting to check in and see how the thread started is, has anyone heard if she has had her twins yet?

my general a dive is to trial labor because that aryl labor is a chance for the babies to turn, if it does not look like that is happening you have plenty of time to waltz back and do the c section, labor is not usually the rushed screaming thing folks see on tv

[abowin]

Hi,

Sorry it took me a while to check back in.  Thank you for your replies.  

My water broke on 1/11, they did an ultrasound at the hospital and they were still both breech so our girls were born by c-section at 37 weeks 6 days.  They weighed 7lbs 5oz and 6lbs 6oz.  One of them had blood in her stool and had to spend a little over 24 hrs in the NICU until testing proved that it was my blood she had swallowed when her water broke.  They had some weight issues along with jaundice and the ped made me switch one of them to only formula for a day and a half.  The other I supplemented with breast milk that I pumped.  I've had them completely off the formula for about four days and am starting to build a stash of breast milk.  The baby that was in the NICU and that had all the formula is taking a while to learn to breastfeed.  I try her a couple times a day when she's awake and in a good mood but it's hard because the other baby sometimes wants to feed every hour to hour and a half during the afternoon and evening.  We got a lot of help from the lactation consultants at the hospital but I think I need to have someone come out to the house now.  If any of you ladies have any words of wisdom about how to transition her off the bottle, I would sure like to hear them. My biggest issue is just finding the time to do everything and still keep my sanity. There's been a lot of screaming in the afternoon/evening.  We can't tell whether we're not feeding them enough or if it's just tummy problems (diaper counts are good and last appt at ped showed a lot of weight gain).  

Thanks,

Amy

[Shuli]

Try the Haberman Feeder. That is what we used with both our twins and our singletons. I think it elimates some of the nipple confusion because if you don't suck, you don't eat and it's just not a bottle dripping milk into them. You can find more information here http://www.mandyhaberman.com/haberman-feeder

When our twins were first born we couldn't get it in our area, so we asked my MIL to order it for us from England. Now we can get it here and I used it for my daughter as well. Just keep trying the breast and I'm sure with help from a lactation consultant it will all be well.