wwyd, re: recommended epidural with twins

curlywhirly

Hi Ladies,

Popping over to this board for some advice. I went completely natural with my first delivery 2 years ago, and would totally choose to do it that way again, except that this time I'm having twins.

I had to switch from a midwife to a doctor in the practice because having twins makes me high risk.

I met with the doctor for the first time last week, and I really got a great feeling from him. He did, however, strongly suggest that I prepare myself for getting an epidural. Assuming Baby A's presentation is suitable for a vaginal delivery, he'd be willing to do a breech extraction for Baby B. I guess this is part of the reason that he suggested an epidural, but the main reason is in case I would need to have an emergency c-section--if I don't have an epidural in place, they would have to use general anesthesia, which would be more dangerous for all of us, and my husband would even have to leave the room and not be able to see the birth of the babies. Yikes.

I definitely do not WANT an epidural, but I'm thinking that it may be the way to go...I think I'd feel terrible if there were some kind of complication because I chose not to do an epidural and did have to do general.

Any thoughts? 

catsinawindow

Hugs to you.  I'm sorry that you're having to make this decision, it sucks!

I had to make a similar decision, but for a different reason.  Also, I was told while at the hospital, being induced, so I didn't really have much time to think or decide about it.  My situation was that my platelets were very low, due to a complication from PreE.  Evidently, if platelets are too low they won't place an epidural, so I was told that it was now or never.  I could either have the epidural placed or not but then need to be under general anesthesia in the event of a c-section.  At the time I was told this, a c-section was looking like a distinct possibility (I did end up delivering vaginally, but that's another story).

After a bit of thinking (and crying) I decided to get the epidural catheter placed, but not have the medicine added to it.  I was told that they would need to do a test-dose to make sure it was placed correctly so I would get a "taste" of the epidural but then it would wear off.  You can imagine how great the temptation is once the catheter is already placed and you get a "taste" of the pain meds.  So, long story short I eventually ask to have the real medicine added to the epidural as well.

It sucks to have to make this decision, but in the end it's your decision to make.  Only you can know what's best for your specific situation.  I wish you the best in making this difficult decision.

pinksweetpea2

I would really question a lot of what he said.  I obviously do not have any experience with twin births, but from everything I have read twin B could very well flip after twin A is born- that is how it happens with a lot of homebirths...and I would have to wonder if that would be as possible if you had an epidural and were giving birth on your back?  Being upright in a good position could facilitate this turning. 

Also, I really have to side eye the fact that he is all or nothing with the epidural.  Does the second twin really come that quickly in EVERY case?  Also, the fact that he pretty much assumes that the baby will have to be "extracted" would make me nervous. 

I would look around you area and see if there are any OBs (or MW) who have experience with natural twin births and get a second opinion before agreeing to anything.  

Just my 2 cents.  

GL! 

MerryLegs

check out enjoyyourlabor.com and the book on there. It is great. Busts all the myths. Go with the epidural, imho you will not regret it.

catsinawindow

pinksweetpea2:

I would really question a lot of what he said.  I obviously do not have any experience with twin births, but from everything I have read twin B could very well flip after twin A is born- that is how it happens with a lot of homebirths...and I would have to wonder if that would be as possible if you had an epidural and were giving birth on your back?  Being upright in a good position could facilitate this turning. 

Also, I really have to side eye the fact that he is all or nothing with the epidural.  Does the second twin really come that quickly in EVERY case?  Also, the fact that he pretty much assumes that the baby will have to be "extracted" would make me nervous. 

I would look around you area and see if there are any OBs (or MW) who have experience with natural twin births and get a second opinion before agreeing to anything.  

Just my 2 cents.  

GL! 

I agree with all this as well.  The benefit of knowing this ahead of time is that you have lots of time to collect more information and make the best decision.  pinksweetpea2 raises valid concerns.  Definately try to find out how likely the GA scenario is, and what your alternatives are.  Good luck!

magnolia_femme

Hi and congrats on your twins!  I am 33w5d with twins and planning on an unmedicated birth (provided Baby A flips....please flip, baby!).  I did a lot of research and finally found a MW/OB team that will support this.

When I asked my OB about a breech extraction for Baby B, he said that for most women the most painful part is delivering Baby A and if I could make it through that, he's not worried about a breech extraction being too painful.

Of course he did mention the possibility of an emergency c-section and that I would have to be put under, but the odds of that happening are low enough that both of us are comfortable with me not having a catheter placed.  I will say, though, that this is one of the only OBs in the Chicagoland area who will do this.

Good luck with whatever you decide!

curlywhirly

Thanks so much for all the thoughts.

I really like this doctor, and he did make it clear that it's ultimately completely up to me, and I didn't feel like he would pressure me into something I wasn't comfortable with.  He seemed very willing to support a natural birth, and that's why he discussed the breech extraction as an option for Baby B, provided Baby A's presentation is favorable to attempt vaginal delivery.

His suggestion for the epidural was solely for the instance that some complication arose and (most likely) Baby B was in some kind of distress that would require emergency c-section. I think I'd feel really bad if neither my husband nor I could see the baby's/babies' birth if the general were required.

I'm going to be thinking a lot about it, and I'll discuss it more with him when I see him next.

Thank you!!

PAAZwife

I have a friend who had a natural delivery with her first baby (a singleton) and then another one with her twins.  Here is her birth story for inspiration:  https://thewhitmers.blogspot.com/2010/08/birth-story-times-two.html

Hope you are able to get the delivery you desire!

mpstochlinski8

I am in the exact same boat as you and it really sucks! I feel like I have very little control over things should I skip the epi and something goes wrong. A friend of mine had to have an emergency c and had to be put under it was terrible, husband was left out of the room and she woke up hours later groggy and too out of it to even hold her baby! I know there are women how have done it naturally with twins and its worked out and Ive known of a couple that had to be put under with baby b. My OB has been trying to wear me down on getting an epi the entire pregnancy and its eating at me so bad! In our child birth classes there were so many women with singleton pregnancies that would express how much they couldnt wait for an epi, it drove me nuts that I felt like they actually had much more of a choice than I and yet wanted it anyhow. To each their own but I have been against labor drugs for my entire life after what my own mother went thru having me (too long of a story). I feel like you do, that just giving in for the epi is the "safe" way to know you will be there and DH will be there to enjoy the birth but its like giving up a strong belief to give in and tears me up. I want to nurse within the hour and have immediate skin to skin with my twins when they are born and don't want to risk that. I really feel for myself it may be a decision I make when I get to L&D because as of right now I'm still totally torn We just have to remember getting LOs here safe and being awake is the main goal no matter what. Will your doc do a cathedar for the epi instead of a full epi? Mine will but they will still have to give me IV fluids and a test dose and said that if something had to happen super fast this wouldnt be enough and they'd put me under anyhow. GL in what you decide, I so totally understand how torn you are! 

kacelle

MerryLegs:

check out enjoyyourlabor.com and the book on there. It is great. Busts all the myths. Go with the epidural, imho you will not regret it.

That is terrible advice.  And that book is promoting a lot of false information.  I can argue against some of the points from my personal experience.