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Need advice on c/s ~ not happy :(

post #1 of 62
Thread Starter 
I just got back from a 32 wk ultrasound and I still have marginal previa. The peri (who I totally pissed off) said in her experience I'd probably need a c/s, and then proceeded directly into "here's baby A head", etc. [FWIW, the most recent scientific study I've found puts that odds at around 25% that it will move]

I tried to press her on how close it was (at 28 wks it was at 0 cm). I think she said it was "within 1 cm" but I couldn't get her to admit that it had moved. Then later, when it was clear that I was unhappy, she asked me if I was going to even try for a "natural" birth (I took that to mean vaginal) given Baby B was transverse @@ As though I'd be nuts to do that. : Baby A is firmly head down and B goes from straight transfer to a head-down transverse tilt pretty regularly.

Needless to say, I have to go back in 4 weeks and I'm going to try to see the nicer peri. I also told her I wouldn't consent to a c/s without confirmation with a transvaginal u/s.

But, I'm pretty upset. Ok, really upset. Can I get some feedback and advice on how to make a c/s more bearable? How long can I push them off for the birth? I don't want a 36 c/s just because it's "term" for twins... I've had no complications nor has either baby. I need to prepare myself, even though I know it could move, because I'm pretty hysterical about it right now.

I'm also really freaked that they'll take the babies from the OR - can I stop them from doing that? How soon can I get out of the hospital? I don't even know what's reasonably negiotiable and what's not with a c/s.

What else do I need to ask my doc?
post #2 of 62
Sorry you're having to deal with this. I will give you my experience based on my conversations with my OB. I am also 32 weeks and sounds like we have a similar issue with both babies positions and the marginal placenta previa. My baby A has always been in a head down position while baby B has moved into every position possible. Currently she is transverse across the top of my uterus. Baby A's placenta has been moving slowly (very slowly!) over the course of my pregnancy. At my last ultrasound it was measuring 2.2cm away. My OB will perform a c-section when it measures 0-2cm away but from 2-4cm he will allow me to attempt a vaginal delivery and have the OR set up in case there are problems and we have to move to a c-section. I think he does this as standard procedure for a multiple delivery anyways. My impression from the OB is that there is still time for it to move a little bit further away. I also remember at my last ultrasound the technician measured two different times because it changed slightly due to babies position. It can also change depending on how full your bladder is, especially since we're talking mm's.

As far as the c-section due to babies positions my OB is very comfortable delivering a potential breech baby (trying to turn during labour) as long as the presenting baby is head down. It seems that is pretty common from what I've read and heard.

The c-section itself - I have no idea really. I do have a friend who has had 3 with single babies. Her last stay was only 2-3 days.

I hope your placenta moves. It is stressful to think about birthing a different way. Take care!
post #3 of 62
Well, mine didn't move much after around 30 weeks, my baby A was head down and ready to go, B was Frank breech. I did do an epidural b/c we just didn't know what B would do after A was out. My OB was comfortable delivering B breech if he presented that way, but instead he turned sideways and stuck his arm out! ACK! I ended up w/ a manual version (yes, it's exactly what you imagine), the Dr. got him headed out head first and he was born 27 minutes after his brother. The majority of hte moms here don't agree w/ an epidrual and I had a hard time making the decison to get one (my last DD was all natural, no drugs,ect), but I really feel for ME it was the best decision and helped me to get my 'natural" (vaginal) delivery instead of a c-sec. As far as the previa goes I"m not really sure how that plays into it, I'd definately want another US right before birth b/c your uterus is going to continue to grow (yeah, a LOT more!) and it may move up even more by then. I don't think I"d consent to a c-sec at 36 weeks, my Dr won't even discuss them til 37 unless there are other factors (pre-E, ect), and they won't induce even for twins until 38 weeks or more (mine were born 37w2d, no inducton needed).

I guess I'd just leave it at "it's too soon to know", childbirth and especially twin childbirth doesn't always go as we'd like or predict. It's the great unknown and we just have to trust that it will be okay in the end.
post #4 of 62
Sorry to butt in - I've only had singletons, but I think most of this still applies.

I'm sure they will do an additional u/s (or several) before any final decision is made. My placenta moved to an acceptable position after 32w, so don't panic yet.

