When Baby A is vertex and Baby B is breech... - Mothering Forums

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#1 of 31 Old 04-19-2005, 11:51 PM - Thread Starter
 
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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?

Trying to get my bearings...
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#2 of 31 Old 04-19-2005, 11:59 PM
 
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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.
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#3 of 31 Old 04-20-2005, 12:22 AM - Thread Starter
 
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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.

Thanks!

Trying to get my bearings...
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#4 of 31 Old 04-20-2005, 11:34 AM
 
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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!
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#5 of 31 Old 04-20-2005, 12:29 PM
 
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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.
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#6 of 31 Old 04-20-2005, 03:20 PM - Thread Starter
 
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It's great to hear about the second baby turning spontaneously sometimes.

Thanks for the responses! Keep 'em coming!!

Trying to get my bearings...
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#7 of 31 Old 04-20-2005, 11:46 PM
 
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Quote:
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.

Thanks!
First baby came at 2:54 am and baby two at 3:03 am
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#8 of 31 Old 04-20-2005, 11:54 PM
 
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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.
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#9 of 31 Old 04-21-2005, 02:46 PM
 
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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.
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#10 of 31 Old 04-21-2005, 08:29 PM
 
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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!
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#11 of 31 Old 04-21-2005, 09:56 PM
 
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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.
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#12 of 31 Old 04-21-2005, 11:13 PM
 
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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.
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#13 of 31 Old 04-23-2005, 12:42 AM - Thread Starter
 
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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.

Trying to get my bearings...
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#14 of 31 Old 04-23-2005, 05:38 PM
 
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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.

Karen - Mama to Haven (9/00) , Lillie & Faith (MZ - 12/02) and my first homebirthed baby, Willa (3/08)
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#15 of 31 Old 04-23-2005, 05:48 PM
 
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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.
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#16 of 31 Old 04-24-2005, 02:03 PM
 
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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
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#17 of 31 Old 04-27-2005, 02:19 AM
 
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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.
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#18 of 31 Old 05-01-2005, 10:22 PM - Thread Starter
 
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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!!

Trying to get my bearings...
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#19 of 31 Old 05-02-2005, 05:09 PM
 
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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?
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#20 of 31 Old 05-02-2005, 09:06 PM
 
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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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#21 of 31 Old 05-04-2005, 02:16 PM - Thread Starter
 
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Kangamom: I was told that at this point they will just do what they like in terms of position. I have heard of using webster technique or moxabustion much later, though I don't know exactly when. Presumably it would be earlier than in a singleton pg. Doing pelvic tilts probably wouldn't hurt at this point.

I am not very informed since my edd is just a day before yours! I don't even know what position these guys are in at this point. I feel kicks everywhere, though some are concentrated high and some low so I have a feeling one of them is breech. I have another u/s in 2 weeks and I am very curious.

Trying to get my bearings...
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#22 of 31 Old 05-05-2005, 07:36 PM
 
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I'm mostly guessing on their positions. I have u/s's at every visit (I have secondary complications and need close monitoring) and thats about where they were last week. They still move around quite a bit, especially the boy. (Every time I mention this to the OB I get the same speech about how moms can't tell which twin is which- but I swear I can tell at least a bit!) I wake up in the morning feeling kicks in all kinds of wierd places but then they setttle into the same spots. So I guess we will see what happens.
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#23 of 31 Old 06-03-2005, 01:20 AM
 
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Unless you have a very very relaxed team delivering your babies, they won't let you rest between babies. I had expected to get a break between babies because my contractions stopped, Baby B was not stressed, and I had heard that it was possible to rest between babies. My country Dr was fine with that in our discussions. The high risk Drs- not so much. I am convinced that if Baby B had not come out as quickly as she did even though I had no contractions then they would have performed an emergency c-section. My babies were 10 minutes apart.

My experience was that once A was out, immediately they were doing an ultrasound to find what position B had moved to. As soon as it was confirmed she was vertex, they were yelling at me to push her out as fast as possible. Later, it was explained that with twins, the longer you have between delivering Baby B, the greater chance you have of an abruption. It may have been different if I had not been in the high risk hospital because of their prematurity. The high risk team was much more uptight than my normal Dr. and I had never met them before because I had to be life flighted to a hospital several hours from my home.

Unlike the other poster, they did not want me on my back. They wanted me semi-upright and several people were pushing on Baby B from the outside to ensure that she would not flip and was heading in the right direction.

Hopefully, you will be term and able to have the birth you want, but it is good to be prepared for what may happen if you deliver with a strange Dr in a strange hospital. The only thing I was able to insist on was no epidural but even that was a battle. I think Dr delivering in higher risk hospitals with higher level NICUs are much more likely to insist an emergency c-section is really necessary than OBs in more regional hospitals. Probably, of course, due to the fact that a full term baby can handle stress better than preemies.
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#24 of 31 Old 06-26-2005, 07:41 PM
 
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baby a was vertex, baby b was transverse, I had a 32 minute break between babies, and the midwife externally was able to guide baby b into a vertex position. And since most ob's haven't been pregnant with twins they have no idea that you can tell the difference. I named mine based on who they were before they were even born, and their personalities have stayed true to my intuitions since,I have a very phsically active baby and a not so active one. One is way more dramatic, the other is shy. I told people all of this before they were ever born

homebirthing,,homeschooling intactalactivist mom to 3dd jumpers.gifand 2dsbouncy.gif.babyf.gifAlways busy
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#25 of 31 Old 06-26-2005, 09:14 PM
 
