Confusion on c-sect vs. vag birth

amd1982

So as you can see from my siggy I'm appraching 24 weeks with di/di twins. I had an OB appointment last week just to see how things were going with me. I've gained about 15 lbs, and we scheduled my glucose test for the third week of October. My doctor and I began discussing birth a little bit, although he said it is a little early. He seems to be very pro vaginal birth with twins, which is good. He said "as long as baby A is head down, we're good to go - baby B can be feet down, it's no problem." he mentioned that if baby A is not head down (about a 30% chance) then we'll do a c-section.

However on this board I've seen several women who have said "once we schedule my c-section...." I was under the impression that a c-section or vag birth was a gametime decision. What factors contribute to scheduled c-sections? is it gest diabetes, pre-E, etc? or other things? when do these usually come about? Thanks!

KayJayDee

I was really hoping for a vaginal birth and it would have been, as you put it, a game time decision, depending on the position of the babies.  However, my baby A went breech around 28 weeks and hasn't budged since.  We scheduled a c-section soon after.  A couple of factors we had to consider were the doctor's schedule, availability at the hospital, and the fact that my previous labor went very quickly and we didn't want to go past 38 weeks with a breech baby A in case I went into labor on my own.  We are scheduled for 37w5d.  

 

SPerry0376

I *plan* on having a vaginal birth. My doctor said the same as yours a few years ago (about baby A being head down). I assume that towards the end if there is something forcing you to have a c-section (breech, placenta previa, etc.) then they will schedule it then. 

macchiatto

I was induced (and did end up with a breech extraction of Baby B even though we started the induction with two head-down babies!), but there can be a lot of different factors that go into scheduling a C-section: previous C-section(s), various complications, and sometimes it's elective if that's what the mom is more comfortable with.

merv123

Mine share a placenta (mono/di) so my dr strongly recommends a c-section even though both babies are head down at almost 32 weeks.  He's concerned about the risk of the placenta being compromised between the delivery of Baby A and Baby B (placenta comes out before Baby B, or gets torn, etc.), in which case they'd have to do an emergency  c-section on Baby B anyway.

I'm bummed because I wanted a vag birth but I want the babies here safely.  I'd rather plan a c-section than have to switch gears mid-stream.

SoldiersGreenBean

We scheduled my c-section really early on, as Baby A was breech.  Had she changed position, we could have canceled it.

BananaPancake

Mine will be scheduled as I've had 3 prior sections. Although my MFM actually asked me if I was going to try a vaginal birth the other day...I swear she lives on another planet.

KDR1979

My OB was comfortable with a twin vaginal delivery from day 1. She said that as long as baby A was head down, we could try it. She was comfortable with a breech delivery of baby B or verting baby B to vertex if necessary. Both babies ended up being head down. Baby B was 1.5lbs bigger than Baby A, but I still had an easy vaginal delivery!

weddinginbloom

I recently changed doctors because the first one would only do a c-section with twins.  My new doctors will allow me to try for vaginal if both heads are down (and no other issues)...so I still may end up a c/s but at least there's a chance for vag.  There seems to be a wide variance in doctor's ideas about twin births.

MrsLnt

My MFM would have been happy to let me try for a vaginal delivery if Baby A was head down, but even when that was the case, I was leaning toward a scheduled c-section because it's a more controlled situation and she understood my position on that. She didn't like doing breech extractions, and with a Baby B that was never head down, that was a big factor. It ended up being that we had to schedule a section because Baby A turned breech around 28 weeks and never turned back. Even if they had both been had down the day I went in for my c-section, I don't think I would have then tried to convert it to an induction. I was very happy with how things went for me and I had a very easy recovery. 

MrsCali_Bride

In order for me to have attempted a vaginal birth both babies would have had to have been head down. I don't know if that was just her rule or the hospital's rule. My Baby A was breech. She chose her spot early on, sat down and stayed there until the end. Baby B was flipping between breech and transverse and was head down on delivery day. I delivered at 37w2d and we waited until after my growth scan at 34w4d to schedule my csection just in case the flipped, which B did.

MuseumMaven

merv123:

Mine share a placenta (mono/di) so my dr strongly recommends a c-section even though both babies are head down at almost 32 weeks.  He's concerned about the risk of the placenta being compromised between the delivery of Baby A and Baby B (placenta comes out before Baby B, or gets torn, etc.), in which case they'd have to do an emergency  c-section on Baby B anyway.

I'm bummed because I wanted a vag birth but I want the babies here safely.  I'd rather plan a c-section than have to switch gears mid-stream.

This seems a bit odd to me - my boys were mo/di and my doctor was very pro vaginal birth.  I was induced and delivered them both vaginally.  If you really want to try a vaginal birth, I would ask your doctor for more information/explanation.

MelleTX

My OB told me up front she was very pro-cs for twins. However, she did say that she would let me try a vaginal birth if BOTH were head down AND baby A was bigger than baby B. When I asked what would happen if B flipped to breech during birth, she siad she was comfortable with a breech extraction but it was not her preference. I don't have a preference either way - I just want them here safe. 

My OB liked to schedule her c-sections and inductions for when she can be the one to deliver so we agreed to go ahead and schedule the c-section so it was on the books at the hospital. It can always be cancelled she said - even that morning.

Plus my cs is scheduled for 38 weeks so it's a possibility I will go into labor before then anyway.