If your Baby A was head down and Baby B was breech, please help

Mrs.Greg

We had an u/s today and these are our babies' positions.  My doctor said I need to think about how I want to deliver.  I'm coming up on 36 weeks.  He says we can attempt a vaginal delivery and he is absolutely comfortable doing that but there are risks involved.  He may not be able to flip Baby B and will have to do a breech extraction and there's a chance the baby's head could get stuck - head entrapment.  And of course, there's the risk of delivering Baby A vaginally only to have a c-section for Baby B.  And when we talk about it, he always uses the word "attempt", which isn't the most comforting word.  Or he could just schedule a c-section.  I don't really want a c-section.  I have a 2 year old DD that I will need to take care of in addition to two newborn babies.  I won't be doing that alone but six weeks is a long time to not be able to be alone with her for any amount of time.  I won't be able to lift her.  And I'm just worried about the difficult recovery from a c-section.  I really want to attempt a vaginal delivery but I feel guilty because I know the risks.  At our u/s today, Baby A was measuring 6lb 15 oz and Baby B was measuring 6lb 8oz.  I know this could be off by up to a pound but considering how big they have been measuring since about 28 weeks (ahead every time), I can't help but think these estimates are fairly accurate.  Another concern of mine is, my doctor will be out of town from August 12 through August 22, when I'll be between 38 and 39.5 weeks.  So one of his on-call doctors will be delivering.  While I trust my doctor 100%, I don't know how I feel about another doctor "attempting" a vaginal delivery.  I was dilated 1 cm today, which I know means diddly, but I'm reallhy hoping to deliver before my doctor goes on vacation.  I'm so confused.  Any advice??  Please?  TIA!

schoolsoutbride

I'd want to know that the on-call docs are comfortable with breech delivery of baby Bs, but otherwise, I would have been thrilled to have had the chance to deliver vaginally.  I'd rather risk the double whammy than go straight to C-section. My vag recovery was MUCH easier than my c-section.  Especially since your baby B is estimated smaller, if I were in your shoes, I'd go for the vaginal.

natb22

My situation was opposite (A breech & B head down) and I've never had a vaginal delivery but my C section recovery was a piece of cake. I felt completely normal by 2 weeks out. I felt almost normal at 1 week, it was really just the first 3 days that were super hard but I was in the hospital with lots of help anyway.

I think this is going to come down to the age old question.. if people had an easier recovery with a V delivery or a C section, and that answer is going to be different for everyone.

 GL making the decision best for you!

Kahana

Both my babies were head down until the day before I delivered when Baby B decided to flip.  At first I was sure that I was going to do a C-section but my Dr.s were all very confident about a vaginal delivery.  I was skeptical at first but decided to take their advice.  I am so glad I did, I had a great delivery!!  Baby A came out no problem and Baby B was a breech extraction 5 minutes after his sister. I have had a great recovery! I also have a 2 year old and was able to help care for him soon after my delivery.

Mrs.Greg

Kahana:

Both my babies were head down until the day before I delivered when Baby B decided to flip.  At first I was sure that I was going to do a C-section but my Dr.s were all very confident about a vaginal delivery.  I was skeptical at first but decided to take their advice.  I am so glad I did, I had a great delivery!!  Baby A came out no problem and Baby B was a breech extraction 5 minutes after his sister. I have had a great recovery! I also have a 2 year old and was able to help care for him soon after my delivery.

Thanks for your response.  How much did your babies weigh at birth?  I'm not sure if the babies' weights make a difference with regard to breech extractions but I'm just curious.  Thanks!

mandi leigh

Kahana:

Both my babies were head down until the day before I delivered when Baby B decided to flip.  At first I was sure that I was going to do a C-section but my Dr.s were all very confident about a vaginal delivery.  I was skeptical at first but decided to take their advice.  I am so glad I did, I had a great delivery!!  Baby A came out no problem and Baby B was a breech extraction 5 minutes after his sister. I have had a great recovery! I also have a 2 year old and was able to help care for him soon after my delivery.

