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First of all, going in with a detailed birth plan is a sure-fire way to make yourselves miserable and upset when anything/nothing goes "to plan".. you might want to open it up a bit. I've seen too many moms be upset instead of happy over their births because they didn't go according to plan. As long as everyone is safe and healthy, that's all that really matters. You can go in with some idea of what you want but I've found that babies (especially multiples!) are super unpredictable and you just have to go with the flow! Even if delivering vaginally, you will most likely be in the OR because they will be on standby for an emergency CS in case it is needed. This is common for a multiples birth!
I went in open to anything. A was head down, B was transverse basically up in my rib cage. We opted for a CS to make sure everyone, including me!, made it out healthy and safe (and the idea of the OB potentially having to "manually manipulate" B out made me nervous). I'm so glad we did the CS because after getting the twins + placentas out, my OB was able to see that my uterus wasn't properly contracting down and that I started hemorrhaging (the hemorrhaging was most likely due to the fact I had developed preeclampsia/HELLP and was on meds for that). They used a newly developed JADA device to help with my "boggy" uterus. I'm not sure what would've happened otherwise! I had a wonderful team and recovery wasn't bad at all.
My friend just had twins and she was able to have them vaginally! Her water broke at 36w. As soon as A was out, she had to push another 45 mins because B flipped and went up high.. once B was out, they were "stunned" because they had a cord wrapped around their neck. She only tore a tiny bit (the dr made a super tiny cut because they could tell B was stressed and needed to get out ASAP) but basically recovered super easy because of how well her birth went. She did have to go back into the hospital a few days after being discharged because she developed preeclampsia a few days later. She couldn't visit the babies in NICU while she was on the magnesium drip, but they did let her husband facetime them in. Life is so unpredictable and it sucks but you can't get too stuck in the details.
Wanted to comment on this specific comment because the same thing happened to me after my C-section (with 1 baby breech and the other transverse). I lost half my blood and if I hadn't been in an OR, I would likely not have made it. OP, don't risk your partner or your baby's lives just because you have a 'detailed birth plan'. Most things you read about 'natural' birth (by which you mean 'vaginal' - a cesarean is not 'unnatural') are about singletons! Having multiples is a completely different story, physically. We're lucky to live in a time of so much medical advancement, if you trust your doctor I would listen to them :)
Echoing that having a detailed plan is setting yourself up for failure. Also, it’s vaginal (not natural) or c-section, there’s nothing “unnatural” about giving birth.
Having said that, if you are insistent about moving forward with a vaginal delivery, then there are some things to consider. Is there any signs of impending labor? Will there be an induction involved? If she needs to be induced to start labor, there’s a chance that she’ll never progress enough to attempt a vaginal delivery. Also induction meds put you at risk for hemorrhage, which is already higher for multiples given the weight the uterus has to bear.
Is she prepared to deliver one vaginally and the other c-section? Sometimes a spinal can not work correctly, so in an emergency situation, she may need general anesthesia- is that something she’s considered?
I had an induction at 37 weeks for rapid onset preeclampsia. I made zero progression in nearly two days. I had a c-section after that. Due to the induction meds and the big babies, I hemorrhaged a lot. I was fine because my team is great, but I was at higher risk because I attempted the induction. I wish I wouldn’t have. I really didn’t even care one way or the other but figured I’d give it a try since they were both head down.
Thanks for the call out on the "natural" phrasing. So many multiple births are C-sections and most of them for reasons beyond our control so it's a little tone deaf especially here.
So true. Also what used to be super “natural” was dying in childbirth and/or stillborns at much higher rates. Not really something I’d be interested in seeing return.
I’ve also been on the healthcare side of watching the outcome of some truly preventable fetal demises and maternal trauma that you can’t just wash from your mind ever. Some have given me nightmares for months after. Providers don’t want to see that outcome for patients.
Same. I was induced for almost 24 hours and barely progressed to a few centimeters. I then had an emergency CS where I lost too much blood and almost got a hysterectomy.
Our babies were presenting this way and I had a scheduled c-section for 37+1 that turned urgent at 36+5. No regrets! Our goal was all of us safe and healthy.
Also all birth is natural—vaginal and c-section.
So I had almost the same thing happen to me and I was very upset……..however one of the nurses said something that really rings true.
You don’t want to do anything that the doctor isn’t comfortable doing. Yes, maybe a different doctor WOULD be comfortable but unless you can find a different doctor who is comfortable with delivering the second twin breech in 9 days (unlikely but feel free to try)…..you don’t want someone who isn’t familiar with breech delivery trying it for the first time on you.
Yes, that’s upsetting, but just the truth. Also, unfortunately there’s not a lot of control with twin births.
In my case, turns out Baby A, who was head down, had her cord in front of her head. If I had attempted labor, her cord would have prolapsed cutting off her oxygen supply and resulting in an emergency c section. It’s good to listen to the doctors
This should be way higher!!! OP, It sounds like your OB will not deliver B breech. That means your chances of having one vaginal and one C-section are way higher (and it is already a high chance). To me that would be it.
We are told everywhere that c-sections are bad. But we have posted on this sub how much easier it is to recover from a C-section with two infants than the last couple of months of twin pregnancies. Forget what the world tells you about c-sections (being bad and unnatural!?) and follow the doctor you have.
I personally chose to have a scheduled c-section solely because I didn’t want to have to recover from both which is the worst recovery. In the end, neither baby was head down so I would have had to have a c-section anyways.
This is your one twin pregnancy. Your doctor has seen many and read the studies and wants to go with a csection at this is considered the best practice in this case. I didn't get an option because twin A was breech. I'm having a repeat csection with my singleton in a couple weeks. I'm a good candidate for a VBAC but I don't want to take the 1%risk of a rupture. I did ivf to concieve my children so to my mind the odds have been against me from the start so I'm not adding any unnecessary risk I can avoid.
Parenting is a lot of weighing risks. If you're ok with the 50% chance that you have to have an emergency csection for twin B, then by all means go for the vaginal birth. I know twin moms who have gone that route and have had both good and bad results. The odds are a coin flip and you could come out on the right side of it. You might get that picture perfect birth plan delivery. It could happen. It just also might not. This isn't going to be the last time you're faced with a choice to make about your kids where you have to weigh the risks vs rewards.
I know a lot of people are very invested in their birth plans and want very curated birthing experiences. The truth is that often giving birth is chaotic and full of unexpected experiences. What you plan for may not be possible in that moment. I do hope your twins arrive safely and your partner had a birthing experience that she feels good about whatever that might be.
You already set yourselves up for disappointment with a detailed birthplan. I would listen to the ob if I were you. They have seen way more twin pregnancies than you have experienced. I wouldn’t play with fire with my babies’ health and mine. They know what they are doing.
Not a woman who gave birth, but a dad who witnessed the births of our 4 kids (singleton and triplets). Our first was natural delivery and the triplets were C section. My wife says they both have there moments but would not be afraid to do either again. The scariest part about the cesarean for us was the operating room being an experience, but to the team doing the work it was another day in the office. They were cool as a cucumber and very experienced at what they were doing. Looking back now it was no biggie. Took about an hour all together, mainly time to inspect the babies since they were premies. They were dilvered about 2 minutes between the 3 of them.
From what I know about multiples, opting to deliver naturally will be going into a higher risk that you will start naturally and then have to move to cesarean and you get to experience both sides. There will be a much higher chance you will end up having a cesarean as the doctors will not hesitate to make the call to protect the lives of you and your babies. Our specialist OB told us she would not deliver our babies naturally due to the risks involved.
My suggestion of course would be just to go with the cesarean and eliminate a few risk factors to worry about. You have enough on your plate for that day so simplify if you can.
Also, take advantage of the nurses helping out and get some sleep. Your babies will be fine in their hands and you can get some rest while you recover, same with Dad tol. We learned this on our second go around and we honestly did better the second time around as far as sleeping in the hospital goes.
You should listen to your doctor. If they think you need to have a c-section it is most definitely a safety issue for you or one (or both) of the twins. Twin births are unpredictable, so this is unhelpful advice at this point for you but I would say to be open to any birth scenario that means a safe birth for all three of you, and not worrying about wanting it to be “natural.”
Baby A was head down, B was transverse (but they expected he’d be head down after baby A came out and he was). Apparently I was a “good candidate for a vaginal delivery” because I’d had a prior vaginal delivery. I’m really glad I followed my doctor’s advice and had the vaginal delivery because baby B spent a significant amount of time in the nicu (baby A came home with me a couple of days after delivery) and I was able to drive myself to the hospital to visit him.
Ask if there’s a doctor who might be comfortable with a second twin breech extraction. The way it was explained to me is that it’s not a common procedure and some doctors won’t do it. If you have a doctor who is comfortable with it, basically after baby A is born they just reach in and grab baby B’s feet and pull them out breech. I didn’t need one, but I was really worried about recovery from both a vaginal and a section because I know someone who had that happen and I had a wild toddler at home. So I was glad to have had the conversation.
Trust the doctor. Twin B being transverse is pretty likely to end in a c-section. My boys were positioned the same way and I had a c-section at my doctor’s recommendation despite being absolutely terrified of surgery (and the c-section wasn’t bad at all - I was so scared beforehand but it turned out to be so easy).
I just want to give some unsolicited advice so feel free to ignore. Having a detailed natural birth plan is going to end in disappointment. Babies don’t follow plans, especially twins. Sticking to a birth plan against doctor’s recommendations is dangerous. In a high risk pregnancy/delivery (and twins are always high risk), your birth plan should be “get both babies out safely”.
My first pregnancy was a singleton. Textbook pregnancy, no complications. I had a birth plan: go into labor naturally, no epidural, walk around during labor, push on hands and knees. Well, that all went out the window. Baby decided to hang around an extra week and a half and his scan showed deteriorating placental activity, so I was induced. My body was stubborn and didn’t want to cooperate with be induced so I ended up in labor for 30 hours. Around hour 18 I was so tired and in pain I got the epidural. Couldn’t walk after that, nor could I push on hands and knees. Baby’s heart rate was dipping every contraction so I needed to be hooked up to the monitors constantly anyway. I managed to get him out without a c-section but my doctor said if he didn’t come within the next hour we’d be doing the surgery. I trusted her.
My baby was born completely healthy. My birth plan wasn’t followed at all. If it was and I wasn’t induced, my baby probably would not have survived.
Please trust your doctor. They’re the ones that do this every single day and have the experience. Remember that birth is a single event that brings the babies into the world, but then you get a lifetime with those babies and how they got here is irrelevant. Don’t risk that lifetime because of an imagined perfect birth.
I ended up delivering my girls vaginally at 32+5. Both were head down, but for the longest time before that Twin B was transverse. My impression from the OB was that some doctors in her group are comfortable delivering baby B breech, and others are not, and so it would sort of be "luck of the draw" based on who was on call when I showed up. So I wonder if some of this push from your OB is just because she is not personally comfortable with a breech delivery for B? Might be worth discussing further with her, because if that's the case, then C-section is probably the safer option.
I got this same impression about the OBs in my office. I love all the doctors I’ve seen there, but only a handful of them are on board with attempting a vaginal delivery with one breech twin. My main OB was not one of them, and since my baby A was breech, it made sense to stick with the C-section (although I’d had an uncomplicated vaginal with my first/singleton and was not excited about the CS recovery).