Unfortunately, it doesn't much help me, because I'm having a planned c-s (after 2 prvious c-s), so I can tell you how a c-s will be, even if mine have all been singletons.

First off, a planned c-s is MUCH easier as far as the actual surgery and recovery than one that is done in an emergency or after labor. It was like night and day with the last two, the planned one being much easier on everyone. Obviously vaginal would have been preferable, but it wasn't to be.

But, I'm pretty upset. Ok, really upset. Can I get some feedback and advice on how to make a c/s more bearable? How long can I push them off for the birth? I don't want a 36 c/s just because it's "term" for twins... I've had no complications nor has either baby. I need to prepare myself, even though I know it could move, because I'm pretty hysterical about it right now.

I'm also really freaked that they'll take the babies from the OR - can I stop them from doing that? How soon can I get out of the hospital? I don't even know what's reasonably negiotiable and what's not with a c/s.
I think depending on what you body is doing, you should be able to go to 37w+ even with twins, unless you are showing signs of labor being imminent. I know several twim mommies who had their c-s after or approaching 38w, which they were happy with.

As far as them taking the babies from the OR - they do usually do this, but you can send the father or someone else you trust to the nursery with them to give any instructions (make sure they don't get formula or whatever else you prefer). I personally hate this part, so I understand completely. One problem c-s babies often have is that the gunk doesn't get squeezed out of their lungs, so they may have to be suctioned a LOT right after birth and may need a short period of observation, but that doesn't mean someone else cannot be with them. You (hypothetically) would be in the OR 20-40min after the babies come out to be stitched back up and all that good stuff, so you'd need to decide whether you want your support person with you or with the babies, but it may well depend on how the surgery is going and how you feel at the time, so I wouldn't make any firm decisions now.

After my 1st c-s I wasn't really in any shape to hold/BF my baby right away, but after the second one I felt up to it, so most of this will depend on how things go, how your body handles the surgery, and so forth.

OTOH, a lot of this may depend on what is typical at your hospital, so you may want to ask about hospital policy. Don't be surprised if your OB is clueless as to the policies as far as the BABY/BABIES, though - you may need to ask someone else who actually deals with the infants.

I hope your placenta starts to move for you, but despite what you may hear, a c-s isn't the end of the world and can be a lifesaving procedure. While I certainly would have preferred a vaginal delivery, the c-sections did the job and I have two very healthy boys and will have a new little girl as of next week.
post #5 of 62
Well I am not the parent of multiples, but I do know that the placenta can move during the pregnancy, my friend was in a similar position when pregnant with her DD, and her placenta did move, so it does happen.

I have had a c/s, mine was unplanned and I don't regret it one bit. I was to have a water birth in our local hospital(which is only 1 of 4 in WA state that is Baby friendly), I was not scared about giving birth, I just wanted my DD and myself to be healthy and happy. Well my birth plan went all out the window and everything pretty much occurred that could ending with a pretty serious emergency c/s. I have never felt violated like some women do, I feel grateful that my DD and I are here. My DD was extremely stuck after pushing for 2 hours and they realized that she was *probably* not coming out, I honestly was a little relieved that they did a c/s on me because I really don't know what would have happened. I'd had a seriously long labor and my DD was having complications, the only reason that I hadn't had a c/s earlier is that I was willing to keep going because I desired a vaginal birth(and I really did). Because of this my DD was really far down and now I have a T-incision on my uterus, so I am no candidate for a v-bac if I ever have more children. I would have a scheduled c/s, but I would try to keep it held off for as long as possible(like 39 weeks if I could, DD was born at 41 weeks).

Anyway my recovery was really easy, the doctor thought I was a little crazy when I was walking around the hospital about 12 hours after my surgery. We stayed in the hospital for 3night/4days, I could have gotten to leave a day earlier if I'd made a stink because I was recovering so quickly. When we came home my DH did a lot for me, I had made and frozen a bunch of dinners before the baby(it is such a good idea to do). We had to bring a bed downstairs because I was not supposed to go up our stairs. I kept up on my pain meds(which was never more than 1/2 a vicodin/tylenol mix), I just never really hurt that badly. I do wish things could have been different, I was mostly sad because I didn't get my water-birth, but that pales in comparison to how much my DD means to me, life doesn't always go as planned.

