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When Baby A is vertex and Baby B is breech...

post #1 of 31
Thread Starter 
I am looking for some insight from moms who have btdt. I am also x-posting on the midwives board. I don't know where my babies will be as I approach term (they're still turning somersaults at this point :LOL ), but I am interviewing an OB and a homebirth midwife next week in the city to which we are relocating. While here in NC I am seeing a family practice doc I really like. When he and I talked about the kinds of questions I should ask possible providers he really stressed asking how they handle the birth of the second baby should he be breech. He talked about turning the baby vs. manual extraction. I asked about just waiting for the baby to descend and let him be born breech? He said his concern about this is that it usually takes awhile (upwards of several hours) and that a lot of blood can be lost during that time. He really didn't think it was an option. My doctor's primary bias was that manually extracting the baby is unnecessarily painful. He said that he usually just turns the baby externally.

So, how was this handled at your birth? I pictured nursing and bonding with the first babe for a bit and then pushing out the second. Is that unreasonable?
post #2 of 31
I had a vertex and breech labor. Luckily for me baby girl A was vertex and could be delivered first. Baby boy B was breech, but turned once his sister was out of the way. My doc said he could turn baby b after A was delivered, or I could do a breech delivery.
post #3 of 31
Thread Starter 
PD: Can I ask how much time elapsed between the first baby's birth and the second's? Just curious.

I am beginning to think that my doc is just a little conservative on this issue.

post #4 of 31
My Baby "A" was born vertex, and 4 minutes later baby "B" was born footling breech by extraction. I was given an epidural when I hit 4 cm. dilated because the OB that was on call at the time wasn't comfortable doing a breech extraction and would have had me deliver in the OR under the circumstances I ended up in. However, I was lucky and she went home around 5:30 PM and the doctor who came on and delivered my babies was comfortable doing a breech extraction. The pain wasn't an issue for me since I had been given the epidural. I did have a small episiotomy though. It certainly wasn't my "ideal" birth but it beat having a c-section which was my only major goal!
post #5 of 31
With my boys, my breech baby B turned on his own after vertex baby A was born. They were 6 mins. apart. I think the plan was to proceed with a breech delivery had he not turned.
post #6 of 31
Thread Starter 
It's great to hear about the second baby turning spontaneously sometimes.

Thanks for the responses! Keep 'em coming!!
post #7 of 31
Originally Posted by Ellie'sMom
PD: Can I ask how much time elapsed between the first baby's birth and the second's? Just curious.

I am beginning to think that my doc is just a little conservative on this issue.

First baby came at 2:54 am and baby two at 3:03 am
post #8 of 31
Add me to the list of those interesting in hearing these stories -- right now Twin B is vertex and low and Twin A is breech and high under my ribs (ouch). My OB said vaginal birth is preferred in this case, but I will ask about manual extraction vs. waiting for breech to deliver or babe to turn.

I'm almost 29 weeks -- what are the odds that they will move between now and when they come??

Thanks for your help.
post #9 of 31
With my girls Kyra was head down the entire pregnancy (twin A) and Emma (twin B) was breech. I was set against a c-section and my ob was very confident that once Kyra was delivered Emma would turn on her own or could be turned. She did turn on her own but unfortunately there was a prolapse in the cord that cut off her oxygen when I would push so she ended up being taken via emergency c-section.
post #10 of 31
My OB and I discussed this type of delivery (though I ended up having a c-section). She said she would deliver A, then deliver B breech. However, she said that all of the other docs in her practice would deliver A, then do an external version to turn B before delivery. She recommended an epidural in either case because she said that turning baby B would be very painful, and that way I would be ready for an emergency c-section if necessary.

I tried moxibustion (an accupuncture-related technique) to try and better position my babies for a vaginal birth. However, I waited till 34 weeks and I don't think there was any room in there for them at that point! I felt a tremendous amount of movement during the treatments, so it might have worked if I had tried earlier. You could also explore a chiropractic treatment, the Webster technique, which I also tried, but felt was less successful for me personally.

Good luck!
post #11 of 31
same here... my OB said that as long as baby A was vertex, she would deliver baby B breech if he happened to be in that position and was willing to give him ample time to descend all on his own. as it was, most of my pregnancy they were vertex/breech, with baby A in the vertex position. then, at 36 weeks my water broke and the ultrasound showed that they were now transverse/breech with no way to turn them.... so off to the operating table i went.