Same here A was 5lbs 5oz and B was breech 13 minutes later-he was 6lbs. Recovery was honestly easier than with DD#1. The nurses were nervous following me around as I walked that day but I felt great-just like I had done too many ab exercises! I never ever felt like I had delivered twins! Good luck with your decision

atc282

My baby B was back and forth of breech and vertex right before my induction. After they broke A's water, B ended up repositioning yet again and my dr. said it was best to convert to a c/s. I was pleased, regardless, to have attempted the vaginal delivery that I wanted and looking back, would still opt for the chance that both babies would have/could have been positioned just so for it to be a vaginal delivery.

Every woman and her response to recovery is different. I know many women who had c/s and loved them and their bodies recovered exceptionally well and fast. I on the other hand had a horrible (and abnormal) c/s recovery--hence the reason I'm trying to VBAC with DS this fall.

GL in whatever you decide. Like others suggested, I'd get a feel for what the on-call dr's you might be delivering with stand for and perhaps you can make a decision that is best for you from there. 

lkstor

I would never plan to do a breech vaginal delivery. I'm a Pedi and I've seen head entrapment. And honestly a smooth vaginal breech delivery is pretty scary for me to watch. Just not the right choice for me - though admittedly I know too much

CER+MEL

I had a c/s in that situation and recovery wasn't too bad.  I was nervous about a breech extraction but would have done it had either my OB or the doctor on call who delivered them encouraged it more.  While both offered it as an option, they both seemed more comfortable with going with a c/s.  Therefore, so was I.  The birth and recovery are descibed in my blog if you want more details.

LakeGenevaBride

I went into a vag delivery with A head down and B breech.  My doc was comfortable with breech delivery.  Turns out B flipped to head down right after A was delivered.  If you want to do a vaginal delivery with your doctor, can you be induced before his/her vacation?  GL. 

ade2be

My babies are in the same position as yours.  I just had my appointment this morning and my OB is setting up for my C section at 38 weeks.  He is not comfortable with breech extractions and has recently read some research that indicates a c-section is safer for the second baby's health.  So with my practice, there isn't a choice.  I've come to terms with that and I'm ok with it.  GL making your decision - its so hard to figure out what is best for everyone involved.

jbl126

I am definitely in the minority here but I went with a c section.  Though in my case, Baby b was transverse and didnt move the entire pregnancy.  And it all was happening so quick that I didnt want the double whammy of a vaginal and c section birth.  So I chose to do the c section.  And I had a great recovery.  I was up and moving the next day.  There was some pain but by the time I left the hospital I wasnt even taking any pain medicine.

Definitely talk with the other drs in your practice and find out their comfortability with a breech extraction.  It is a personal decision and whichever you choose will be the right one.

komurphy

my twins were both heads down the morning I went into labor so we went ahead with a vaginal delivery. I really wanted to at least attempt a vaginal delivery.  Unfortunately, baby B flipped during delivery of baby A and he had to be taken out via C-section (after the doctor, who is experienced in breech delivery, decided it was to dangerous to try to deliver baby b vaginally).   We knew it was a possibility going into it but I wanted to give it a try.  It really wasn't as bad as the doctor had made it out to be when we had the "start thinking about your delivery" discussion the week earlier.

My suggestion is go with what you want and make sure that your delivery team is comfortable and experienced in what ever you decide.

Hunter22

My girls were both flipping all over the place before I delivered and B ended up being head down and A was breech (which was the reverse literally the day before). I am now two weeks and two days post c-section and here are my thoughts (after having a vaginal delivery with my son which is not entirely comparable to birthing two).

Vaginal - I was sore, lots of bleeding, had stitches but all and all had a pretty easy delivery (labor for 9 hours, had pitocin and literally pushed for three minutes). I don't know how long I would have lasted pushing for 30 minutes to several hours. As easy as my delivery was, my son came out with his cord wrapped around his neck which I know happens a lot but was scary for DH and I and I didn't even want to think of the complications that could occur with twins.