Oh and DH got to hold her when she was first born. WE made a choice to have her go to our room(our hospital only does room-in) when our wonderful nurse Karen(who was my L&D nurse) kept guard over her while they finished my surgery. My DH chose to stay with me and we were very comfortable with Karen taking care of her for that little bit, she was kept in an incubator for 15 minutes, then DH went and got her to bring her to me in recovery. She was breastfed within an hour or so after birth. I don't feel that we lost any bonding, we just had to wait a little longer than normal. All in all our experience was really wonderful even with all the topsy-turvys that happened. IDK about your hospital, but ours is "baby friendly" so they are really in to making everything easy for mothers, babies and their family, so I really did have a good experience. Also I went into my labor with a really open mind and a positive attitude, so that if things did get weird or not go as planned I'd be flexible, and I believe this helped the most. HTH.
post #6 of 62
Thread Starter 
It's the great unknown and we just have to trust that it will be okay in the end.

Sure. But I know myself, and what will make this a good experience for me is to understand it and plan it out in so much as I can. Honestly, the fact that a c/s wasn't so bad for some people, or the "as long as you have a healthy bab(ies) in the end" reasoning just is of no comfort for me. Right or wrong.

So I'm really most interested in hearing specifics of how a c/s works, what choices you had (and made and why), what you'd have done differently, etc.
post #7 of 62
I'm jumping in also, I have one daughter born by c-section.

My stay was 3 days long, of the entire time in the hospital my daughter was only away from me for about 5 minutes for the hearing test. After she was "birthed" they took her wiped her off and weighed her in the OR with my dh present. She was then brought to me. We were transferred together to the recovery room where she nursed for about an hour before she was given a real bath (once again right with us.)

I would find out what the hospitals policies are so that you can prepare for what you do want just in case. I was fortunate that it turned out being a good recovery with my daughter. I hadn't prepared for the possibility of a c-section, so I just feel lucky that for a c-section it was a good experience.

Good luck mama
post #8 of 62
[QUOTE=worcma;11217610So I'm really most interested in hearing specifics of how a c/s works, what choices you had (and made and why), what you'd have done differently, etc.[/QUOTE]

If you do a search in the VBAC forum, there was a great thread there on making a birth plan for a c-section. My c/s was unplanned and as such I was unprepared. They did take dd away for almost 2.5 hours! My dh did go with her, but it still upsets me. However, the lactation consultant at the same hospital had a schedule c/s and she kept the baby in the OR until the stiching was done and then had the baby in the recovery room for initial bonding and feeding. The testing and bath were all done later. So...plan ahead if you want to have the best experience possible.
post #9 of 62
Originally Posted by worcma View Post
Honestly, the fact that a c/s wasn't so bad for some people, or the "as long as you have a healthy bab(ies) in the end" reasoning just is of no comfort for me. Right or wrong.

So I'm really most interested in hearing specifics of how a c/s works, what choices you had (and made and why), what you'd have done differently, etc.
Actually my c-sections and/or the recovery have been quite unpleasant, but I wanted to spare that aspect of my experience since it doesn't pertain to you. Given what I had to deal with (health issues, not hospital issues) the fact that I have healthy babies is a comfort to me. Sometimes you can't change what is medically necessary and it's best to try to accept it, even if it takes time to do so. And it did take some time, so I understand where you are coming from.

You really need to look into the particular hospital's policies as to what choices you have or can request and keep in mind that you will need to be flexible - sometimes things happen that we don't plan for and if you are holding tight to a particular vision, you may be overly disappointed. Things happened with my experiences that ended up with us deviating dramatically from any "plan" and some of it really blindsided me (like the almost 3 week hospital stay after DS2), but everything did turn out fine in the end.

I hope you end up with the vaginal birth you want, though, and you don't have to plan for a c-s at all. (((Hugs)))
post #10 of 62
I'm sorry, mama! That sounds really stressful. I don't know much about placenta previa but as a pp said, you uterus is going to get a LOT bigger and there is still time for it to move. I have a friend who had placenta previa twice and it moved both times. If for whatever reason it doesn't move, I would try and push your c-section date back as far as possible. I realize that a planned, scheduled c-section is easier than an unexpected one, but I would try and push your date back to at least 38 weeks or more. It would be a shame to take the babies 3 or 4 weeks early, when they would have stayed in til 40 weeks. Taking care of newborn twins after surgery is hard enough without having to deal with preemie issues on top of that.