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Dear mom with twins, my twins, now 14 were positioned as follows:
The presenting baby was footling breech, and the second twin was head-
down. I was working with a lay mid-wife during the pregnancy who helped
me with nutrition; thus I had big twins! But, my OB, though very open-
minded towards a single breech birth was beginning to feel concerned about
their position. After the end of my 9th month, with no signs of labor, we
agreed on a cesaerean because he felt that the birthing would be too
difficult --- difficult on me, should some true emergency develop, and
hard on the babies, because of a possibility of interlocking chins. No mother
wants to accept something this horrible! I so much wanted to deliver these
dear ones by myself. My husband was concerned for their safety.

But, in your situation, the second baby is breech; and, should be able to
turned without performing an extraction! I had a friend who birthed her
twins in still another way! The first was head down, and she birthed
her normally. Her 2nd twin was breech and the Dr. did a C-section.

I would say, consult with your mid-wife and Dr. and follow your heart.
Make sure that you and your husband feel safe and connected to your
decision. In my case I had to change course after months of joyful
anticipation. That is life, I guess. We can't always control everything.

But, I feel I still gave birth to my twins! It was the crowning moment of
my life. (No pun intended)!

I heard Ina May Gaskin speak at the University of Ct. years ago when my
4 year old twins were still nursing! She, of course, delivered all sorts of
twins in all sorts of positions. Had I known this, I may have tracvelled to
Tenn. to have her assist my birthing.

Well, I hope you find the answers you are looking for. Be brave and trust
yourself and God. She knows your every need.

~ spirit dove
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#26 of 31 Old 06-27-2005, 10:04 PM
 
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Our baby A was vertex, baby B was breech. Baby A's water broke at 34w6d and off to the OR we went. While we delivered in the OR, with, oh, maybe 150 people in there, my OB was VERY cool with the idea of delivering baby B breech. So Baby A was delivered, handed off to the NICU team and then my OB broke Baby B's water, and pulled her out by her feet. They were 3 minutes apart. No ultrasound to check position, he just reached up in there and pulled her out. And not any more painful than delivering the 1st, but I did have an epidural. And of both babes, baby B is the one I CLEARLY remember birthing. Meaning, I CLEARLY felt her slide out of my body. And watched my stomach go down. As opposed to Baby A, who I didn't realize I'd even pushed out until I heard a cry. (first words out of my mouth? oh my god! did I just give birth?) Not quite the birth I'd wanted, but I'd take an episiotomy and epidural any day over a c section. Due to "hospital policy" because they were born prior to 36 weeks, they went straight to the NICU. Where due to the cascade of interventions, they stayed for 15 L-O-N-G days. I had a lot of anger for a long time about the whole thing. But ultimately, I've come to a peace that the birth we had is the birth we had. I can't change it, so I focus not on the birth itself but on the "ever after" - the parenting of these two amazing little ones.

When interviewing OBs, mine was very skilled in the art of delivering a breech baby, and respected my desire to have as close to a natural birth as is possible in a large teaching hospital setting. His take all along was that as long as baby A is vertex, and larger, he would deliver baby B breech. And we were fortunate that he wasn't on vacation, I wasn't handed off to a different team, he himself delivered 98% of all babies born to his practice, AND his partner had a similar birth philosophy (she would have delivered a breech also). Good luck. I know we all focus on the birth process when pregnant, but try to accept that it's the first of many times that you can't control what your little ones do. Be prepared as much as possible, and just make the best of it.

peace to you and your wee ones!

Elizabeth
mom to the Wonder Twins (b 8/28/01) and my Sugar Plum Fairy (b 4/22/04)
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#27 of 31 Old 06-28-2005, 09:22 AM
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Thanks for this thread. I've been worried about a lot of these issues!
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#28 of 31 Old 06-30-2005, 01:06 PM
 
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My baby A was vertex and baby B was breech. I wound up with an emergency c-section over baby B being breech. They were both vertex 3 days before the birth but my dd managed to flip. I was fully dialated and the hospital couldn't get ahold of my doc so I got stuck with a staff doctor at the hospital. Plus the nurses scared my dh telling him that baby B could die going through the birth canal breech so he pushed for the section too. He felt bad about it later.

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#29 of 31 Old 07-16-2005, 06:00 PM - Thread Starter
 
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I've been offline for a month (just moved) and I am amazed at the number of responses this thread has generated! During the last 6 weeks my guys have gone from both breech to A vertex and B breech, and as of last week they were both vertex. I am planning a homebirth, and having parallel care with an OB and they both seem comfortable with a vaginal birth in a variety of situations. I'm 31 weeks, so there is still plenty of time for position changes! We'll see!

Thanks again for sharing your experiences.

Trying to get my bearings...
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#30 of 31 Old 07-16-2005, 08:34 PM
 
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Mine keep changing positions also. They were both vertex for a month or so and then last week Baby B flipped to breech again and if he stays in the position he is in now he will probably be a footling breech. I am not getting any more u/s so we will just have to see when they come out! I am also planning a hb now and still being seen by a doc and both are fine with the 2nd baby being breech. It just doesn't seem like there is room in there to flip around like that, but they manage to do it!
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