i would say to those who are pg, just be aware that your babies may make last minute position changes (God only knows how, considering how cramped it is in there...) and you might find yourself having a C-sect after months of anticipating a natural birth. just be aware that anything can happen with twins and usually does... of course, that doesn't stop once they're born either, i've discovered.
post #12 of 31
Hi, I'm brand new here. I have twins that baby a was vertex and baby b was sometimes transverse and sometimes breach (he moved ALOT). Baby a came out fine, but they lost baby b's heartrate on the monitor and when they found it, it was really low, so they manually extracted him breach. He has turned out fine, though. And they were born 6 minutes apart.
I delivered at a small community hospital with both OBs there when I delivered, and it was in the OR, not the normal birthing room.
post #13 of 31
Thread Starter 
Thanks again for the replies! It seems like there is lots of variation. I am various interested to hear what the midwife and OB I am interviewing next week have to say about their practice.
post #14 of 31
My Baby A was vertex and Baby B was transverse...amost a full breech. My OB said as long as Baby A stayed head down that we were going for a vaginal birth. He said he would attempt to turn Baby B to vertex if she didnt' do it herself after Baby A was born. I was induced due to high bp at 38w3d. I too had an epidural at around 4 or 5 cm's and had to deliver in the OR (which sucked). Baby A was born with a few pushes...I got to reach down and pull her out and onto my belly! I held her a few moments and then they got the ultrasound out to see what Baby B was doing. She didn't flip on her own so one OB (there were 2 there) turned her from the outside while the other had his hand inside of my uterus holding her cord back so that it didn't prolapse. She flipped rather easily and I began pushing her. She was born 47 minutes after her sister.
post #15 of 31
Both of my babies were vertex heading into a natural delivery. Then after Baby A was born vaginally (no meds / no interventions), Baby B became transverse, with his feet kind of hanging down, threatening to become a footling breech. We tried a few things, but they were early and no one was interested in messing around too much. Out he came via c-section.

Statistically, "Baby B's" don't fare as well as Baby A's, because their placentas can detach, they're more likely to be breech or otherwise malpositioned, their cords can prolapse, their presentation can change right after the birth of Baby A (there's so much room in there afterwards they can float around!), etc..

Twins run in my family... strongly. But my twins were the first (in our memories anyway) in my family to survive. They were all born early or had problems during delivery. In the end, I didn't care how they came into the world... the fact that they're here and healthy is enough for me.
post #16 of 31
My babies were vertex/breech when I delivered. Lexie (A) had been vertex for quite awhile, Ashlyn (B) was still somersaulting the week I delivered. My ob recommended an epidural because of the uncertainties involved when Baby B is breech so we did get the epidural (by the time they got around to administering it I was (IMO) complete) & the hospital I delivered in required twin deliveries to be in the operating room so we did that as well.

Once Lexie was delivered, the ob broke Ashlyn's bag of waters (quite frankly I wasn't up to laboring for any length of time in the OR, though I'd planned to ask the dr. not to break her bag of waters (I ended up delivering w/ an ob I'd never met before that day)) & Ashlyn's feet literally washed out w/ the amniotic fluid. She was born footling breech 4 minutes after Ashlyn with no complications.

I think the important thing to remember is that there are so many unknowns, you need to plan for the possibility of complications but many/most deliveries will go off w/o a hitch regardless of baby B's positioning
post #17 of 31
My baby A was vertex and baby B was transverse/vertex... But let me tell you, I grilled and grilled every doctor or midwife I came into contact with to find the practice where I'd have the best chance to deliver naturally, in the regular labor room, even with breech presentation.

Another tip for you (don't know if it helped me or was just coincidence that it worked out this way)... Be a butthead about being as upright as possible during labor and delivery. Especially after baby A comes out, when baby B has lots of room suddenly to flip around. That's when they try to lay you flat on your back and do an ultrasound to see how baby B is positioned. I refused to lie back. And when I did lie back as much as I would (they were insisting they needed me back farther, farther, farther...), I just made sure my pelvis was shifted forward. (see www.spinningbabies.com)

Also, after my water broke at home, I spent all my time either on the toilet, on the birth ball, or sitting in the car. Basically, upright and pelvis forward.

My babies came 31 minutes apart. There was no urge to push baby B out until 30 minutes after baby A... Then baby B's water broke and he came out easily in one push.
post #18 of 31
Thread Starter 
Well, I met with an OB and a homebirth midwife this week. Thanks to everyone for sharing your experiences. It really helped me to envision the various possible scenarios so that I was able to ask informed questions. The midwife was awesome and I am so excited to be planning my homebirth! I will be seeing a homebirth-friendly perinatalogist for parallel care.Thanks again to everyone!!
post #19 of 31
I'm 20 weeks along and my baby "A" (boy) is pretty snug and comfy lying transverse and low with his back across my cervix. Occaisionally he flips over and I can feel him kicking around in there, but mostly I think he just kicks his sister. Baby "B" (girl) is mostly head down and higher up. I'm wondering how much time they will have to get into a more favorable position. I Know they can decide to flip around whenever, (one woman told me her baby B flipped breech at 39 weeks!) But it just looks to me like whenever he runs out of room lying transverse he's perfectly lined up to settle in breech, and then its off to the OR I go. Is there anything I can do to try to encourage him to go head down, and at what point should I start that?
post #20 of 31
I delivered my twins at 33 weeks my daughter Britney was vertex the whole way throughout my pregnancy my son Tyler was breech the whole way, delivery day came and Daughter was born at 10:24am no problem then came Tyler my ob tried to turn Tyler externally and internally but he wasn't moving no way, so he was delivered breech with forceps at 10:33am it really wasn't bad.
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