I know you are looking for experience with c-sections and I am sure other twin mamas will pop in and let you know what they recommend.
post #11 of 62
I would recommend reading the Cesarian Birth section of Birthing From Within. With a planned cesarian birth, you can get a lot of "extras" that you won't necessarily be able to have in a C/S after labor, like music, extra people in there with you (like dad & grandma), etc.

How long your doc will "let" you go will really be based on their expertise, experience & expectations. & Most babies born by cesarian do have to go to the nursery for a little while, for reasons described above. That's why its good to have dad there to go w/ the babies & someone for you (grandma, bff, doula) to stay behind w/ you while you are being repaired.

Good luck mama, do lots of visualizing of that placenta growing up, up, up! & don't give up on making this birth experience as much "yours" as you possibly can!
post #12 of 62
my twins were born via c/s and did not leave the OR until DH and I did all together. i believe the primary reason for this was not any advance planning on my part (since my c/s was after a HB transfer) but the fact that i was 39w5d and they were over 7-8 lbs each and perfectly developed. i would do some research, some soul searching and some serious discussion with your care provider about how far off you think you can safely push a scheduled c/s if that becomes the route you need to take. there is a momma here who went past 41w with her twins recently and they were still only 6-7lbs each. i am so happy for her that she was able to do that, b/c i cannot imagine how tiny and underdeveloped they would have been if she had been force into birthing them 4-5 weeks earlier at 36-37w. they would have been tiny and in the nicu for sure!

my recovery was terrible. not going to lie. what made it doable/survivable was that i had A TON of outside help for the first 2-3mo. we rallied help from every corner of our lives- church, the local twin moms club, DH's work, family, friends, a natural parenting group, neighbors, etc. people brought us food, came and played with DD1, watched sleeping babies so i could shower, did my laundry and dishes, etc. we made a book with lists of things people could do for us, a running grocery list, ideas for entertaining DD1, important phone numbers etc. people called a friend who was my single point of contact and said when they were available. she scheduled them to come by so the help was spread out evenly. they'd show up, bring a meal, check the book and get to work. it allowed me to focus on what was really important- healing and getting breastfeeding well established. i recommend that strongly for an twin mom to be no matter how you birth!

ITA with the PP who said check out Birthing From Within's advice on planning for a c/s. She has a very holistic approach to make the best of an undesireable situation. I also agree that you should not totally lose hope for a vaginal birth. Placentas do move higher, babies do flip in the late third trimester. Stranger things have happened.

And lastly I wanted to say that if you plan to make the best of it, have a c/s and find yourself not feeling positively about it in the end even though you have two beautiful healthy babies--- that is ok. You are totally allowed to grieve the birth experience you lost due to circumstances beyond your control while at the same time being grateful for and in love with your twins. A lot of people wont understand that, but it's an important thing to remember in your heart while you heal physically and emoitionally.
post #13 of 62
i had a c/s with my twins against all my highest efforts and hopes.

the babies went upstairs to my room (with my dh whole time) and never left my side save for that first 45 minutes (which sucked, yes). i was out of that hospital faster than they had ever seen a mother. i left after <24 hrs roughly? (they want to see you healthy, walking around and peeing/pooing iirc.) i was jogging at 5 weeks.

i had great health throughout preg, no complications and my awesome dr said he would let me go to 42 weeks if i wanted before we talked c/s. i had them on their "due date" and still Chase was a tiny 5lb12oz (but Charlie was 7lb12oz) i second the "labor at home as long as possible" deal as hormones during labor help develop lungs. i got to hospital at 8cm and both were breech, they had been flipping right up til the end.

i don't know that twins should be "taken" early or that twins are term any earlier than singleton(health of mom and babies aside). stick to your guns, give them your solid, educated ideas/wishes and think positive! i agree with a pp who talked about it being okay to grieve if birth doesn't go your way. acceptence comes after realizing your unhappiness. i spent the whole preg trying to fend off what ended up happening anyway and somewhere along the way i mysteriously forgot my beef with the c/s. (i think it was after reading a new earth? )
post #14 of 62
I had a c-section with my twins, planned, because they were monoamniotic (same amniotic sac = knotted cords = no vaginal birth). They had to go the NICU from the OR because they were preemies, and I had my husband go with them. For me, planning to have my husband go with them was one of the best things I did for my comfort, because I trust him completely and knew that they'd be okay because they were with their daddy. I also had him take pictures of them so that he could come back and show me (which I highly recommend).