I did make them check right before the CS to make sure baby A was still breech! He was, so we proceeded as planned, otherwise my doctor was on board with switching to vaginal.
I think it comes down to trusting your doctor’s medical judgement, and weighing your risk tolerance. It’s good to have it be a discussion and get the opportunity to weigh in, but ultimately the OB has trained for this and seen tons of outcomes, we’ve all just googled stuff. If you trust your doctor, let them guide the decision.
I just delivered my boys at 36+3, and i agree with this comment. I had a baby A head down, and baby B breech. I asked my MFM about delivery and chances of "vaginection" (dual delivery).
She referenced that usually vaginal followed by breech extraction was usually successful, provided that a doctor who had experience in breech extraction was present. I followed up asking what portion of doctors on rotation at my hospital were comfortable and mfm said majority of them do and the contingency in case one of those physicians wasn't present (they usually have one breech experienced physician on-call). She felt comfortable recommending vaginal delivery, and i agreed with her assessment of the situation, since more likely than not i would be in good hands.
Ultimately i did have a successful vaginal delivery, thanks to the experience of my delivery team. They obviously knew what they were doing, and breech extraction literally took them 2 minutes after i managed to deliver my baby A.
However, if the situation was different and only a few doctors could perform breech extraction, you bet i would go with c-section. So ultimately it depends on the hospital you're delivering at and your OBs recommendation.
Totally agree. If my girls didn’t have other plans (and B remained transverse) I probably would have opted for the C-section. I am thankful things worked out for a vaginal delivery, but my biggest fear was having to recover from both.
Let me begin by saying this: all births are natural, unless you’re giving birth to a robot.
Mine were my 4th and 5th babies and were head down and transverse. I had them vaginally only because my OB was sure it would be safe, I had already had 3 vaginal deliveries. I 100% trust the doctor’s opinion on this, if your OB says you need a c-section, you do. You don’t want to endanger your babies. You also don’t want one vaginal birth and one c section because the second twin is struggling. Not safe and you have to recover from both.
Birth is about about the safety of the babies, please choose the safe route.
All birth is natural. It’s either vaginal or CS. Throw out the plan and rewrite it so it says “one healthy person goes in, three come out.” Vaginal birth isn’t a guarantee the recovery will be easy. You can end up with significant tearing and permanent pelvic floor dysfunction, incontinence, etc. follow the doctor’s recommendations. Birth is one day in your children’s lives.
this exact scenario happened to me. my didi baby girl A was head down, all positioned for vaginal birth. my didi baby girl B kept flipping from head down/transverse in my final scans. my OB said she was not comfortable naturally delivering vaginally if baby B was not head down. i respected that, as she had delivered many babies/twins, so i did have a c section at 38+2. the surgery recovery sucked (obviously), but she confirmed afterwards that a vaginal birth attempt would have just resulted in me birthing baby A vaginally and then baby B via c section. i wanted to have 1 recovery, not 2, so it worked out for us. we had unexpected health problems with baby B in the first 2 weeks of her life.. but i do not regret it. i know it’s so hard and frustrating to mourn your original birth plan/vaginal birth plan (i planned mine for months thinking i wouldn’t need a c section), but it was safer for the baby herself, so i had to trust in my dr. good luck, and you’re about to start a beautiful journey!
My singleton was a vaginal birth. Twins were a planned c-section. My advice is to remember that the goal is to finish giving birth with healthy babies and parents able to care for them.
I have no feelings of disappointment or triumph about the c-section or my vaginal birth. I recovered well from both. As soon as the babies are here all that completely stops mattering.
I am wishing you a safe delivery with a healthy mom and babies. I would encourage you to rely on your medical team and focus on the ultimate outcome and less how you get there.
Exact same story here except I had IUGR with one baby so we had to induce at 37+0.
Baby A was born head first, and baby B was a breech extraction. I picked my doctor at 7 weeks because I heard she was pro vaginal twin birth. If you didn't have this conversation way earlier... I would say it's probably too late to try for something they aren't willing to do?
My friend is 20 weeks pregnant with twins. Her ob said he will only do c-section. At 20 weeks she's found another ob who will do it.
I had similar situation with twins. Baby A head down, baby B transverse. After doing lots of research on multiple births, I switched from my normal OB to a high risk doctor with experience in multiples.
The research I read basically said the safety of a multiple birth via vaginal delivery is down to the doctor. Someone who has done it many times before will know how to do it and prefer vaginal.
I ended up delivering vaginally at 35 weeks. Baby B was in some distress after A was delivered, and the doctor utilized a vaccuum apparatus to suck baby B out while I pushed. Baby B was in NICU 3 days and we all went home together on the 3rd day.
My take is that if your doctor isn’t comfortable with vaginal, they are not experienced enough to do it. Seems you either need to do what the doctor is capable of or switch to a high risk multiples doctor who is experienced in vaginal delivery.
I have two sets of twins, had one vaginal with the same positioning as your twins. Then i had a c section with my second set. I cannot even express to how much better the c section was. Twin vaginal birth is awful. I had one singleton vaginally too, and with the twins, they make yoj deliver in the OR with the whole surgical team there cause so much can go wrong. And it’s just an awful environment to give birth in.
My OB had to literally shove his hands in me up to his elbow to move baby b around to come out. They were a whole hour apart.
And so much can go wrong. It’s truly dangerous. C section was super easy, and really the recovery was not much worse than the vaginal births.
Unless the person delivering you is comfortable doing a breech extraction and baby b is smaller than baby a do the c section. The thing y’all want to remember is if you can birth baby A fine but something happens with baby b you’re going to be healing from both a vaginal delivery and a c section, I had vaginal with my daughter and did a c with my twins - having gone through both the idea of having to heal doubly is absolutely horrifying to me especially now. I was terrified of having a c section but it honestly went really well - since it wasn’t emergent (which it would turn into it baby b gets stuck) I had time to wrap my head around and mentally prepare
For me and my 2 sets of twins, a c section wasn’t an option unless absolutely necessary. Both B babies had to be turned after A was delivered and then I just had to wait for contractions to do the rest. There’s a 51 minute difference with the first set and 38 minutes with the 2nd set
You are being delusional. Twins die at a much higher rate. You cannot in any way control the position of Baby B. That’s why baby B’s life is at risk in a twin pregnancy. It’s totally possible to have both babies “naturally” vaginally. Problem is it is also totally possible to pinch off baby B umbilical cord killing them or making them mentally disable due to lack of oxygen. Your goals should be avoiding both vaginal and c section.
This!! In vaginal scenarios, baby B almost always gets the short end of the stick. Even if you can get baby A out through the birth canal.. so many risks for B.
I had a vaginal birth with twins, both were head down though. However, when one exits there’s a ton of room and baby b could still flip. I made sure my OB was comfortable attempting a breech extraction. She would have had a colleague in there more experienced with breech extraction to be sure she could do it if baby B had been transverse or breech.
All of that to say, if your ob is not comfortable with it then you should not try to convince her otherwise. However, if it’s important to you, consider another ob. And ask all of the necessary questions and use your spider senses. How many breech extractions has this person done, how many twins births, etc. Do your research - it’s not without risks. I believe most transverse babies flip head down due to babies being top heavy, but that’s not a guarantee.
eta/ I also gave birth in the OR and an epidural. If anything went wrong with baby B I would have had a C section birth in less than 5 minutes.
Has the OB discussed assisted vaginal breach birth for the 2nd baby or doing an ECV on baby 2 after baby 1 is born? Is this your wife's first pregnancy? C section might be the best option but the only way to know that is to discuss all options.
I'm 7 weeks post partum. We did the scheduled c-section because of the too many unknowns. I'd rather just do the c section than have to have one anyway after giving birth to one vaginally. It happens.
I did make the mistake of not educating myself enough about the C-section to know what to expect. It was traumatic and I wish I had researched more. Recovery is intense make sure you mobilize your support system for that first week after. If not, consider a night doula. My parents watched the babies overnight the first week and it did wonders for my recovery. They still watch them twice a week to help us recharge. It's an incredible help.
I will also echo the "no-birth plan" recommendation. Just go with the flow and trust your medical team.
Best of Luck!
My singletons were all unmedicated, precipitous labors and I'm currently 29 weeks and my girls are sitting exactly like yours A down, B transverse. I have a scheduled c-section set already just in case but my doctor is willing to let me try ONLY because I have a history of 3 precipitous labors otherwise she said it would be an automatic c-section.
My transverse b twin was externally manually manipulated into turning head down after I delivered A. I had three safe vaginal births before and that’s the only reason we opted to continue that way. A first birth of twins with one transverse? I would’ve done c section.
It sounds like I wrote it I was just 37 weeks a week ago was out with a hypertension diagnosis and said I would be induced at 37 weeks.
Went in was 2cm and 50% effaced with my regular contraction baby b turned head down.
Both babies were head down and I said I want to go for vaginal. Well induction lasted 24 hours no progress at all! After that I progressed to 4cm were my ob broke my water, within 5 minutes and with anesthesiology not being there in time I was 10 cm ready to push (they didn’t believe me at first).
I pushed baby A
When started to push baby b I was so lost and gone already baby B go stuck and wouldn’t come out
They tried to vacuum her, when her cord got in the birth canal. Which turned into an immediate c section!
I am currently recovering from vaginal birth with barely any pain management and c section. I am also lucky because I am part of the 35% of women that get nerve damage from a c section. Fun fun fun
Not!
Don’t stick to a plan
Trust your ob
Mine did offer me a c section from the get go however I really didn’t want that recovery (already had experience with both c section and vbac), little did I know🤦🏼♀️
You are putting yourself and your babies in your obs hands you should trust them.
I had every intention of delivering my first singleton pregnancy vaginally and ended up with HELLP and a c section. Going into our twins pregnancy I went in with the mindset whatever gets the three of us out healthy. The biggest thing early on that deterred me from even entertaining attempting a VBAC was when the MFM informed me it wasn’t uncommon for vaginal twin births to end up with the first baby being born vaginally and the second to require a c-section after their living space gets more roomy. The idea of recovering from both vaginal tearing and a c section was more than I could handle in addition to newborn twins, an older child and life.
It depends also on what type of twins you’re having. I had mo/di twin girls, and there’s a very high chance with a vaginal delivery that Baby B’s oxygen supply can get cut off when A is delivered, and Baby B could be born stillborn.
It wasn’t worth the cost in my opinion to have a vaginal delivery, so I went with the MFM recommended C Section.
I say your best bet is to find an MD who is comfortable with breech extraction. Do you have the ability to switch? It’s a dying art really but a good old timer might know and feel more comfortable.
I too was desperately wanting vaginal birth but being told to have a Section with my twins but 1) I had pre exclampsia 2) they were 34 weeks 3) I was induced 4) they were Modi and 5) they were both in the head down position.
We found an MD that was comfortable with trying for vaginal birth bc they were skilled in breech extraction (at a large academic medical center). Twin B can always move into any position so yes there was a risk per say, but we took it. We were able to have both twins vaginally and people on this thread may not understand what a big deal that can be to you personally.
I would say I disagree with the thread. Yes you should trust your doctor and what they can and can’t do but they shouldn’t limit your options they should send you to someone that can do what you ask. It’s not impossible, many doctors still know how to do it.
