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inducing labor with twins?

post #1 of 13
Thread Starter 
I am 37 weeks with twins. Unexpectedly, they are now BOTH vertex (this was not true earlier), and they are also both doing well--growing, good blood flow, etc.

I also feel pretty good, considering I'm this far along with twins!

So here's my question: my doctor likes to deliver twins at 37-38 weeks; she had previously planned a c-section for December 1, when the babies were in weird positions and it looked like a c-sec would be "necessary"...I don't want to get into a discussion of her definition of necessary here...My question is about how to deal with having a natural delivery in these circumstances. I bet she's going to want to induce by December 1, if nothing is happening, and I know there can be major problems with induced labor.

Can someone help with how, exactly, to talk with my doctor. We are on good terms; i have really tried to keep a good, friendly relationship with her. Her philosophies about pregnancy and taking care of myself are quite good, and she has listened to me a lot throughout the pregnancy, which is why I've stayed with her. BUT her ideas about delivery are really medical/surgical. I need help with how to talk with her without ruining a decent relationship.

I know I can deliver these babies naturally, and I feel so excited about the idea of sharing this experience with my DH and my mom, but I don't want to antagonize this doctor whom I really like and who has been available and open with me all along.

post #2 of 13

Are these your first? My doctor was greatly relieved when he heard I delivered my 9 pound son (with a head in the 97th percentile) vaginally -- he said "twins will be no problem after that" and it was true -- it was a much easier delivery.

Do they have a sense of how big they are? I know US is often wrong, but if the ballpark range of their weight/head size is the 7 poundish (or less) and they don't have HUGE heads, it should make for an easier delivery. Even if it's your first, I have heard that the weight of having two in their can make labor quicker, etc.

Do you want other children? You could say that you REALLY want to avoid a CS because you'd like the chance and ease of future vaginal deliveries. (I'm trying to think of ways to appeal to their medical sides, not that you couldn't have a VBAC).

Are you starting early labor at all? Any dialation? If so, you could say your body has already started the process, and should be allowed to finish even if not on their timeschedule. If not, you could say that the twins, who often DO come early, must not be ready to make their entrance into the world if you haven't shown any signs of labor.

How are YOU feeling? I was pretty good up to about week 36 and then started going crazy that last week... and was VERY glad to go into labor at 37 weeks. I had irregular contractions throughout the last two weeks, and at 36w5days asked my husband to "help" get them more regular thru nipple stim, and sex (although the nipple stim did more to help the ctxns). I think it worked.

it's SO awesome both babes are vertex -- that's like their ASKING to be born vaginally!!!

I wish I could think of more suggestions -- just know that I am rooting for you and know you can do it.

Good luck,
post #3 of 13
Hi Kir - That's great that they have turned vertex. I don't have any suggestions, but just wanted you to know that I'm worried about the same thing... especially since my doctor is 4 days off on her dates. She is going by my last menstrual period, instead of my ovulation date, which I was closely tracking and the ultrasounds confirmed.

I'm 2cms dilated and 70% effaced, so I'm hoping she trusts that if she gives me an extra week or so I'll go into labor on my own. I'm not sure though.. we'll see what she says.

Good Luck!
post #4 of 13
Thread Starter 
I am not dilated (as of the last time they checked), and I have had no activity that feels like contractions. I've never been pregnant or had experience with labor before, so it's tough to be certain that I'm not contracting, but that sense that my body is close to going into labor is definitely not there. Up until now i was happy not to have pre-term labor, but now i'm ready for some activity.

Thanks for the suggestions....the one about not wanting subsequent c-secs is good (although right now we feel DONE with having kids hahahaha!). Based on estimates, the babies are not too big--between 5.5 and 6.5 pounds now. And most of all, I feel great! I'm not 100% mobile, but I feel pretty good and am still cooking, nesting, even getting out of the house a little with DH. I don't feel that "get them out of me" sentiment that others in my DDC have right now.

