Multiples

advice on delivery options

Hi 
Any advice about what to ask about c section vs vaginal birth if the doctor is willing to do an attempt at a vaginal deliveryA?
As I get closer to the due date I am getting more worried about the details. I want to go into my next appointment with some good questions.

My doctors have an unofficial twin team, I'm still unclear about what that means. I am seeing this 3 doctor team but since I am not scheduling a c section I am not sure how anything will happen. They say the only way to start with vaginal delivery is if baby A is head down of course. Some doctors are comfortable if baby A is head down and B is breech to continue with the vaginal delivery. 
For me, Baby A is consistantly head down so far and B flips all over. 
If B ends up breech after A is vaginally delivered what type of thing helps make the decision to go on with the vaginal delivery. Besides doctor experience and baby position/status anything else? 
I googled complications of breech delivery and now I am not confident in it at all.



Re: advice on delivery options

  • edited October 2014
    Well the decision is made before you go in to active labor to have a breech delivery of Baby B. It is an immediate thing.  You can't decide after Baby A is born.  The only reason there would be a change of plan is if Baby B is experiencing distress and there is an emergency c-section, which would happen in about 90 seconds.  That would be the doctor's decision not yours.

    I can tell you my story:  After about 30 minutes of pushing, Baby A was born.  He was vertex.  Immediately after, the doctors broke Baby B's water and pulled him out.  We knew he was breech (as he was the entire pregnancy).  The whole process took 5 minutes exactly,  It didn't hurt, but I felt a weird sensation.

    It was the best decision I ever made.  But I was at one of the best hospitals in the country with an MFM who had done many breech deliveries.  I would not have done it if I wasn't confident in her.

    Every twin delivery should have a "twin" team.  Basically it is a double set-up.  2 sets of everyone and everything in the OR.  Each baby will have
    his own neonatalogist and nursing staff.  There was a radiologist in the room who performed US during delivery to see what Baby B was doing.  And there were 2 anesthesiologists for me, along with 4 obs (one was a fellow and one was a resident).
      

    D & L are here at 34 weeks 4 days by vaginal and breech delivery on 11/19/2013
    Two healthy boys weighing 4 lbs 15 ozs and 4 lbs 5 ozs.  Only 6 days in the NICU and getting bigger, stronger and cuter every day! 
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  • My MFM will do breech extractions like the PP. I have an induction date set at this point for 38 wks. A is head down- B is breech. They will pull her out feet first if she doesn't flip. My MFM said you don't want just anyone doing a breech extraction but his team does them all the time. I would ask if slim the doctors on your "unofficial" team are confident in breech extractions. How often do they do them? If not often, I'd opt for a c/S if B stays breech.

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  • Some drs will not allow vaginal birth if baby b is significantly larger than baby a regardless of position.
  • When I was admitted into the hospital on bed rest I signed a form consenting for a breech extraction and a c-section. At this time both babies were head down. But they were a just in case.

    2 hrs after being admitted I had another u/s and baby A was now breech. I ended up having an emergency c section because baby As feet were in the birth canal.
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  • I have a scheduled c-section for 38weeks because even though baby b is vertex baby a is breech. They will do one last ultrasound before my csection and if baby a by some miracle flips we will do an induction instead. Chances are slim to none now though.
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