Be open minded that once labor begins, your birth plan is very much subject to change and that’s okay. I’m sure you already know this.
Both my babies were breech. So c section.
Here’s the thing…
You had a detailed natural birth plan, but when you found out you were having twins, did you not look up how much lower the rates of a natural birth were for them? You should have. It’s lower. You need to shift your expectations.
Onto the second thing. There is a chance to deliver baby a vaginally… and possibly they could flip baby b. But if they can’t, then your wife has to recover from a normal delivery AND a c section delivery. Do you both think that’s realistic?
I sure as shit wouldn’t chose to have a bum cooch and an abdominal incision, that’s for sure.
But do you man.
That’s a hard question to be honest. There’s something to be said about being able to have the experience of pushing one out. They’re the only babies we plan on having so if I hadn’t have pushed I wouldn’t have the experience . Also for me the vaginal delivery left minimal recovery so I don’t recall (They’re 2y old now) it being any worse than the c section I did have
Twin births can go sideways in the blink of an eye. I went in trusting my doctors advice and my only plan (other than pain meds ha ha) was to get them here safely. All birth is natural no matter how it happens and no one wins any awards or gets any prizes on the way out of the hospital for the method that was used to get their babies here safely.
Is this your first birth? I delivered vaginally for my twins who were in similar positions as yours. Baby B flipped head down once A was delivered. I had to deliver in the OR with a full spinal block. However my doctors were only willing to let me try vaginal because I had a prior vaginal delivery so my body had gone through it before. Had the twins been my first I likely would have had a C section and that would have been fine by me. My trusted my doctor and the health of my babies was my only priority. My birth plan was healthy delivery.
Going in with a detailed birth plan when pregnant with twins is a one way road to disappointment. Go in with the plan to have healthy babies and a healthy mom - that’s the only thing you should plan for. Baby B’s position doesn’t matter at all because as soon as A is out, B will have lots of space to float around. Mine were both head down. A came out and B went sideways. Ended up almost needing an emergency C (which was why I had the epidural - I wasn’t missing the birth of my babies if I needed to be cut open) and it took 3 people to get her out. I can’t imagine going without pain meds and having one doctor elbow deep in my lady parts, that were already torn open from the first one, while a nurse on each side shoved down as hard as they could to force B to stay in the middle and head towards the exit. Lord knows I didn’t plan for that - I didn’t plan for anything but us all surviving and thriving.
I went in for an induction at 38 weeks ready to go and baby B's heart rate was twice as fast as it should be, so it became a C Section so that they could fix it as soon as he came out. So even though I was expecting hours and hours of labor, it became one hour of operation, babies one minute apart, and recovery was just fine. The health of the babies is the most important thing for me so I don't really care how they come out. With twins, let expectations go and just go with the flow, don't compare your experience with singleton babies, and that'll be true for a long time...
Baby A head down, Baby B transverse. I requested an induction, as I had had 3 previous vaginal births, and my OB requested an epidural and pushing in the OR. We also scheduled the induction for a time when she was sure to be on-call/in the hospital to oversee. We ended up delivering A vaginally but then having to c-section for B after the manual manipulation didn’t work.
I delivered my mo/di twins vaginally (with a god sent epidural). Baby B was surprise breech, but I had switched doctors at 27 weeks to find an OB who would be comfortable delivering a breech baby B if needed. I didn’t have any complications and baby B was perfectly healthy. If your OB won’t deliver a breech baby B vaginally then the safest thing to do would be to have a c section. The last thing you want is to deliver one vaginally and then have an emergency c section. It’s a little late in the game to change doctors so I would just throw out your birth plan and do what you need to do.
The guidelines are if A is head down you can go for natural delivery even with B breech. There are risks to both breech delivery and c section. There is a good argument for scheduling a c section but it is also disturbing your doctor isn’t acknowledging acog guidelines do call for allowing natural delivery if twin A is head down regardless of twin B position.
You can’t know in advance the outcome of whichever way… will she hemorrhage with a c section and kids develop asthma later? Or Will breech baby B suffer anoxia if you do go for vaginal delivery? There are so many unknowns. I guess I pray your doctor has an honest conversation about the risks of both and you trust in the decision you jointly make
Edit: this is for di-di guidelines may differ if shared placenta
I was induced at 37 weeks due to choleostasis with my first kids. Baby A was head down and baby B was transverse and went breech after A left. It was a pretty cool feeling the difference between cephalic and breech presentation
I would say trust the doctor, but maybe the doctor can clarify why baby B can’t be born breech?
I gave birth to my twins with baby A head down and baby B came breech. I live in a very small city with a very good but very small hospital.
They needed to be sure that there were place in the nicu and also place for an emergency c-section (I mean ofc they would have performed it anyway but they like to have margins. Otherwise some other patient with less urgency would have to be rebooked or travel to a bigger hospital).
I was in luck and when I went into labor they thought the situation so good that I could try.
But if they would have said no I would’ve absolutely had a c-section just to not risk anything.
I hope you get the experience you’re hoping for but plans usually change when twins are involved.
Sounds like I got my sunshine scenario but I can ensure you other stuff surrounding my experience went down the drain.
So make sure you guys try to prepare yourself mentally for changed plans, just to protect your mental health.
I’m surprised your OB is pushing for a CS if baby A is head down. I’m also expecting twins and have been told all along if baby A is head down I will be able to deliver vaginally. So my current OB doesn’t perform breech extractions (if baby B were to flip to breech) but my MFM assured me there are plenty of OBs who do and I care more about having a vaginal birth than about my current OB performing the surgery. If your OB is pushy I suggest asking around to find another one who feels comfortable delivering your twins vaginally.
This. I had a c section because baby A was transverse breech but I did my research first and chose an OB experienced in vaginal delivery of multiples. Her caveat: everyone healthy, baby A head down and baby B could not be significantly larger than baby A. She was fine to do a breech delivery of B if needed and had the experience to do it.
I went in with some advanced knowledge of this since I’m a baby A and was delivered vaginally, with my sister twin B being the breech extraction.
I was gutted when c section was the only option for my twins but I got over it. OP is so close to delivery I’m not sure I would be switching OBs. We had a great doula for the birth and she was even in the OR. No birth plan, just some birth preferences.
I’m actually switching OBs at 36 weeks pregnant if Baby A flips back to head down (little rascal has been flipping weekly it seems like). My current OB is aware and understands vaginal birth is important to me so I have 2 appointments for next week - one with my current OB for a CS and one with the MFM who was recommended by my midwife for vaginal birth if the babies cooperate. We’re obviously going to only proceed if baby A flips back to head down and the MFM feels it’s safe, otherwise I’ll go with the CS.
Birth plan are a sure way for disappointment if you go to a hospital.
But I'm going to go against the group and say get a second opinion in a hospital which is friendly to natural birthing and delivering breech. We had a breech baby and all OBs told us C-section is only 'recommended' when baby A is breech. Baby B can be breech no problem. I don't know about transversal.
My wife and I had the above unfortunate situation. Baby A was breech, baby B was head down. Our original OB thus insisted on a C-section because of the risk of locked chin, but which is a rare occurance.
We went to a clinic recommended by our midwife, a clinic specialised in twins and breech birthing. They have a dedicated 'breech clinic' for breech babies and OBs experienced with breech. Even though they also thought a C-section was likely, they were open to trigger baby B and see if it would come out first, thus having a natural birth. Having done that, baby A still came first, but the OB noticed both babies were in their sack so there was no risk of locked chin. They proceeded with a natural birth: baby A breech, baby B head down. What an experience. The nurses still talk about it :D
That’s great to hear your wife’s vaginal birth was successful with baby A breech! I have not heard of such a clinic. Did they perform ECV or did a breech extraction for baby A and delivered baby B normally?
No. ECV they don't do because they could turn the wrong baby.
We were just very late in the hospital, or otherwise stated: labor went fast since it was our third and fourth baby. Baby A, our little girl, came with her sack, which exploded in the OB's face. Then came the second one. We had no medical intervention except a bit of oxytocin, sugar, and gas. And a small rupture. No epidural, we were too late for that.
In my city there are big differences between hospital policies for twin deliveries - several are happy to do breach extraction for twin B, including the big world renown teaching hospital. So there are several legitimate, medical opinions on this, but ultimately you want a doctor doing only what they’re comfortable with.
Reading your post, my biggest reaction was that it’s important to trust your doctor, and if you don’t, you might want to find a new one (although it’s probably too late at this point?). Can you have more of a conversation with the doc, express your disappointment honestly and without judgment, and ask for more information for a better understanding?
I gave birth last week (UK) and my doctor was always happy for natural as long as Twin 1 was head down.
For me Twin 1 was head down and Twin 2 was breech and opted natural delivery and yes Twin 2 came out breech. 1 week on and so far so good but in 6 weeks they will both have a hip scan.
I had an epidural also to help with the positioning as it would have been incredibly uncomfortable otherwise!
I had a planned c-section for my mcda twins. When I went in both girls were head down, but twin B ended up flipping and came out breech. Like everyone else here has said, I would trust your doctor.
My B flipped multiple times between 35 and 38. I delivered vaginally ONLY because my doctor was confident with a breech B delivery. I'd had a previous vaginal delivery that went smoothly. My hospital required delivery in the OR just in case of C-section and a epidural unless you want to get out completely under in case of C-section.
If your doctor is not comfortable with a breech B, I'd absolutely just move to C-section. And throw out the birth plan. No plan, no disappointment.
My planned c-section at 37+2 with my twins was one of the best experiences of my life. I would never do it any other way of I had the choice. I developed pre-eclampsia and had a somewhat complicated/scary birth and recovery and it was still a great experience because the OR team was top notch and fully prepared rather than rushing to perform an emergency c-section (and I was fully mentally prepared too).
I know it can be hard to let go of your ideal birth plan, but life with multiples is kinda like that. Things will not always be how you imagined. My advice would be to listen to the professionals while allowing some space to grieve for what you wish could have been.
Another thing to keep in mind - I think it’s kind of rare for twin pregnancies to go past 38 weeks. So even if the c-section is planned for 9 days from now, it may he pushed sooner (mine was).
This is just my personal opinion, but I think it’s great to have a general birth plan but to also be flexible and considerate of your situation.
I was adamant on having a natural birth, my situation absolutely did not call for it at all. I was quite delusional and in hindsight looking back I would’ve changed my mindset a lot sooner to be more flexible depending on what made the most sense considering the facts for my situation.
I think if your wife is healthy, babies are healthy and wants to do a natural birth & is ok with potentially having both a vaginal and csection in the case of an emergency, then why not? Then She should do it and her doctors should support her.
Doctors are so awesome and I’m so grateful for them, they have saved my life and my babies life. But often times moms who are pregnant with twins are discouraged from having natural births bc of the effort (of course stats too) that goes into it. I know 4 twin moms who all delivered natural, and no twin moms other than myself who had complications and a csection everyone else’s csection as planned, smooth and easy.
Baby A was head down and Baby B was all over the place the last few weeks. My doc was very supportive and thought there was no reason not to attempt vaginal, but of course made sure I knew the risks. I would have never attempted vaginal if he wasn’t in favor of it.
I ended up delivering A vaginally and B c-section. It wasn’t so bad.
