VBA2C with Twins? - Mothering Forums

VBA2C with Twins?

MyFillingQuiver's Avatar MyFillingQuiver (TS)
02:44 AM Liked: 452
#1 of 3
08-23-2014 | Posts: 839
Joined: Sep 2009
Hello experienced mama's of multiples! I will give a brief background as I ask for your experiences and advice!

I had 2 babies vaginally. I then had a c-section for transverse lie. Then I had a "forced" unnecessary section due to hospital VBAC ban, and I was ignorant of any other options, basically.

Then I really became educated, had major heart/head changes and went "all natural" with our lifestyle and health choices. I then had a natural VBA2C with a great OB in a hospital I found via ICAN. The baby was 8 lbs 10 oz. My next VBA2C was a homebirth of a 10 lbs 9 oz baby boy at 42 weeks. Then I have had 2 more natural VBA2C's with my OB (long story why I don't have a homebirth again..I can fill you in if you desire) 8 lbs 11 oz, 9 lbs 12 oz.

My OB is incredibly VBAC supportive (that's why I travel an hour to see him and have a birth at that awesome hospital), and vaginal twin birth promoting. He told me today that he is somewhat concerned about the lower uterine segment being very stretched in a twin pregnancy and then laboring. He said ultimately, like always, it's my decision and he will support me.

What do you ladies think? I measured 44 weeks with my almost 11 lb baby, so he says I certainly can carry large baby(s) in my uterus and then labor...

Right now I am thinking I will go with the vaginal birth attempt, once again...but, I don't want to be naive or selfish with that choice if it truly isn't the safest choice for my history. I just cannot imagine scheduling a surgical birth if baby A is head down..can't fathom it.

I suppose I do feel a bit of doubt/worry, as one of my dear friends lost twin B and her uterus in a twin vaginal birth at home a few years ago..it is still with me, because it is still with her

Thanks so much for your input!
TizTaz5's Avatar TizTaz5
10:44 PM Liked: 51
#2 of 3
Today | Posts: 133
Joined: Jul 2010
For what it's worth, if I were pregnant with another set of twins now, I would attempt a hospital vbac. Reason why is a homebirth midwife I met and felt was very competent told me that, given my not having had a vaginal birth yet, I wouldn't be a good hbac candidate (with twins, a singleton is a different issue entirely).

However, even though it's a singleton this time, I am going to have a scan at the end of the pregnancy to check the baby's position, the placenta's position, and the thickness of the lower uterine segment. Have you considered doing this? Has your ob suggested it? Maybe, after having a scan and seeing what your ob says, you can make a decision from there.

I'd never want a section if baby A was vertex. That's just me, however, but I can understand your feelings. If my twins had been double vertex, vertex/breech, maybe even vertex/transverse, I'd have done it vaginally in a heartbeat. Is your ob comfortable trying to flip a breech or transverse baby b?

Best of luck to you. Wish I had some "been there, done that" advice, but I don't. I have read of stories of women having successful vbacs/hbacs with twins, so it CAN be done. You just have to look at a lot of factors first. What kind of twins, how many bags/placentas, health of mom and babies, position of babies, etc. It sounds as if your ob is very sensible, open-minded, and naturally-minded. I have only thus far heard of ONE local ob who supports vbac with twins, which is beyond sad. Twins are not an automatic c-section. Again, it depends on a lot of factors, from what I've heard and read.
MyFillingQuiver's Avatar MyFillingQuiver (TS)
11:42 PM Liked: 452
#3 of 3
Today | Posts: 839
Joined: Sep 2009
Thank you so much for your input.

I had an appointment today, and my OB and I are planning on proceeding with another VBA2C, as long as baby A is vertex and my previa resolves..which, we expect it will.

We will ultrasound uterine thickness at the end of pregnancy, more for a "measure of due diligence", as he will receive some professional flack for being supportive of my choices. I will also plan on a "controlled birth" with AROM at full-term (provided I go that long, I am hoping because of my history I will) so that he can be in attendance for the birth, since no one else would be willing to take care of me with this situation. While I trust a completely intervention free birth would be fine, I will not have a problem with a good balance to avoid surgery. It was my choice with my last baby to have AROM (I had a very odd feeling baby needed to be born) and he supported my choice and it went very well. I had a doula, hep lock, labored in the tub, etc. I expect I may give up some of those, but he hasn't asked me to.

My OB is one of the very few I'm aware of who supports vaginal twin birth, and does breech extractions and turning of the 2nd twin.

I'm quite confident we should be able to plan on a VBA2C and be very safe doing so. At this point, if I do end up with a section, I will know it's because I/babies truly need one, and not because of policy or how things are usually done, etc.

Thank you again, and I am certainly more excited about the birth now that I can feel confident a surgery isn't a given!
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