Epidural with twins? - Mothering Forums

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#1 of 8 Old 11-07-2008, 10:44 PM - Thread Starter
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Hello Ladies,

I am new to this forum and this is my first post. I am carrying twins, just crossed 34 weeks. Have been on strict bed rest since 24 weeks. Both babies fortunately are head down and at this point I am getting ready for a vaginal delivery. I am going to a hospital which is more friendly with vaginal delivery/BF etc., and have picked a doctor who has had a lot of experience in delivering twins and breech babies. My question to you guys:

This doctor says he would like to give epidural just in case there is a complication with baby B they are ready for a c-section as he has had bad experience when epidrual was not given and complications arose with baby B. What do you guys think? I don't want to give epidrual, but if thats the only way to have vaginal without jeopardizing baby B then I am willing to do it...

Also, any experience with twin vaginal delivery and any tips?

Thanks so much,

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#2 of 8 Old 11-07-2008, 11:06 PM
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Haven't had twins. Did have epidural. Would not advise that you do this.

An epidural will prevent you from moving around (even "walking" epidurals can make it quite hard for you to move your legs, and I have not heard of a hospital that lets patients with walking epidurals actually stand, let alone walk). Being unable to move around may complicate your delivery (it sure complicated mine, and I was only having one baby), leading to a longer and less productive pushing phase, a higher chance of coached "purple" pushing, forceps or vaccuum delivery, or to a surgical section.

If you are committed to vaginal delivery (twins or no twins) I would advise you to minimize interventions in the natural birth process. Ask if the hospital has monitoring equipment that will allow you to move around, if not, feel no compunction about taking the monitor off (if you must give them an explanation, tell them you need to get up to pee). If you feel you can refuse monitors entirely, go for it. Pee at least once every hour (a full bladder can impede delivery). You and your partner should read up on and practice some pain management techniques for contractions. Hire a doula if you don't have one already.

In an emergency, they may have to place an epidural quickly or give you general anesthesia, but I think that having an epidural "just in case" raises your odds of having a c-section so much that I wouldn't do it.

To be honest about my biases, I had the nightmare epidural - it stopped working during the pushing phase, leaving me immobilized, but able to feel all the pain, the baby got stuck behind my pubic symphesis. The only reason they held off on a section was that they'd have to push the baby back in to do it. If there had been a second baby, I don't imagine that would have stopped them.
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#3 of 8 Old 11-08-2008, 12:57 AM
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My mother had a complicated delivery with me, I wound up an emergency c-section. They wanted to give her the epidural as soon as the room started getting prepped for surgery but she said no. She wanted the least effect on me, so she had them wait until the room was prepped and she was on the table, they did the epidural, and as soon as she could not feel, they made the first cut. It made the whole procedure take less than 5 minutes longer, and it made it so the drugs did not reach my system.
Of course, I was a C for failure to progress and bad presentation, both of which were somewhat bogus. In a truly life threatening situation for baby those couple of minutes may make a true difference. But for a 'what if' situation that could actually be caused by you not being able to move around to get those babies into position? I would never consent to an 'in case' epidural.

Also keep in mind that depending on the size of your hospital, surgery rooms may have to be prepped, which takes longer than the epidural takes to come into effect. If you have a very big hospital they may keep them standing by, but many do not.
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#4 of 8 Old 11-08-2008, 02:20 AM
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this makes sense from a medical stand point, sure. one less thing THEY have to worry about doing. and i completely get that, if i were an OB or on staff at the hospital. however my main goal in a hospital stay isn't usually making it easiest on them, it's getting what I need and am paying for.
so for YOU, it doesn't make any sense. pushing is so very complicated by epidurals and you already have the fact that you are having twins going "against you" in that way medically speaking (not that I personally believe twins is something that is bad or whatever... you know what I mean) epidurals slows down the pushing ability and often blocks all feeling or urge to push. why does this matter? well try drinking out of a straw after having your face numbed for a dental procedure. it doesn't matter how many people try to cheer you on and direct you where to do, or even if you are in front of a mirror watching yoursef, you can't make your lips feel the straw and it's often a really terrible wasted effort that leaves you more thristy while working up a sweat trying to get the drink! that is much how it is to push with an epidural. and to add to that the act that you have twins and are likely going to be put on a time limit (whether they tell you this or not!) really seems just another unnesseacry intervention to me, one that could potentially be the reason you end up not being able to deliver vaginally.

I don't mean to scare you out of an epidural, but I do mean to say, no matter how much you like your OB or hospital or nurse... or anyone, NEVER take a medication to make them feel more at ease! medications should only be taking if YOU decide you need them. I ASSURE you, with out a doubt, they can give you a spinal or put you under if an emergency happens. if you don't believe me, you can call your head of obstetrics at your hospital and ask him if you can talk with an anesthesiologist.

I would highly advise you to NOT take the epidural. they can always gie you a spinal or even put you under if it was an emergency (which is what they would do in a real emergency anyhow, but they wouldnt have time to mes with locals which they give along with the epidural so it doesn't hurt when they use the scalpel.)

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#5 of 8 Old 11-08-2008, 06:34 PM
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I just birthed my twins in a hospital (in the operating room) 2.5 weeks ago. Both my boys were head down, seperate sacs, merged placentas. There was a TON of pressure from the OBs and anethesiologist to have an epidural. They are convinced that there is no ill effects of the epidural, so they truly don't unerstand why I wanted to refuse.

In the end, I refused the epidural and had a fantastic birth experience. My midwife got to catch both babies (very rare in a hospital) as the OB stood in the corner waiting for me to beg for drugs. I decided that as long as there were no sign of trouble, I wouldn't act as if there would be trouble.

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#6 of 8 Old 11-09-2008, 10:29 PM
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Congratulations on your twin pregnancy!

It is well-documented that epidurals interfere with your body's natural ability to push. By agressively preparing in that manner for a "what-if", you are doing stacking the deck against yourself.

My twins were vertex-breech vaginal birth. And yes, the natural delivery was an absolute cakewalk compared to the stress, strain, and fighting with medical providers to avoid a highly drugged vaginal birth or a c-section. That's not to say the birth was painless or "easy". It's to highlight the challenges you will undoubtedly face in asserting your rights as a patient, and as a parent looking out for the best interests of those babies. Despite those troubles, it was soooo worth it!

Did you search for old threads on this topic? I know there's been several good comments, particularly from moms in the Multiples section of the forum.

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#7 of 8 Old 11-09-2008, 10:57 PM
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I think the idea is that if twin b does flip breech and maybe there are heart decels, that they can immediately do a c/s and not wait for the epi to take affect. Now my thoughts are this- if there was a huge emergency with a singleton, what would they do? If they didn't have time for an epi to take affect, they'd put you under completely.

The only reason they wouldn't have time to wait for the the epi to take affect would be if something was wrong (not just breech baby, but baby in distress), and *I* personally would be ok with being put under if it was a huge emergency.

Clear as mud... I guess what I'm saying is from a personal stand point, no, I wouldn't get an epi just for that. If something was urgent, I would just be fine with them putting me under.
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#8 of 8 Old 11-10-2008, 02:26 AM
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I was a surrogate and had twins for a couple. The hospital I birthed at insisted that I birth in the operating room and have an epidural, they would not budge on this rule.. So, I got the epidural at 9cm... It was extremely light, and I had the twins within about an hour after I got the epidural...

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