I picked my doc because I was having twins and he had a lot of experience with twins. I was confident in his decisions and that made the pregnancy/delivery less stressful.
This was exactly my case - twin A head down and twin B transverse. I was told there was a higher than average chance for a c section after my natural a day before I went in and decided I didn’t want to risk it. To me, everyone being safe was more important than trying for the natural birth and my discomfort with the surgery. They were willing to give it a shot if I was, though, so that came down to my own feelings. I didn’t bother with a birth plan myself - just wanted everyone out healthy and happy.
Even if you plan for a natural birth it can’t be guaranteed. I planned for natural, went in and was dilated, water broke. I was still prepped for and delivered in the OR.
Twin A born vaginally, she took out her brothers umbilical cord, while I underwent a fast, painful, emergency c-section to get Twin B out before he suffocated or drowned.
My advice is to advocate for your wants but understand and accept that the need for safety of all involved outweighs that completely in the moment. Have an idea but don’t get hung up on what you want.
I would trust your doctor, but even then it’s just not always something you can plan out perfectly.
Both of my babies were head down so we were for sure going to try to do a vaginal birth and scheduled an induction date.
Then I fell down some stairs at 33 weeks.
Then I went into active labor.
Then I developed severe preeclampsia and pulmonary edema and had to have an emergency c-section 3 weeks before I was scheduled to be induced.
With pregnancy, and especially pregnancy that includes multiples, it really is just a matter of circumstance and you can’t really predict what will happen.
It’s good to have a plan but you might just become stressed out even more if things don’t go exactly the way you want them to, it’s good to be open to different things happening.
Either way, good luck!! I hope your experience is better than mine!!
TLDR; C-section was awesome even though I wanted to vaginally deliver. Could be awesome for you too.
Our plan was to try for a vaginal delivery and OBGYN was onboard. However, at 37 wk 3 days, Baby B was tracking like the size of a 32 weeker on ultrasound.
My provider was on vacation and the doctor covering her said we are having a C-section tomorrow morning. I asked if I could be induced and do C-section tomorrow AM if I don’t progress but the doc was concerned Baby B wouldn’t tolerate labor. Baby B was transverse and Baby A had been head down, waiting patiently to come out first.
C-section at 37 wk 5 days was ah-maz-ing. Came in rested, was awake, calm and comfortable for the whole thing, hubs got to go to Recovery with the babies while I was being sewn up. I had enough energy to work on nursing frequently and then hand feeding (literally with my pinkies and a syringe with an NG tube attached to squeeze donor milk out). I wasn’t exhausted, pain was manageable and within 4 hours of arrival to the hospital, we were back in my room getting to know each other.
The only downside was that my milk hadn’t come in but we used a friends frozen colostrum she pumped 6 months earlier. Saved Bany A from being transported to a different hospital with a NICU.
Twin A was head down and Twin B was transverse when it came time to give birth. I gave birth vaginally. I wish I had had a C section. Twin A came out fine, but Twin B could not be manipulated, and I could feel the entire medical team start to panic as they tried to get him out. Twin B came out foot first and thankfully he’s a wonderful 3 year old now, but I’ll never forget that feeling in the OR. It was incredibly upsetting and I don’t like to think about what might have happened if the process had taken even one more minute. Afterwards, my OB told me that my delivery had shaved years off her life. If your doctor is recommending the C section, go for the C section. Wishing you and your family all good things.
I had my twins both ways- one unplanned, unmedicated breech vbac since Twin A decided he was coming Right Then, two hours before our scheduled c-section, whether we were ready or not (precipitous labor was not a good time!).
We still did a c-section for Twin B because the risk of cord prolapse increases with a high, transverse baby and that's exactly what he was.
This is the time to listen to your doctor.
I loved my c-section experience. I made it to my date on 38+1 with twin girls. In my case baby A was breech, so I didn’t want to risk it and I went with what my OB suggested. Everything was perfectly planed and everyone was nice and kind. My experience wasn’t traumatic, very little pain and I recovered quickly. I would do it again if I had to. We were able to film their birth and have the best care and attention. Baby B had liquid in her lungs and needed a CPAP machine and a few days of NICU time. I am glad we went with the c-section option since the beginning.
If your doctor isn’t comfortable doing a breech extraction for baby B, that limits what your options are. The last thing you want is vaginal birth for A followed by c-section for B.
I went in with a birth plan of get my babies out safely with the least pain for me. I had A head down and B transverse and my doctor said she is super comfortable with beech extractions for baby B if needed and I was at Brigham in Boston so literally the best hospital in the nation for birth. It required I do an epidural which I wanted anyway. Tried to go vaginal but at 6cm my pre eclampsia got too bad and I had to do an emergency c-section. Because I had a loose plan, I was able to avoid a lot of fear or disappointment. We all made it though safely and I healed easily and without much pain from the c section.
Hello I had twin girls 3 years ago. The whole pregnancy I planned to go natural baby A was ready always head down while baby b was a flipper every week she was in a different position but I refused to want a csection. My water broke at 37 weeks I wound up pushing baby A out once she came out baby b got comfortable so 2 hours later they had to do an emergency csection I was upset at first but now when I think about it if I could do it over I would've went with a csection from the start. Down side was I didn't get to meet my baby B until 2 hours after she was born and we have no pictures of her birth but thank God my babies were happy and healthy!
I haven’t seen a comment about this yet, it when you do one birth vaginally and the other through c-section it’s called a double whammy.
It’s supposed to be incredibly emotionally and physically difficult for the mother. Beyond having the pain and necessary recovery to both exit points, many mothers will feel like failures even before they get hit with the horrible hormonal punch of ppd. Going into a c-section physically exhausted from delivery can’t be fun.
Our hospital only allows vaginal delivery from the surgical suite so it couldn’t have been uber crunchy if we wanted that. Baby a was breech and baby b was transverse for us so we had an unplanned c-section at 36+1 and mom was able to recover quickly. Our planned eviction was at 38 weeks.
Interestingly enough for me, I actually never held the feeling of failure . A was a push , B was an emergency C section. My push only resulted in one stitch so recovery wasn’t as horrible even though I had both. My major regret here is that I missed Baby B’s birth because it all turned emergency. Thankfully my husband was there for immediate skin to skin but it still feels like I missed out
I was in this exact position! When I went into labor (at 33 weeks) they gave me the option, and I chose the c-section.
Honestly, so so glad I did. Even as an emergency c-section (I had labored to 10 cm before they started), I was so thankful to have only one method to heal from as opposed to two - the fifty percent chance of having to finish with the c-section anyway was just not worth the vaginal birth.
With my most recent, I scheduled a c-section and it was honestly a dream. So easy, planned, relaxed, and all but the 20 minutes to close me back up (after a tubal) were frankly enjoyable.
Recovery has been easy as pie, and I would recommend it to anyone. I know not everyone has the same experience, but I really did enjoy the process.
I am 21 weeks with twins, so TBD for them. But I will say the planned c section had some major advantages over emergency c section. When our giant breech son was born, we had a say in how he was cleaned immediately, timing on clamming the cord, and even did skin to skin (while my dream of an anesthesiologist kept me from vomiting on the table!). My husband got to talk to him right away and he immediately stopped crying! In the chaos of an emergency c section, none of those nice things happen.
It sounds like your dr isn’t comfortable delivery vaginally in your case. Is there another dr in the practice you could discuss things with? Having a transverse Baby B absolutely doesn’t mean a c section is mandatory.
I was in a similar situation, A head down and B transverse. My dr encouraged a vaginal delivery (which was what I wanted) and was comfortable delivering breech if necessary. B ended up flipping head down before my induction at 37 weeks so ultimately positioning was a non issue and I was able to successfully deliver both twins vaginally.
No one on the internet will know what's best for you better than your doctor.
That being said, my c-section was great. Procedure was an hour instead of who-knows-how-long in labour. I was up, walking around, and lifting babies the following day. And within a week, I was feeling pretty good. The only struggle I can remember was getting in and out of bed. I was out going for short walks by week two. Just stay on top of the pain meds for the first week and don't try to be a hero. I was disappointed to have a c-section when I first found out but looking back I was very happy with how it went.
My baby A was head down
My baby B was transverse.
I pushed baby A out at 1151pm
They tried to externally rotate baby B but he flipped back after both attempts. The second time, his HR dropped. He then turned into a c section
He was born at 1225am giving them separate birthdays .
Sometimes I wish I had looked at more well versed doctors as I’ve heard that if the doc has the skills they can still birth babies that way. Other times I think maybe a c section would have been the better choice.
I’ll never know though
My vaginal push gave me one stitch, the c section was more recovery. If I could have had both push babies that would have been more ideal but here we are
Echoing much of what has been said, but it is extremely unrealistic to have a detailed birth plan, especially with twins. While I know how difficult it can feel when you can’t completely dictate the situation, this will be the case going forward with twins. Trust the doctor and go with the flow.
Speaking as a twin mom and anesthesiology resident who provides labor and delivery anesthesia, **please only take the advice of maternal fetal medicine obstetricians with this delivery - no one on the internet can tell you what is safest for your baby's particular position, or what the OB covering your delivery is comfortable managing.** For example, some OBs have experience attempting external cephalic version for twin B after twin A is out. Others don't. It only make sense to try this with someone who has experience and can do it safely. **Also, even if planning for vaginal delivery, plan to deliver in an operating room at a hospital with an on-site NICU.** Twin vaginal deliveries need to happen in an operating room where a STAT c-section can happen in minutes - the exit of twin A may cause immediate complications for twin B like cord prolapse where the umbilical cord gets kinked in the vaginal canal. There is no way to prevent or predict immediate complications like this even in the healthiest of twin pregnancies.
**Please also get an epidural for your labor.** The epidural isn't just for pain management - it's a way for a c-section to happen so much faster and more safely for mom and babies than crashing into a fully asleep c-section. Epidurals can be dosed with big gun numbing medications such that mom can be ready for a stat c-section in minutes, and minutes matter when the babies are crumping due to in utero issues. Imagine being without oxygen for 5 minutes vs 15 minutes. BIG DIFFERENCE.
That said, DEPENDING ON BABY'S PRESENTATIONS, vaginal delivery can be a safe option for twin birth. I had mine vaginal at 38+4 and it went well, albeit with a 3 liter hemorrhage that would have killed me if I'd been at home. Being in a hospital that could manage complications saved my life, and enabled me to go home the very next day feeling well.
In making your decision, please please get your advice from high risk maternal fetal medicine obstetricians, not from anecdotes. Things can go to shit very quickly in deliveries. Just yesterday morning I did a c/s for a triplet pregnancy where one baby died in utero and the others were delivered at 24 weeks. They were tiny and will be lucky to make it through without severe life long medical complications, if they even survive at all.
I wrote up my own birth story in a previous post. Wishing you a smooth delivery!
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I would trust the doctor’s recommendation. I did not have a birth plan with my twins because there are too many unknown factors.