C-Section - Day one was more pain that I thought, definitely kept up with my percs and opted to have the epidural out before 24 hours so I could go to the NICU to see the babies. By the time I was discharged 4 days later I was still taking the percs and by one week out I was only on motrin. I have had minimal bleeding and every day I have less pain in my incision area. I have a 2.5 year old and I am able to do everything with him (sit on the ground and play picnic, pick up his toys and make dinner) and have been able to since I got home. The ONLY thing I cannot do is pick him up but this nisn't much of a change because I was on bedrest for the last two plus months. He can get into the car by himself and days when I am going to be home alone he sleeps in my bed for naps. During the C-Section Baby B who was head down actually flipped transverse again and all was well.

Personally, there are benefits to both. With twins I personally was not willing to risk a double whammy or something going wrong. The recoveries are different, it just depends your circumstances and your stance on c-sections. I accepted a long time ago that it was probably going to be a c-section so my expectation level was low.

L D

I was more worried about the risks for baby #2 than I was for how I would recover.  My dr. was up to doing a breech extraction but only after he made sure I understood all the risks and possible complications.  He only got half way through and I stopped him and scheduled a c-section.  

Im not saying you arent worried about your babies health so please dont take what I said wrong.    

My girls were born at 36wks & 2 days.  One was head down and one was breech.  My Dr. also said that ID add to more risks when doing a vaginal birth.  I know plenty of women do vag. births of twins with no problem but I wasnt up to the risks.

I had my ds at 38wks vag. with not complications.  He was a very fast 41 mins start to finish labor.  I was pretty confident that it wouldnt be too much different but the risks just werent worth it.  

Landon was 1yr & 11 days old when the girls were born so I had 3 under 13 months.  He was just a baby himself.  I had a very fast recovery and by the time we came home (6days in the hospital due to Kaydance getting fluid in her lungs while being pulled out.  She then got addicted to the Oxygen and her O2 levels in her blood would drop when they tried to take her off of it.  She was on it for 4 days and then 24hrs of monitoring.)  I was taking care of Landon just fine.  I had help from my mom, MIL, and dh but still was caring for L as well.  I took it easy but still picked him up and changed him, bathed him, etc.  

I would say by 2wks I felt great.  Still sore but overall felt good.   

Rangergal9

I had a scheduled c/s since one was breech.  They wouldn't consider vaginal delivery and I was completely fine with it.  And FWIW I was picking my older DD up by 2 weeks PP.  

Twinluv

lkstor:

I would never plan to do a breech vaginal delivery. I'm a Pedi and I've seen head entrapment. And honestly a smooth vaginal breech delivery is pretty scary for me to watch. Just not the right choice for me - though admittedly I know too much

This

My Baby A was head down and B was transverse (both were head down a week prior). My Dr flat out told me to attempt a vaginal was NOT the safest way to go. I did not want to have a C-section, but I took my Dr's advice. BEST decision ever!

To attempt a vaginal with the potential life-threatening complications, didn't make sense to me. A single breech baby birth is risky enough, but with two?

I know it is a sensitive topic and many have strong feelings against C-section, but it really is the safest way to go in a situation where one baby is in a non-head down position. And this is coming from someone who was TERRIFIED of surgery. My babies arrived smoothly, safely and quickly. Maybe I just got lucky, but the section was a cake walk. Sure, the wearing off of the anesthesia was unpleasant, and yes, there was a bit of pain, but nothing painkillers can't knock out. I'm a year PP and you can barely see my scar. 

This is just my 2 cents. I do think you should consider it. I think C-sections are getting a bad rap these days IMHO 

Good luck with your decision!

  

thiswillbe

We picked our OB and OB practice specifically because they were experienced with breech extractions of Baby B, and ended up with a scheduled (albeit scheduled at the last minute) c-section. I was (still am) really bummed I didn't get to try for a vaginal delivery, but in the end we decided to go with what my Dr was recommending. I wish there would have been a way to check positioning on delivery day, and go vaginal if Baby B had turned. It haunts me to this day that I don't know if DD turned to be head-down before my c/s. All that said, the goal was getting them safely into the world, and we did that.