E&R Mommy

macchiatto

I'm curious; can you tell me more about your decision to try to deliver both babies vaginally even if both are breech? My A was vertex for basically the whole third tri but B kept flipping back and forth so I did a lot of research on best mode of delivery for a breech Baby B and switched to an OB who was experienced in breech extractions. I don't know much about doing it when both are breech though; can you tell me how you came to that decision? I'm just curious, after my research and experience with breech second twins.

E&RMommy

I'm crazy. 

What I have seen in my training is a massive exodus from vaginal breech delivery.  It's not taught anymore.  The white haired doctors who used to do them without second guessing aren't doing them either.  I keep asking myself...why?  Midwives are way more likely to allow them and at home even.  For the life of me I am trying to understand why midwives who don't deliver anywhere near the volume that most ob/gyns do are still willing to perform vaginal breech deliveries yet my own colleagues are not.  It makes no sense.  All I can surmise is that the high level of lawsuits has very much skewed the practice of breech vaginal delivery to almost non-existence. 

When I was picking my provider, I chose my doctor for his experience.  He became an ob/gyn in Costa Rica.  He then came to the US where he repeated his residency and then went on to become an MFM.  He is extensively trained in forceps deliveries, twin vaginal deliveries and breech deliveries.  I knew that if anyone was still willing to perform a breech delivery (of even a singleton) it would be him.  He has the necessary skills, knowledge and temperment to do it. 

So it's a calculated risk.  We will have the ultrasound machine watching closely to make sure their heads don't lock.  It will take communication between us to ensure I do exactly what he needs me to do.  My babies will not be very big (estimated to about 5.5 lbs each at 37 weeks), so we have that working our favor as well. 

In the end, we will see if I am willing to go through with it.  As long as my doctor has the skill and I have trust in him, delivering them vaginally is not totally unreasonable.  Would I trust anyone else to do it?  Just a handful of doctors. 

Like I said....I am crazy.  I know.  But my background allows me the knowledge and experience to make an informed decision.  That's what is most important.     

 

macchiatto

Sounds reasonable in your situation! I will look forward to hearing how it goes.

And yeah, it was harder to find doctors willing to do breech extraction even on Twin B (despite the research that I found--in medical journals and high-risk OB textbooks--supporting it). I think that's really sad! I was very lucky that the OB I switched to was willing to give me his personal cell phone number--even when he was on vacation when I hit 37w!--so he could be there when I delivered, b/c he knew the vaginal delivery was important to me and that his partner would've wanted to section me.

volgirl123

I wish I was as brave as you. My baby A is breech and I really, really want a vaginal delivery. My OB said she would do a breech extraction on Baby B (who is transverse) but that A needed to be head down for me to try for a vaginal delivery. I really, really, really want a vaginal delivery but I just don't think it's in the cards. I think since I have been on bed rest for so long my babies are confused about which direction is down!

E&RMommy

You still have some time for A to flip.  It's certainly frustrating when you want a vaginal delivery and it doesn't seem to be in the cards.  Our jury is still out....what I want may not be what I get!