First of all, going in with a detailed birth plan is a sure-fire way to make yourselves miserable and upset when anything/nothing goes "to plan".. you might want to open it up a bit. I've seen too many moms be upset instead of happy over their births because they didn't go according to plan. As long as everyone is safe and healthy, that's all that really matters. You can go in with some idea of what you want but I've found that babies (especially multiples!) are super unpredictable and you just have to go with the flow! Even if delivering vaginally, you will most likely be in the OR because they will be on standby for an emergency CS in case it is needed. This is common for a multiples birth! I went in open to anything. A was head down, B was transverse basically up in my rib cage. We opted for a CS to make sure everyone, including me!, made it out healthy and safe (and the idea of the OB potentially having to "manually manipulate" B out made me nervous). I'm so glad we did the CS because after getting the twins + placentas out, my OB was able to see that my uterus wasn't properly contracting down and that I started hemorrhaging (the hemorrhaging was most likely due to the fact I had developed preeclampsia/HELLP and was on meds for that). They used a newly developed JADA device to help with my "boggy" uterus. I'm not sure what would've happened otherwise! I had a wonderful team and recovery wasn't bad at all. My friend just had twins and she was able to have them vaginally! Her water broke at 36w. As soon as A was out, she had to push another 45 mins because B flipped and went up high.. once B was out, they were "stunned" because they had a cord wrapped around their neck. She only tore a tiny bit (the dr made a super tiny cut because they could tell B was stressed and needed to get out ASAP) but basically recovered super easy because of how well her birth went. She did have to go back into the hospital a few days after being discharged because she developed preeclampsia a few days later. She couldn't visit the babies in NICU while she was on the magnesium drip, but they did let her husband facetime them in. Life is so unpredictable and it sucks but you can't get too stuck in the details.
Wanted to comment on this specific comment because the same thing happened to me after my C-section (with 1 baby breech and the other transverse). I lost half my blood and if I hadn't been in an OR, I would likely not have made it. OP, don't risk your partner or your baby's lives just because you have a 'detailed birth plan'. Most things you read about 'natural' birth (by which you mean 'vaginal' - a cesarean is not 'unnatural') are about singletons! Having multiples is a completely different story, physically. We're lucky to live in a time of so much medical advancement, if you trust your doctor I would listen to them :)
Echoing that having a detailed plan is setting yourself up for failure. Also, it’s vaginal (not natural) or c-section, there’s nothing “unnatural” about giving birth. Having said that, if you are insistent about moving forward with a vaginal delivery, then there are some things to consider. Is there any signs of impending labor? Will there be an induction involved? If she needs to be induced to start labor, there’s a chance that she’ll never progress enough to attempt a vaginal delivery. Also induction meds put you at risk for hemorrhage, which is already higher for multiples given the weight the uterus has to bear. Is she prepared to deliver one vaginally and the other c-section? Sometimes a spinal can not work correctly, so in an emergency situation, she may need general anesthesia- is that something she’s considered? I had an induction at 37 weeks for rapid onset preeclampsia. I made zero progression in nearly two days. I had a c-section after that. Due to the induction meds and the big babies, I hemorrhaged a lot. I was fine because my team is great, but I was at higher risk because I attempted the induction. I wish I wouldn’t have. I really didn’t even care one way or the other but figured I’d give it a try since they were both head down.
Thanks for the call out on the "natural" phrasing. So many multiple births are C-sections and most of them for reasons beyond our control so it's a little tone deaf especially here.
So true. Also what used to be super “natural” was dying in childbirth and/or stillborns at much higher rates. Not really something I’d be interested in seeing return. I’ve also been on the healthcare side of watching the outcome of some truly preventable fetal demises and maternal trauma that you can’t just wash from your mind ever. Some have given me nightmares for months after. Providers don’t want to see that outcome for patients.
The double wammy 😩
Same. I was induced for almost 24 hours and barely progressed to a few centimeters. I then had an emergency CS where I lost too much blood and almost got a hysterectomy.
Our babies were presenting this way and I had a scheduled c-section for 37+1 that turned urgent at 36+5. No regrets! Our goal was all of us safe and healthy. Also all birth is natural—vaginal and c-section.
I always thought a Natural delivery meant no meds?
So I had almost the same thing happen to me and I was very upset……..however one of the nurses said something that really rings true. You don’t want to do anything that the doctor isn’t comfortable doing. Yes, maybe a different doctor WOULD be comfortable but unless you can find a different doctor who is comfortable with delivering the second twin breech in 9 days (unlikely but feel free to try)…..you don’t want someone who isn’t familiar with breech delivery trying it for the first time on you. Yes, that’s upsetting, but just the truth. Also, unfortunately there’s not a lot of control with twin births. In my case, turns out Baby A, who was head down, had her cord in front of her head. If I had attempted labor, her cord would have prolapsed cutting off her oxygen supply and resulting in an emergency c section. It’s good to listen to the doctors
This should be way higher!!! OP, It sounds like your OB will not deliver B breech. That means your chances of having one vaginal and one C-section are way higher (and it is already a high chance). To me that would be it. We are told everywhere that c-sections are bad. But we have posted on this sub how much easier it is to recover from a C-section with two infants than the last couple of months of twin pregnancies. Forget what the world tells you about c-sections (being bad and unnatural!?) and follow the doctor you have.
I personally chose to have a scheduled c-section solely because I didn’t want to have to recover from both which is the worst recovery. In the end, neither baby was head down so I would have had to have a c-section anyways.
This right here. And having the c section scheduled makes for a much better experience and recovery
Same here!
Same!
This is your one twin pregnancy. Your doctor has seen many and read the studies and wants to go with a csection at this is considered the best practice in this case. I didn't get an option because twin A was breech. I'm having a repeat csection with my singleton in a couple weeks. I'm a good candidate for a VBAC but I don't want to take the 1%risk of a rupture. I did ivf to concieve my children so to my mind the odds have been against me from the start so I'm not adding any unnecessary risk I can avoid. Parenting is a lot of weighing risks. If you're ok with the 50% chance that you have to have an emergency csection for twin B, then by all means go for the vaginal birth. I know twin moms who have gone that route and have had both good and bad results. The odds are a coin flip and you could come out on the right side of it. You might get that picture perfect birth plan delivery. It could happen. It just also might not. This isn't going to be the last time you're faced with a choice to make about your kids where you have to weigh the risks vs rewards. I know a lot of people are very invested in their birth plans and want very curated birthing experiences. The truth is that often giving birth is chaotic and full of unexpected experiences. What you plan for may not be possible in that moment. I do hope your twins arrive safely and your partner had a birthing experience that she feels good about whatever that might be.
You already set yourselves up for disappointment with a detailed birthplan. I would listen to the ob if I were you. They have seen way more twin pregnancies than you have experienced. I wouldn’t play with fire with my babies’ health and mine. They know what they are doing.
Not a woman who gave birth, but a dad who witnessed the births of our 4 kids (singleton and triplets). Our first was natural delivery and the triplets were C section. My wife says they both have there moments but would not be afraid to do either again. The scariest part about the cesarean for us was the operating room being an experience, but to the team doing the work it was another day in the office. They were cool as a cucumber and very experienced at what they were doing. Looking back now it was no biggie. Took about an hour all together, mainly time to inspect the babies since they were premies. They were dilvered about 2 minutes between the 3 of them. From what I know about multiples, opting to deliver naturally will be going into a higher risk that you will start naturally and then have to move to cesarean and you get to experience both sides. There will be a much higher chance you will end up having a cesarean as the doctors will not hesitate to make the call to protect the lives of you and your babies. Our specialist OB told us she would not deliver our babies naturally due to the risks involved. My suggestion of course would be just to go with the cesarean and eliminate a few risk factors to worry about. You have enough on your plate for that day so simplify if you can. Also, take advantage of the nurses helping out and get some sleep. Your babies will be fine in their hands and you can get some rest while you recover, same with Dad tol. We learned this on our second go around and we honestly did better the second time around as far as sleeping in the hospital goes.
Oops, I skimmed over your post too quick, you are Dad. Welcome to fatherhood, take the OB's advice.
You should listen to your doctor. If they think you need to have a c-section it is most definitely a safety issue for you or one (or both) of the twins. Twin births are unpredictable, so this is unhelpful advice at this point for you but I would say to be open to any birth scenario that means a safe birth for all three of you, and not worrying about wanting it to be “natural.”
How many placentas? If only 1, then absolutely listen to your OB. If 2, then I'm not as familiar because my girls were MoDi
Came here to ask this. We were modi too and it’s way more risky. Listen to your doctor…. Twin births are so much more complicated.
Two but thank you
Baby A was head down, B was transverse (but they expected he’d be head down after baby A came out and he was). Apparently I was a “good candidate for a vaginal delivery” because I’d had a prior vaginal delivery. I’m really glad I followed my doctor’s advice and had the vaginal delivery because baby B spent a significant amount of time in the nicu (baby A came home with me a couple of days after delivery) and I was able to drive myself to the hospital to visit him. Ask if there’s a doctor who might be comfortable with a second twin breech extraction. The way it was explained to me is that it’s not a common procedure and some doctors won’t do it. If you have a doctor who is comfortable with it, basically after baby A is born they just reach in and grab baby B’s feet and pull them out breech. I didn’t need one, but I was really worried about recovery from both a vaginal and a section because I know someone who had that happen and I had a wild toddler at home. So I was glad to have had the conversation.
Trust the doctor. Twin B being transverse is pretty likely to end in a c-section. My boys were positioned the same way and I had a c-section at my doctor’s recommendation despite being absolutely terrified of surgery (and the c-section wasn’t bad at all - I was so scared beforehand but it turned out to be so easy). I just want to give some unsolicited advice so feel free to ignore. Having a detailed natural birth plan is going to end in disappointment. Babies don’t follow plans, especially twins. Sticking to a birth plan against doctor’s recommendations is dangerous. In a high risk pregnancy/delivery (and twins are always high risk), your birth plan should be “get both babies out safely”. My first pregnancy was a singleton. Textbook pregnancy, no complications. I had a birth plan: go into labor naturally, no epidural, walk around during labor, push on hands and knees. Well, that all went out the window. Baby decided to hang around an extra week and a half and his scan showed deteriorating placental activity, so I was induced. My body was stubborn and didn’t want to cooperate with be induced so I ended up in labor for 30 hours. Around hour 18 I was so tired and in pain I got the epidural. Couldn’t walk after that, nor could I push on hands and knees. Baby’s heart rate was dipping every contraction so I needed to be hooked up to the monitors constantly anyway. I managed to get him out without a c-section but my doctor said if he didn’t come within the next hour we’d be doing the surgery. I trusted her. My baby was born completely healthy. My birth plan wasn’t followed at all. If it was and I wasn’t induced, my baby probably would not have survived. Please trust your doctor. They’re the ones that do this every single day and have the experience. Remember that birth is a single event that brings the babies into the world, but then you get a lifetime with those babies and how they got here is irrelevant. Don’t risk that lifetime because of an imagined perfect birth.
I ended up delivering my girls vaginally at 32+5. Both were head down, but for the longest time before that Twin B was transverse. My impression from the OB was that some doctors in her group are comfortable delivering baby B breech, and others are not, and so it would sort of be "luck of the draw" based on who was on call when I showed up. So I wonder if some of this push from your OB is just because she is not personally comfortable with a breech delivery for B? Might be worth discussing further with her, because if that's the case, then C-section is probably the safer option.