Anyway, I'm seeing her tomorrow morning. I'll emphasize how i'm feeling great, and how i'm happy about the babies' growth. It's sort of a weird situation b/c my mom is coming tomorrow night and staying for about a month. We thought the babies would be born around 37-38 weeks and this plan was to optimize post-partum help from my mom...but now that there's a question of going longer, it's sort of weird! I don't want to lose out on my mom's help, but i also really don't want to deliver these babies before we're all good and ready.
post #5 of 13
Thread Starter 
Stacy...good luck to you with your twins! The dates thing can be weird, right? I also know exactly what happened, but luckily the LMP dates correlated with my known ovulation dates, so i haven't had to have that argument!
post #6 of 13
My doc also wanted twins to be born around 37 weeks, but I made it very clear that I did not want to be induced unless medically necesary and he respected that. He asked me at every appointment and wrote in my chart that I refused induction, but as long as me and the babies were doing OK he said that I could keep going. I ended up having them at 40 weeks 3 days at home My baby B also moved right at the end to head down, he had been going from breech to transverse and then back throughout my pregnancy and then durring my last u/s he was transverse at first, the tech left the room and when she came back he was vertex.
post #7 of 13
Thread Starter 
Wow...what a great story, Sarah!
post #8 of 13
I would get all of the information as to why exactly and tell him you will research and decide (which is your right about everything)
THis is not confrontational or dismissive of his professoinal opinion.
My consulting dr wanted me induced at 38 weeks. When I reached 40 weeks he asked "why hasnt she been induced yet?!!!" So I got my induction at 40 weeks and have a natural lovely vaginal birth of my twins.
You can communicate to your doctor that you are concerned about induction and want to really understand if there are truly very real risks involved with carrying your babies to term.
You do not have to blindly go along with everything he says to maintain your good relationship. YOu just need to assert yourself in a calm and knowledgable way and ask for lots of information.
It is also kinda tough when you expect your babies to come earlier because they are twins, you are all ready, and then you get to wait some more. LOL
My midwive gave me the "go ahead" to have the babies at any time after 35 weeks. I took castor oil that weekend (because the doctor who is not a knife happy misogynist was on call,) but to no avail. I remained pregnant for 5 more weeks! LOL
post #9 of 13
Thread Starter 
Well my doctor was so cool when i met her today!

She asked that I continue getting checked to monitor the well-being of the baby with low fluid....I would want that anyway, so that makes total sense. And she said we'll "wait and see" about how to deliver them. She didn't seem excited about inducing labor, but she was totally willing to see how things look for a natural labor, which is how I feel too. She was genuinely surprised that one baby had flipped, too, which was cool, because it was nice to see her re-think her earlier assumptions and show that she's open-minded about how to proceed.

Let's see what happens.....

Thanks for all the advice in this thread. Really appreciate it.
post #10 of 13
We really depended on information from ICAN prior to our birth ~ we even kept copies with our birthplan for the peri's.


much luck

post #11 of 13
You need to know that YOU get to choose, it is YOUR body and your babies!! Just say NOOOOO!

Induction of ANY kind gives you a flat 50% chance of c-section. . . and that is with a singleton. However, with them both head down, you may be willing to take that chance. Risks from induction depend on the method. ICAN has lots of good info.

Doctors get antsy with everyone these days. However, babies know when they are ready and then they come. Only 5-10% of the time is there any real problems (according to the world health organization). Most of the problems come from antsy doc's who get bored waiting.

Get a DOULA or a friend who know a lot about birth to be with you during labor. It can help you stand up for yourself with someone else standing in your corner. Sometimes a third party to just listen to you list the pro's and con's can help you decide or can see bs more clearly than you can.

ENJOY the feel of those babies inside!! It is the best.
post #12 of 13
I was so ready to deliver my twins at 38 weeks. By 39 weeks I was in tears every day because I hadn't given birth yet. It's so exhausting carrying that much baby weight. That said, I went into labor naturally at 39 w 2 d and delivered my twins (both vertex) at home quite easily. One was 8 lb 2 oz and one was 9 lb 2 oz!

I don't know what to tell you to say to your doctor, but keep in mind that twins are not abnormal and you can deliver these babies naturally. Hundreds of women before you have done so.
post #13 of 13
Just a few suggestions about inductions: with Pitocin they usually want an IV running 24 hrs/day. I had one and it added to my already bad edema to the point I could no longer bend my knees. They also usually want very frequent monitoring, which reduces your mobility.

Avoid them trying to strip membranes to hasten labor, it gave my dd an infection in her placenta that meant NICU time, xrays and antibiotics.

Just make sure you and your SO are dedicated to your plan, b/c in the thick of things it is easy to give in to the concerns of the OB.
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