Hardest part was not getting to see them till the next day. Which, if you go term, you might not have to deal with.

I had my parents waiting in the recovery room, so that there'd be someone with me while my husband was with the babies. I was glad they were there. I didn't have anyone with me in the OR after the babies left, but that was okay because I'd been in the hospital for six weeks at that point and I knew the nurses REALLY well by then. But you might want to arrange to have someone come into the OR while you're getting cleaned up if you send your first support person out with the babies.

Um, how c-sections actually go . . . well, for me, the scariest part was as they were doing the anesthesia, because there's these few moments between when they start and when they get it all done where I felt like I couldn't breathe. I could, I just couldn't FEEL my lungs filling up with air, and I was tilted backwards with all the weight of the babies on my lungs, ick. It was terrifying. I knew I was fine, I knew it was going to happen, I trusted everyone in the room, and it was still scary. Knowing it was going to happen helped, but not enough to make it not-scary. I was terrified, in those moments, that I wasn't going to be able to handle it, and they'd have to put me under, and I wouldn't see my girls being born. But then they got all the drugs straightened out, and I was fine. So, be aware that you might have a few moments like that, but that it'll be over quickly. I'd recommend having some sort of prayer or mantra or focus point for getting through those moments. I used the Jesus prayer: "Lord Jesus, have mercy on me," because another friend of mine had suggested it - it's what she used to get through her c-section.

I won't lie, recovery isn't fun. Isn't, isn't, isn't. But it'll be over eventually. I puked the night away after my surgery, and I couldn't fall asleep because I was itching so much - apparently it's an allergic reaction to the duramorph (morphine) they gave me at the end of the surgery. But then they gave me benadryl for the itching, and I was able to sleep.

So, yeah. Not fun. But you'll get through it, your babies will get through it, and you'll be okay.

Someone else will have to give you advice about recovery with babies, because my girls didn't come home from the hospital till a month later, by which time I was mostly recovered.

Good luck, and I hope you need none of my advice because you have a lovely vaginal birth!
post #15 of 62
Originally Posted by worcma View Post
It's the great unknown and we just have to trust that it will be okay in the end.

Sure. But I know myself, and what will make this a good experience for me is to understand it and plan it out in so much as I can. Honestly, the fact that a c/s wasn't so bad for some people, or the "as long as you have a healthy bab(ies) in the end" reasoning just is of no comfort for me. Right or wrong.

So I'm really most interested in hearing specifics of how a c/s works, what choices you had (and made and why), what you'd have done differently, etc.
Here Here! That's how I felt when I was being given that crap about automatic c/s at 36 weeks. Our medical issues are different, but I was told the same thing. I persisted in putting mine off until 38 weeks. I did'nt get nasty with anybody, I just kept pushing back with, "NO NICU babies" as my goal, and they understood that. I am also a planner so I had already mapped out what I wanted weeks before going in just n case. So here's what happened, the long version:

I was put on the c/s schedule a week before my surgery occurred. I was given my choice of 3 dates and 2 possible docs. I picked the doc I liked best, and opted for the Friday date to give my DH more time with us without having to take extra time off. That day I was sent to the blood lab where they drew blood samples so I would have the correct blood reserved for me during surgery just in case. I was told nothing by mouth for 12 hours before the surgery, but talked them into 8 hours. My DH got up at 4am, made a HUGE break and served it to me in bed. I went back to bed for several hours and then we made our way to the hospital.
After you finish the admitting procedures (lab work and vital signs) they will probably give you a bed in L&D to prep you for surgery. They monitor you and the babies, put in your IV, shave you (yuck) and you consult with the surgeon and anesthesiologist. (NOTE: some hospitals with put your bladder cathetar in at this point. Request that they put it in AFTER the epi is done!) I spent an HOUR talking with the docs. I was very nervous about the epi, and I has never had surgery before. I asked a million questions, and they were great about answering everything. My anesthesiologist discussed various drug combinations and how much freedom/sensation I wanted to have. She was surprised I even cared, because most people want the maximum numbing effect and that is the end of it. I wanted to be numb to pain, but able to move all of my limbs during surgery. In fact I was asked to stop wiggling my toes.