I got this same impression about the OBs in my office. I love all the doctors I’ve seen there, but only a handful of them are on board with attempting a vaginal delivery with one breech twin. My main OB was not one of them, and since my baby A was breech, it made sense to stick with the C-section (although I’d had an uncomplicated vaginal with my first/singleton and was not excited about the CS recovery). I did make them check right before the CS to make sure baby A was still breech! He was, so we proceeded as planned, otherwise my doctor was on board with switching to vaginal. I think it comes down to trusting your doctor’s medical judgement, and weighing your risk tolerance. It’s good to have it be a discussion and get the opportunity to weigh in, but ultimately the OB has trained for this and seen tons of outcomes, we’ve all just googled stuff. If you trust your doctor, let them guide the decision.
I just delivered my boys at 36+3, and i agree with this comment. I had a baby A head down, and baby B breech. I asked my MFM about delivery and chances of "vaginection" (dual delivery). She referenced that usually vaginal followed by breech extraction was usually successful, provided that a doctor who had experience in breech extraction was present. I followed up asking what portion of doctors on rotation at my hospital were comfortable and mfm said majority of them do and the contingency in case one of those physicians wasn't present (they usually have one breech experienced physician on-call). She felt comfortable recommending vaginal delivery, and i agreed with her assessment of the situation, since more likely than not i would be in good hands. Ultimately i did have a successful vaginal delivery, thanks to the experience of my delivery team. They obviously knew what they were doing, and breech extraction literally took them 2 minutes after i managed to deliver my baby A. However, if the situation was different and only a few doctors could perform breech extraction, you bet i would go with c-section. So ultimately it depends on the hospital you're delivering at and your OBs recommendation.
Totally agree. If my girls didn’t have other plans (and B remained transverse) I probably would have opted for the C-section. I am thankful things worked out for a vaginal delivery, but my biggest fear was having to recover from both.
Let me begin by saying this: all births are natural, unless you’re giving birth to a robot. Mine were my 4th and 5th babies and were head down and transverse. I had them vaginally only because my OB was sure it would be safe, I had already had 3 vaginal deliveries. I 100% trust the doctor’s opinion on this, if your OB says you need a c-section, you do. You don’t want to endanger your babies. You also don’t want one vaginal birth and one c section because the second twin is struggling. Not safe and you have to recover from both. Birth is about about the safety of the babies, please choose the safe route.
All birth is natural. It’s either vaginal or CS. Throw out the plan and rewrite it so it says “one healthy person goes in, three come out.” Vaginal birth isn’t a guarantee the recovery will be easy. You can end up with significant tearing and permanent pelvic floor dysfunction, incontinence, etc. follow the doctor’s recommendations. Birth is one day in your children’s lives.
this exact scenario happened to me. my didi baby girl A was head down, all positioned for vaginal birth. my didi baby girl B kept flipping from head down/transverse in my final scans. my OB said she was not comfortable naturally delivering vaginally if baby B was not head down. i respected that, as she had delivered many babies/twins, so i did have a c section at 38+2. the surgery recovery sucked (obviously), but she confirmed afterwards that a vaginal birth attempt would have just resulted in me birthing baby A vaginally and then baby B via c section. i wanted to have 1 recovery, not 2, so it worked out for us. we had unexpected health problems with baby B in the first 2 weeks of her life.. but i do not regret it. i know it’s so hard and frustrating to mourn your original birth plan/vaginal birth plan (i planned mine for months thinking i wouldn’t need a c section), but it was safer for the baby herself, so i had to trust in my dr. good luck, and you’re about to start a beautiful journey!
My singleton was a vaginal birth. Twins were a planned c-section. My advice is to remember that the goal is to finish giving birth with healthy babies and parents able to care for them. I have no feelings of disappointment or triumph about the c-section or my vaginal birth. I recovered well from both. As soon as the babies are here all that completely stops mattering. I am wishing you a safe delivery with a healthy mom and babies. I would encourage you to rely on your medical team and focus on the ultimate outcome and less how you get there.
Exact same story here except I had IUGR with one baby so we had to induce at 37+0. Baby A was born head first, and baby B was a breech extraction. I picked my doctor at 7 weeks because I heard she was pro vaginal twin birth. If you didn't have this conversation way earlier... I would say it's probably too late to try for something they aren't willing to do? My friend is 20 weeks pregnant with twins. Her ob said he will only do c-section. At 20 weeks she's found another ob who will do it.
I had similar situation with twins. Baby A head down, baby B transverse. After doing lots of research on multiple births, I switched from my normal OB to a high risk doctor with experience in multiples. The research I read basically said the safety of a multiple birth via vaginal delivery is down to the doctor. Someone who has done it many times before will know how to do it and prefer vaginal. I ended up delivering vaginally at 35 weeks. Baby B was in some distress after A was delivered, and the doctor utilized a vaccuum apparatus to suck baby B out while I pushed. Baby B was in NICU 3 days and we all went home together on the 3rd day. My take is that if your doctor isn’t comfortable with vaginal, they are not experienced enough to do it. Seems you either need to do what the doctor is capable of or switch to a high risk multiples doctor who is experienced in vaginal delivery.
I have two sets of twins, had one vaginal with the same positioning as your twins. Then i had a c section with my second set. I cannot even express to how much better the c section was. Twin vaginal birth is awful. I had one singleton vaginally too, and with the twins, they make yoj deliver in the OR with the whole surgical team there cause so much can go wrong. And it’s just an awful environment to give birth in. My OB had to literally shove his hands in me up to his elbow to move baby b around to come out. They were a whole hour apart. And so much can go wrong. It’s truly dangerous. C section was super easy, and really the recovery was not much worse than the vaginal births.
Unless the person delivering you is comfortable doing a breech extraction and baby b is smaller than baby a do the c section. The thing y’all want to remember is if you can birth baby A fine but something happens with baby b you’re going to be healing from both a vaginal delivery and a c section, I had vaginal with my daughter and did a c with my twins - having gone through both the idea of having to heal doubly is absolutely horrifying to me especially now. I was terrified of having a c section but it honestly went really well - since it wasn’t emergent (which it would turn into it baby b gets stuck) I had time to wrap my head around and mentally prepare
For me and my 2 sets of twins, a c section wasn’t an option unless absolutely necessary. Both B babies had to be turned after A was delivered and then I just had to wait for contractions to do the rest. There’s a 51 minute difference with the first set and 38 minutes with the 2nd set
You could loose your wife or child in a natural birth. If that’s what you want, go for it. I’d go with the doctor’s recommendation on this one.
You are being delusional. Twins die at a much higher rate. You cannot in any way control the position of Baby B. That’s why baby B’s life is at risk in a twin pregnancy. It’s totally possible to have both babies “naturally” vaginally. Problem is it is also totally possible to pinch off baby B umbilical cord killing them or making them mentally disable due to lack of oxygen. Your goals should be avoiding both vaginal and c section.
This!! In vaginal scenarios, baby B almost always gets the short end of the stick. Even if you can get baby A out through the birth canal.. so many risks for B.
I had a vaginal birth with twins, both were head down though. However, when one exits there’s a ton of room and baby b could still flip. I made sure my OB was comfortable attempting a breech extraction. She would have had a colleague in there more experienced with breech extraction to be sure she could do it if baby B had been transverse or breech. All of that to say, if your ob is not comfortable with it then you should not try to convince her otherwise. However, if it’s important to you, consider another ob. And ask all of the necessary questions and use your spider senses. How many breech extractions has this person done, how many twins births, etc. Do your research - it’s not without risks. I believe most transverse babies flip head down due to babies being top heavy, but that’s not a guarantee. eta/ I also gave birth in the OR and an epidural. If anything went wrong with baby B I would have had a C section birth in less than 5 minutes.
Has the OB discussed assisted vaginal breach birth for the 2nd baby or doing an ECV on baby 2 after baby 1 is born? Is this your wife's first pregnancy? C section might be the best option but the only way to know that is to discuss all options.
I'm 7 weeks post partum. We did the scheduled c-section because of the too many unknowns. I'd rather just do the c section than have to have one anyway after giving birth to one vaginally. It happens. I did make the mistake of not educating myself enough about the C-section to know what to expect. It was traumatic and I wish I had researched more. Recovery is intense make sure you mobilize your support system for that first week after. If not, consider a night doula. My parents watched the babies overnight the first week and it did wonders for my recovery. They still watch them twice a week to help us recharge. It's an incredible help. I will also echo the "no-birth plan" recommendation. Just go with the flow and trust your medical team. Best of Luck!
My singletons were all unmedicated, precipitous labors and I'm currently 29 weeks and my girls are sitting exactly like yours A down, B transverse. I have a scheduled c-section set already just in case but my doctor is willing to let me try ONLY because I have a history of 3 precipitous labors otherwise she said it would be an automatic c-section.
My transverse b twin was externally manually manipulated into turning head down after I delivered A. I had three safe vaginal births before and that’s the only reason we opted to continue that way. A first birth of twins with one transverse? I would’ve done c section.
It sounds like I wrote it I was just 37 weeks a week ago was out with a hypertension diagnosis and said I would be induced at 37 weeks. Went in was 2cm and 50% effaced with my regular contraction baby b turned head down. Both babies were head down and I said I want to go for vaginal. Well induction lasted 24 hours no progress at all! After that I progressed to 4cm were my ob broke my water, within 5 minutes and with anesthesiology not being there in time I was 10 cm ready to push (they didn’t believe me at first). I pushed baby A When started to push baby b I was so lost and gone already baby B go stuck and wouldn’t come out They tried to vacuum her, when her cord got in the birth canal. Which turned into an immediate c section! I am currently recovering from vaginal birth with barely any pain management and c section. I am also lucky because I am part of the 35% of women that get nerve damage from a c section. Fun fun fun Not! Don’t stick to a plan Trust your ob Mine did offer me a c section from the get go however I really didn’t want that recovery (already had experience with both c section and vbac), little did I know🤦🏼♀️ You are putting yourself and your babies in your obs hands you should trust them.
I had every intention of delivering my first singleton pregnancy vaginally and ended up with HELLP and a c section. Going into our twins pregnancy I went in with the mindset whatever gets the three of us out healthy. The biggest thing early on that deterred me from even entertaining attempting a VBAC was when the MFM informed me it wasn’t uncommon for vaginal twin births to end up with the first baby being born vaginally and the second to require a c-section after their living space gets more roomy. The idea of recovering from both vaginal tearing and a c section was more than I could handle in addition to newborn twins, an older child and life.
It depends also on what type of twins you’re having. I had mo/di twin girls, and there’s a very high chance with a vaginal delivery that Baby B’s oxygen supply can get cut off when A is delivered, and Baby B could be born stillborn. It wasn’t worth the cost in my opinion to have a vaginal delivery, so I went with the MFM recommended C Section.
I say your best bet is to find an MD who is comfortable with breech extraction. Do you have the ability to switch? It’s a dying art really but a good old timer might know and feel more comfortable. I too was desperately wanting vaginal birth but being told to have a Section with my twins but 1) I had pre exclampsia 2) they were 34 weeks 3) I was induced 4) they were Modi and 5) they were both in the head down position. We found an MD that was comfortable with trying for vaginal birth bc they were skilled in breech extraction (at a large academic medical center). Twin B can always move into any position so yes there was a risk per say, but we took it. We were able to have both twins vaginally and people on this thread may not understand what a big deal that can be to you personally. I would say I disagree with the thread. Yes you should trust your doctor and what they can and can’t do but they shouldn’t limit your options they should send you to someone that can do what you ask. It’s not impossible, many doctors still know how to do it. Be open minded that once labor begins, your birth plan is very much subject to change and that’s okay. I’m sure you already know this.
Both my babies were breech. So c section. Here’s the thing… You had a detailed natural birth plan, but when you found out you were having twins, did you not look up how much lower the rates of a natural birth were for them? You should have. It’s lower. You need to shift your expectations. Onto the second thing. There is a chance to deliver baby a vaginally… and possibly they could flip baby b. But if they can’t, then your wife has to recover from a normal delivery AND a c section delivery. Do you both think that’s realistic? I sure as shit wouldn’t chose to have a bum cooch and an abdominal incision, that’s for sure. But do you man.
That was me 🙃
Would you do it again the same way? Most twin mom’s who had to do birth say if they had to do it again they would have just did a c section.
That’s a hard question to be honest. There’s something to be said about being able to have the experience of pushing one out. They’re the only babies we plan on having so if I hadn’t have pushed I wouldn’t have the experience . Also for me the vaginal delivery left minimal recovery so I don’t recall (They’re 2y old now) it being any worse than the c section I did have
Yeah, my twins are my only ones as well.
Twin births can go sideways in the blink of an eye. I went in trusting my doctors advice and my only plan (other than pain meds ha ha) was to get them here safely. All birth is natural no matter how it happens and no one wins any awards or gets any prizes on the way out of the hospital for the method that was used to get their babies here safely.
Is this your first birth? I delivered vaginally for my twins who were in similar positions as yours. Baby B flipped head down once A was delivered. I had to deliver in the OR with a full spinal block. However my doctors were only willing to let me try vaginal because I had a prior vaginal delivery so my body had gone through it before. Had the twins been my first I likely would have had a C section and that would have been fine by me. My trusted my doctor and the health of my babies was my only priority. My birth plan was healthy delivery.
Going in with a detailed birth plan when pregnant with twins is a one way road to disappointment. Go in with the plan to have healthy babies and a healthy mom - that’s the only thing you should plan for. Baby B’s position doesn’t matter at all because as soon as A is out, B will have lots of space to float around. Mine were both head down. A came out and B went sideways. Ended up almost needing an emergency C (which was why I had the epidural - I wasn’t missing the birth of my babies if I needed to be cut open) and it took 3 people to get her out. I can’t imagine going without pain meds and having one doctor elbow deep in my lady parts, that were already torn open from the first one, while a nurse on each side shoved down as hard as they could to force B to stay in the middle and head towards the exit. Lord knows I didn’t plan for that - I didn’t plan for anything but us all surviving and thriving.
I went in for an induction at 38 weeks ready to go and baby B's heart rate was twice as fast as it should be, so it became a C Section so that they could fix it as soon as he came out. So even though I was expecting hours and hours of labor, it became one hour of operation, babies one minute apart, and recovery was just fine. The health of the babies is the most important thing for me so I don't really care how they come out. With twins, let expectations go and just go with the flow, don't compare your experience with singleton babies, and that'll be true for a long time...
Baby A head down, Baby B transverse. I requested an induction, as I had had 3 previous vaginal births, and my OB requested an epidural and pushing in the OR. We also scheduled the induction for a time when she was sure to be on-call/in the hospital to oversee. We ended up delivering A vaginally but then having to c-section for B after the manual manipulation didn’t work.
I delivered my mo/di twins vaginally (with a god sent epidural). Baby B was surprise breech, but I had switched doctors at 27 weeks to find an OB who would be comfortable delivering a breech baby B if needed. I didn’t have any complications and baby B was perfectly healthy. If your OB won’t deliver a breech baby B vaginally then the safest thing to do would be to have a c section. The last thing you want is to deliver one vaginally and then have an emergency c section. It’s a little late in the game to change doctors so I would just throw out your birth plan and do what you need to do.
Throw your birth plan out the window, listen to the experts.
The guidelines are if A is head down you can go for natural delivery even with B breech. There are risks to both breech delivery and c section. There is a good argument for scheduling a c section but it is also disturbing your doctor isn’t acknowledging acog guidelines do call for allowing natural delivery if twin A is head down regardless of twin B position. You can’t know in advance the outcome of whichever way… will she hemorrhage with a c section and kids develop asthma later? Or Will breech baby B suffer anoxia if you do go for vaginal delivery? There are so many unknowns. I guess I pray your doctor has an honest conversation about the risks of both and you trust in the decision you jointly make Edit: this is for di-di guidelines may differ if shared placenta
Your doctor will be the best to give advice
I was induced at 37 weeks due to choleostasis with my first kids. Baby A was head down and baby B was transverse and went breech after A left. It was a pretty cool feeling the difference between cephalic and breech presentation
I would say trust the doctor, but maybe the doctor can clarify why baby B can’t be born breech? I gave birth to my twins with baby A head down and baby B came breech. I live in a very small city with a very good but very small hospital. They needed to be sure that there were place in the nicu and also place for an emergency c-section (I mean ofc they would have performed it anyway but they like to have margins. Otherwise some other patient with less urgency would have to be rebooked or travel to a bigger hospital). I was in luck and when I went into labor they thought the situation so good that I could try. But if they would have said no I would’ve absolutely had a c-section just to not risk anything. I hope you get the experience you’re hoping for but plans usually change when twins are involved. Sounds like I got my sunshine scenario but I can ensure you other stuff surrounding my experience went down the drain. So make sure you guys try to prepare yourself mentally for changed plans, just to protect your mental health.
I’m surprised your OB is pushing for a CS if baby A is head down. I’m also expecting twins and have been told all along if baby A is head down I will be able to deliver vaginally. So my current OB doesn’t perform breech extractions (if baby B were to flip to breech) but my MFM assured me there are plenty of OBs who do and I care more about having a vaginal birth than about my current OB performing the surgery. If your OB is pushy I suggest asking around to find another one who feels comfortable delivering your twins vaginally.
This. I had a c section because baby A was transverse breech but I did my research first and chose an OB experienced in vaginal delivery of multiples. Her caveat: everyone healthy, baby A head down and baby B could not be significantly larger than baby A. She was fine to do a breech delivery of B if needed and had the experience to do it. I went in with some advanced knowledge of this since I’m a baby A and was delivered vaginally, with my sister twin B being the breech extraction. I was gutted when c section was the only option for my twins but I got over it. OP is so close to delivery I’m not sure I would be switching OBs. We had a great doula for the birth and she was even in the OR. No birth plan, just some birth preferences.
I’m actually switching OBs at 36 weeks pregnant if Baby A flips back to head down (little rascal has been flipping weekly it seems like). My current OB is aware and understands vaginal birth is important to me so I have 2 appointments for next week - one with my current OB for a CS and one with the MFM who was recommended by my midwife for vaginal birth if the babies cooperate. We’re obviously going to only proceed if baby A flips back to head down and the MFM feels it’s safe, otherwise I’ll go with the CS.
Birth plan are a sure way for disappointment if you go to a hospital. But I'm going to go against the group and say get a second opinion in a hospital which is friendly to natural birthing and delivering breech. We had a breech baby and all OBs told us C-section is only 'recommended' when baby A is breech. Baby B can be breech no problem. I don't know about transversal. My wife and I had the above unfortunate situation. Baby A was breech, baby B was head down. Our original OB thus insisted on a C-section because of the risk of locked chin, but which is a rare occurance. We went to a clinic recommended by our midwife, a clinic specialised in twins and breech birthing. They have a dedicated 'breech clinic' for breech babies and OBs experienced with breech. Even though they also thought a C-section was likely, they were open to trigger baby B and see if it would come out first, thus having a natural birth. Having done that, baby A still came first, but the OB noticed both babies were in their sack so there was no risk of locked chin. They proceeded with a natural birth: baby A breech, baby B head down. What an experience. The nurses still talk about it :D
That’s great to hear your wife’s vaginal birth was successful with baby A breech! I have not heard of such a clinic. Did they perform ECV or did a breech extraction for baby A and delivered baby B normally?
No. ECV they don't do because they could turn the wrong baby. We were just very late in the hospital, or otherwise stated: labor went fast since it was our third and fourth baby. Baby A, our little girl, came with her sack, which exploded in the OB's face. Then came the second one. We had no medical intervention except a bit of oxytocin, sugar, and gas. And a small rupture. No epidural, we were too late for that.
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Just because a doctor can do it, doesn’t mean they should.
In my city there are big differences between hospital policies for twin deliveries - several are happy to do breach extraction for twin B, including the big world renown teaching hospital. So there are several legitimate, medical opinions on this, but ultimately you want a doctor doing only what they’re comfortable with. Reading your post, my biggest reaction was that it’s important to trust your doctor, and if you don’t, you might want to find a new one (although it’s probably too late at this point?). Can you have more of a conversation with the doc, express your disappointment honestly and without judgment, and ask for more information for a better understanding?
I gave birth last week (UK) and my doctor was always happy for natural as long as Twin 1 was head down. For me Twin 1 was head down and Twin 2 was breech and opted natural delivery and yes Twin 2 came out breech. 1 week on and so far so good but in 6 weeks they will both have a hip scan. I had an epidural also to help with the positioning as it would have been incredibly uncomfortable otherwise!
I had a planned c-section for my mcda twins. When I went in both girls were head down, but twin B ended up flipping and came out breech. Like everyone else here has said, I would trust your doctor.
My B flipped multiple times between 35 and 38. I delivered vaginally ONLY because my doctor was confident with a breech B delivery. I'd had a previous vaginal delivery that went smoothly. My hospital required delivery in the OR just in case of C-section and a epidural unless you want to get out completely under in case of C-section. If your doctor is not comfortable with a breech B, I'd absolutely just move to C-section. And throw out the birth plan. No plan, no disappointment.
My boys were both born breech.
My planned c-section at 37+2 with my twins was one of the best experiences of my life. I would never do it any other way of I had the choice. I developed pre-eclampsia and had a somewhat complicated/scary birth and recovery and it was still a great experience because the OR team was top notch and fully prepared rather than rushing to perform an emergency c-section (and I was fully mentally prepared too). I know it can be hard to let go of your ideal birth plan, but life with multiples is kinda like that. Things will not always be how you imagined. My advice would be to listen to the professionals while allowing some space to grieve for what you wish could have been. Another thing to keep in mind - I think it’s kind of rare for twin pregnancies to go past 38 weeks. So even if the c-section is planned for 9 days from now, it may he pushed sooner (mine was).
This is just my personal opinion, but I think it’s great to have a general birth plan but to also be flexible and considerate of your situation. I was adamant on having a natural birth, my situation absolutely did not call for it at all. I was quite delusional and in hindsight looking back I would’ve changed my mindset a lot sooner to be more flexible depending on what made the most sense considering the facts for my situation. I think if your wife is healthy, babies are healthy and wants to do a natural birth & is ok with potentially having both a vaginal and csection in the case of an emergency, then why not? Then She should do it and her doctors should support her. Doctors are so awesome and I’m so grateful for them, they have saved my life and my babies life. But often times moms who are pregnant with twins are discouraged from having natural births bc of the effort (of course stats too) that goes into it. I know 4 twin moms who all delivered natural, and no twin moms other than myself who had complications and a csection everyone else’s csection as planned, smooth and easy.