Anyway, I walked to the c/s room with the nurse, and she held me while they put in the epi. It is a pinch, and a pop, then cold. It feels a little like a chiro adjustment. No big deal. They laid me down. hung the drape, put in the cathetar and then waited for me to be numb. It was casual and light hearted. Much different then the emergency c/s you see on tv shows. I chatted with the docs while the nurses had raptures over the cloth diapers I brought in with me. My DH came in just after they made the first incision, and sat next to me holding my hand. I was not strapped down, and was able to keep my glasses on to see.
The boys were born 2 minutes apart, and DH was called over to see them as soon as they were both clear of the c/s table. The nurses called everything out to me as each baby was weighed and measured. DH was able to hold them in turns and they were both brought to me to see and touch. Neither baby was taken from the room, even when their blood sugar started to drop. It is impossible to nurse on a c/s table, so I consented to supplementation while I was being closed, but said DH had to give the bottles so they could bond. It was immediately granted.
We all left the c/s room like 30 minutes later, and went together to the recovery room. They were not allowed on the bed with me in the hall. Only one patient per bed, apparently. In the recovery room I was handed the baby with the lowest blood sugar first to nurse right away, and my mother and DH walked the other baby. An hour later we all went to our room, where we all stayed for the next 4 1/2 days. The babies were never taken. At my request EVERY medical procedure was performed in front of me, in my room. When they were jaundiced we stripped them, opened the curtains and let them get natural UV rays instead of the bili lights. I co-slept with both babies in turns, had everything I wished to support breast feeding, and was generally treated like a queen. I hurt like hell for 2 weeks, and I nearly passed out the first 2 times I tried to go to the bathroom. No big deal. It was the same with my vaginal birth. The pain was in a different place, but no better or worse for me. As far as getting up, well that's what nurses are there for. And they rocked. I followed their advice, and took it very slow for a month. I had nerve pain for a few months and still get occasional tweaks in part of my incision scar, but that is what happens when you cut through nerves.
I hope my long ramble answered some of your questions, or allayed some of your fears. Planning it out really does help take the edge off the fear.
post #16 of 62
A mother that I worked with as a doula had partial placenta previa less then 1cm, and it did move away within the last weeks. She went on to have a homebirth. It has time to move at this point!
post #17 of 62
here is a great article about family centered c/s:


i have been researching this b/c my midwives risked me out of my homebirth today for having 2 transverse babies at 35 wks.....sigh.
post #18 of 62
Thread Starter 
Thanks everyone. The ICAN stuff and some of the resources from VBAC board look like really good information. I'll have to pick up birthing from within from the library. I'll be making a list of questions to ask my doc.

I appreciate the kind words on the placenta moving...I know it now can and am hopeful but thinking about what to do in case it doesn't is really important for my psyche. And I know if I have a bleed, I'll have to make these decisions quickly.

And I got an appt with a doctor in the practice, rather than the m/w's so I can at least start to build a relationship with him and get his advice on hosp. policies and how long he'll let me go. They're supposedly 4.6 and 4.8 lbs now, but I'm a bit uncertain how accurate those #s are.
post #19 of 62
Thread Starter 
*sigh* Didn't move ...36 wks and not looking good at all.

The peri was really nice and explained that in the US, he's European, between the docs and the lawyers he'd be shocked if I found anyone to let me try a vaginal birth given where the placenta was right now (right up to the edge) & the twins. I told him it was probably even more unlikely given I am a lawyer, and we all laughed about that one. He gave me a 38 wk u/s appt just to get a final look, which I really appreciated.

My MWs will let me go to 38-39 wks because I'm showing no signs at all of labor which is great. I'm totally depressed about it though. I have tons of help but I don't *want* it -- I hate having to depend on other people.
post #20 of 62
Maybe you could start visualizing the placenta moving up more. It can't hurt! Plus, if you stay at home and labor (once it starts and assuming you have no abnormal bleeding or pain) as long as you can and come in pushing, I don't think they'll rush you in for a c-section.

I would stick with the 38-week ultrasound and between now and then keep talking to the babies and let them know the placenta needs to move so they can have a peaceful birth. I am a firm believer in visualization and attraction. If you believe it can happen, it can. I've seen stranger miracles.
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