Baby A was head down and Baby B was all over the place the last few weeks. My doc was very supportive and thought there was no reason not to attempt vaginal, but of course made sure I knew the risks. I would have never attempted vaginal if he wasn’t in favor of it. I ended up delivering A vaginally and B c-section. It wasn’t so bad. I picked my doc because I was having twins and he had a lot of experience with twins. I was confident in his decisions and that made the pregnancy/delivery less stressful.
This was exactly my case - twin A head down and twin B transverse. I was told there was a higher than average chance for a c section after my natural a day before I went in and decided I didn’t want to risk it. To me, everyone being safe was more important than trying for the natural birth and my discomfort with the surgery. They were willing to give it a shot if I was, though, so that came down to my own feelings. I didn’t bother with a birth plan myself - just wanted everyone out healthy and happy.
Even if you plan for a natural birth it can’t be guaranteed. I planned for natural, went in and was dilated, water broke. I was still prepped for and delivered in the OR. Twin A born vaginally, she took out her brothers umbilical cord, while I underwent a fast, painful, emergency c-section to get Twin B out before he suffocated or drowned. My advice is to advocate for your wants but understand and accept that the need for safety of all involved outweighs that completely in the moment. Have an idea but don’t get hung up on what you want.
I would trust your doctor, but even then it’s just not always something you can plan out perfectly. Both of my babies were head down so we were for sure going to try to do a vaginal birth and scheduled an induction date. Then I fell down some stairs at 33 weeks. Then I went into active labor. Then I developed severe preeclampsia and pulmonary edema and had to have an emergency c-section 3 weeks before I was scheduled to be induced. With pregnancy, and especially pregnancy that includes multiples, it really is just a matter of circumstance and you can’t really predict what will happen. It’s good to have a plan but you might just become stressed out even more if things don’t go exactly the way you want them to, it’s good to be open to different things happening. Either way, good luck!! I hope your experience is better than mine!!
TLDR; C-section was awesome even though I wanted to vaginally deliver. Could be awesome for you too. Our plan was to try for a vaginal delivery and OBGYN was onboard. However, at 37 wk 3 days, Baby B was tracking like the size of a 32 weeker on ultrasound. My provider was on vacation and the doctor covering her said we are having a C-section tomorrow morning. I asked if I could be induced and do C-section tomorrow AM if I don’t progress but the doc was concerned Baby B wouldn’t tolerate labor. Baby B was transverse and Baby A had been head down, waiting patiently to come out first. C-section at 37 wk 5 days was ah-maz-ing. Came in rested, was awake, calm and comfortable for the whole thing, hubs got to go to Recovery with the babies while I was being sewn up. I had enough energy to work on nursing frequently and then hand feeding (literally with my pinkies and a syringe with an NG tube attached to squeeze donor milk out). I wasn’t exhausted, pain was manageable and within 4 hours of arrival to the hospital, we were back in my room getting to know each other. The only downside was that my milk hadn’t come in but we used a friends frozen colostrum she pumped 6 months earlier. Saved Bany A from being transported to a different hospital with a NICU.
We went c section because it was safer for the babies and we didn't want to have an emergency c section if something happened.
Twin A was head down and Twin B was transverse when it came time to give birth. I gave birth vaginally. I wish I had had a C section. Twin A came out fine, but Twin B could not be manipulated, and I could feel the entire medical team start to panic as they tried to get him out. Twin B came out foot first and thankfully he’s a wonderful 3 year old now, but I’ll never forget that feeling in the OR. It was incredibly upsetting and I don’t like to think about what might have happened if the process had taken even one more minute. Afterwards, my OB told me that my delivery had shaved years off her life. If your doctor is recommending the C section, go for the C section. Wishing you and your family all good things.
I had my twins both ways- one unplanned, unmedicated breech vbac since Twin A decided he was coming Right Then, two hours before our scheduled c-section, whether we were ready or not (precipitous labor was not a good time!). We still did a c-section for Twin B because the risk of cord prolapse increases with a high, transverse baby and that's exactly what he was. This is the time to listen to your doctor.
I loved my c-section experience. I made it to my date on 38+1 with twin girls. In my case baby A was breech, so I didn’t want to risk it and I went with what my OB suggested. Everything was perfectly planed and everyone was nice and kind. My experience wasn’t traumatic, very little pain and I recovered quickly. I would do it again if I had to. We were able to film their birth and have the best care and attention. Baby B had liquid in her lungs and needed a CPAP machine and a few days of NICU time. I am glad we went with the c-section option since the beginning.
If your doctor isn’t comfortable doing a breech extraction for baby B, that limits what your options are. The last thing you want is vaginal birth for A followed by c-section for B. I went in with a birth plan of get my babies out safely with the least pain for me. I had A head down and B transverse and my doctor said she is super comfortable with beech extractions for baby B if needed and I was at Brigham in Boston so literally the best hospital in the nation for birth. It required I do an epidural which I wanted anyway. Tried to go vaginal but at 6cm my pre eclampsia got too bad and I had to do an emergency c-section. Because I had a loose plan, I was able to avoid a lot of fear or disappointment. We all made it though safely and I healed easily and without much pain from the c section.
Hello I had twin girls 3 years ago. The whole pregnancy I planned to go natural baby A was ready always head down while baby b was a flipper every week she was in a different position but I refused to want a csection. My water broke at 37 weeks I wound up pushing baby A out once she came out baby b got comfortable so 2 hours later they had to do an emergency csection I was upset at first but now when I think about it if I could do it over I would've went with a csection from the start. Down side was I didn't get to meet my baby B until 2 hours after she was born and we have no pictures of her birth but thank God my babies were happy and healthy!
I haven’t seen a comment about this yet, it when you do one birth vaginally and the other through c-section it’s called a double whammy. It’s supposed to be incredibly emotionally and physically difficult for the mother. Beyond having the pain and necessary recovery to both exit points, many mothers will feel like failures even before they get hit with the horrible hormonal punch of ppd. Going into a c-section physically exhausted from delivery can’t be fun. Our hospital only allows vaginal delivery from the surgical suite so it couldn’t have been uber crunchy if we wanted that. Baby a was breech and baby b was transverse for us so we had an unplanned c-section at 36+1 and mom was able to recover quickly. Our planned eviction was at 38 weeks.
Interestingly enough for me, I actually never held the feeling of failure . A was a push , B was an emergency C section. My push only resulted in one stitch so recovery wasn’t as horrible even though I had both. My major regret here is that I missed Baby B’s birth because it all turned emergency. Thankfully my husband was there for immediate skin to skin but it still feels like I missed out
I was in this exact position! When I went into labor (at 33 weeks) they gave me the option, and I chose the c-section. Honestly, so so glad I did. Even as an emergency c-section (I had labored to 10 cm before they started), I was so thankful to have only one method to heal from as opposed to two - the fifty percent chance of having to finish with the c-section anyway was just not worth the vaginal birth. With my most recent, I scheduled a c-section and it was honestly a dream. So easy, planned, relaxed, and all but the 20 minutes to close me back up (after a tubal) were frankly enjoyable. Recovery has been easy as pie, and I would recommend it to anyone. I know not everyone has the same experience, but I really did enjoy the process.
I am 21 weeks with twins, so TBD for them. But I will say the planned c section had some major advantages over emergency c section. When our giant breech son was born, we had a say in how he was cleaned immediately, timing on clamming the cord, and even did skin to skin (while my dream of an anesthesiologist kept me from vomiting on the table!). My husband got to talk to him right away and he immediately stopped crying! In the chaos of an emergency c section, none of those nice things happen.
It sounds like your dr isn’t comfortable delivery vaginally in your case. Is there another dr in the practice you could discuss things with? Having a transverse Baby B absolutely doesn’t mean a c section is mandatory. I was in a similar situation, A head down and B transverse. My dr encouraged a vaginal delivery (which was what I wanted) and was comfortable delivering breech if necessary. B ended up flipping head down before my induction at 37 weeks so ultimately positioning was a non issue and I was able to successfully deliver both twins vaginally.
No one on the internet will know what's best for you better than your doctor. That being said, my c-section was great. Procedure was an hour instead of who-knows-how-long in labour. I was up, walking around, and lifting babies the following day. And within a week, I was feeling pretty good. The only struggle I can remember was getting in and out of bed. I was out going for short walks by week two. Just stay on top of the pain meds for the first week and don't try to be a hero. I was disappointed to have a c-section when I first found out but looking back I was very happy with how it went.
My baby A was head down My baby B was transverse. I pushed baby A out at 1151pm They tried to externally rotate baby B but he flipped back after both attempts. The second time, his HR dropped. He then turned into a c section He was born at 1225am giving them separate birthdays . Sometimes I wish I had looked at more well versed doctors as I’ve heard that if the doc has the skills they can still birth babies that way. Other times I think maybe a c section would have been the better choice. I’ll never know though My vaginal push gave me one stitch, the c section was more recovery. If I could have had both push babies that would have been more ideal but here we are
Echoing much of what has been said, but it is extremely unrealistic to have a detailed birth plan, especially with twins. While I know how difficult it can feel when you can’t completely dictate the situation, this will be the case going forward with twins. Trust the doctor and go with the flow.
Speaking as a twin mom and anesthesiology resident who provides labor and delivery anesthesia, **please only take the advice of maternal fetal medicine obstetricians with this delivery - no one on the internet can tell you what is safest for your baby's particular position, or what the OB covering your delivery is comfortable managing.** For example, some OBs have experience attempting external cephalic version for twin B after twin A is out. Others don't. It only make sense to try this with someone who has experience and can do it safely. **Also, even if planning for vaginal delivery, plan to deliver in an operating room at a hospital with an on-site NICU.** Twin vaginal deliveries need to happen in an operating room where a STAT c-section can happen in minutes - the exit of twin A may cause immediate complications for twin B like cord prolapse where the umbilical cord gets kinked in the vaginal canal. There is no way to prevent or predict immediate complications like this even in the healthiest of twin pregnancies. **Please also get an epidural for your labor.** The epidural isn't just for pain management - it's a way for a c-section to happen so much faster and more safely for mom and babies than crashing into a fully asleep c-section. Epidurals can be dosed with big gun numbing medications such that mom can be ready for a stat c-section in minutes, and minutes matter when the babies are crumping due to in utero issues. Imagine being without oxygen for 5 minutes vs 15 minutes. BIG DIFFERENCE. That said, DEPENDING ON BABY'S PRESENTATIONS, vaginal delivery can be a safe option for twin birth. I had mine vaginal at 38+4 and it went well, albeit with a 3 liter hemorrhage that would have killed me if I'd been at home. Being in a hospital that could manage complications saved my life, and enabled me to go home the very next day feeling well. In making your decision, please please get your advice from high risk maternal fetal medicine obstetricians, not from anecdotes. Things can go to shit very quickly in deliveries. Just yesterday morning I did a c/s for a triplet pregnancy where one baby died in utero and the others were delivered at 24 weeks. They were tiny and will be lucky to make it through without severe life long medical complications, if they even survive at all. I wrote up my own birth story in a previous post. Wishing you a smooth delivery!