C section vs vaginal delivery

brookith · June 2012

I am looking for some advice.

I am 34 weeks with identical twin boys. My dr office was going to wait to deliver until 38 weeks. I recently found out I have cholestasis so they are going to deliver at 36 weeks

There are 2 doctors that I really like at my practice. One of them is fine with me choosing a c section and the other said I should try a vaginal delivery. Is this a personal choice? Both babies were head down as of last week.

Just curious if you ladies chose a c section even with both babies head down? Is there a benefit to one or the other. Just trying to make the best decision for the babies and I. I appreciate any insight you ladies may have! Thanks!

LadyNikon · June 2012

vaginal delivery is the natural and how babies are normally born. C-Section is a major surgery. Personally I would always choose vaginal delivery over a C-Section. I would ONLY choose a C-Section if the life of my child or I are in jeopardy

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TryingforBaby1 · June 2012

I am trying to make a similar decision. Baby A is head down, but Baby B is transverse. Baby B can change once baby A is born or my doctor would be willing to do a breech extraction. While I am not scheduling this now, I have been having contractions for 7 weeks and we could go into labor any day- my doc is hoping I can keep them baking until at least 34, but I am hoping for 36.

I am terrified of a tear and a c-section. I tore very badly with my first baby and had a very difficult recovery. All that being said, so much will depend on the circumstances when I actually go into labor. I think it really depends on what your pros and cons list looks like. What are the biggest priorities for you?

I have a very long list of thoughts on this subject, but my number one goal is to avoid NICU, if possible. My next is to avoid recovering from both a bad tear and a bad c-section. It's my understanding that c-section babies have a higher chance of breathing problems. In an effort to give the babies the best chance to avoid the NICU, I think I am leaning towards vaginal delivery. But, again, depending on how things are on the day of and what the doctors recommend, I may end up electing a c-section.

It's a very difficult decision. It helped me a lot to sit down and talk with DH, tell him all of my thoughts and then come up with a couple different plans, depending on what the circumstances are at the time of delivery.

hayleydeee · June 2012

I agree with the last poster, that given the choice I'd avoid having a c-section. Having had one vaginal birth (granted it was with a singleton) and one c-section, in my experience, the first was a MUCH better experience overall.

From what I've heard being induced isn't so great, but is still do-able.

What do your doctors advise as far as the baby's safety?

Switzerland87 · June 2012

I opted for a c-section, though both of mine were head down at their last ultrasound. My Twin B's position was just so variable toward the end of my pregnancy, that I didn't feel comfortable with the prospect of her staying head down. We were very concerned that she would turn once her sister was delivered and potentially getting tangled in her cord.

I just felt more comfortable and at peace with the safety of a section for all three of us.

Reilly626 · June 2012

I'm going c section- I have a family member with cerebral palsy and the risk of the second twin's oxygen getting cut off scares me to death. I won't put my child at risk.

MrsOjoButtons · June 2012

I'm only 35w, haven't had my babies yet, but finally finished my birth plan today. The front side is my ideal outcome, the back side is the worst-case scenario. Ideally, I'd give birth vaginally without an epidural or pitocin. My hospital has a really atrocious c-section rate and I know those drugs up the chances of having a c-section. *For me*, it's counter-intuitive to have a c-section, major surgery, with two newborns to care for. Respiratory issues are also more common in babies who haven't been through the contractions of labor and had their lungs squeezed through the birth canal.

Long term, I hope to have more kids, and I do not want to be stuck having repeat c-sections every time I get pregnant, compromising my uterus, putting myself at risk of uterine prolapse. The VBAC rate in the US is only 5%, so, "You can have a VBAC next time!" just isn't a valid response if I have to have a c-section this time.

Since I do not intend to get an epidural and my hospital will not allow "walking epidurals," if an emergency arises and I NEED a c-section, I'll likely be put under general anesthesia. That's a risk I'm willing to take, but I know that's not a popular choice. My birth plan does include what I'd like to happen in the event I have to be fully sedated.

It's a tough choice and so much can change so fast. That's actually why I've put off typing out my birth plan so long. Now that I've made it this far in pregnancy though, I'm feeling confident that barring any super weird situations, my babies will be able to avoid NICU time and they'll be healthy and strong.

lrrb · June 2012

Do not be scared to give birth to the babies vaginally. If both are head down and things look good I would try. Major surgery is NOT easy to recover from (not that a vaginal delivery is a walk in the park haha). Honestly, if your doctor is encouraging you to try for a vaginal delivery you should maybe try. I delivered my twins quick and easy, both were head down and things went perfect. Yes it is a personal decision but you are taking about major surgery over something your body is made to do, I would choose vaginal. GL on whatever you decide, it is your decision....

Kelli&Jed · June 2012

Thanks to modern medicine it is your choice. Don't let anyone get you down about what you chose. I've seen both easy and hard c-section recoveries as well as easy and hard vaginal recoveries. Like you I was afraid of having to make this decision but my boys made it for me. One was transverse and the other head down for nearly all of my pregnancy so I was prepared for c-section. Literally 4 days before delivering the other went head down. So mentally I had to switch from c-section to vaginal delivery. 12hrs into labor one of my little guys was in distress so I had an emergency c-section which turned out to be for the best because as he was being delivered his placenta was rupturing. My recovery was better than I thought it would be. Looking back I only remember a minor amout of "oh sh!t" type of pain from the surgery. No matter what you chose don't let anyone give you grief about it...you know what is best for you and your babies. Good luck!

lmydogally · June 2012

Just wanted to say sorry you got Cholestasis, I had it and it sucks. The good news is that it goes away almost immediately after you deliver.

GeauxTigers82 · June 2012

Obviously, it's a personal choice and all the previous posts had some good points. I personally would never "choose" a c-section. If that's what's needed to be done for the safety of my babies and myself, then by all means...cut away, but otherwise, no thanks. That's a major surgery that your body will have to recover from. Since I had no issues with the babies and their position was right (they did an u/s right before they took me to the OR, just to make sure), I was thrilled to be able to have a vaginal delivery.

I've never had a c-section, so I can't speak about that, but I've had 2 vaginal deliveries. The twins were head down the whole time. I also felt very comfortable with the doctor that delivered me and his ability to deliver both babies vaginally. My babies were also pretty small though, so they did just pop out! As far as my vaginal recoveries, easy peasie. I was up and walking as soon as the epidural wore off (okay, after a nap too). I was a little sore down there, and took Tylenol and Motrin around the clock for a couple days, but certainly nothing that required anything stonger. That being said, I did have more discomfort after a trip to the NICU and back.

Talk to your doc a little more about it. Maybe they can outline the risks vs. benefits for each, based on your specific situation. Everyone is different, so it's hard to compare.

KDR1979 · June 2012

I had cholestasis too-miserable!!

I had a wonderful vaginal birth (both head down). Ob broke my water at 1030pm and baby A came at 216am! I pushed 4x for my 5lb daughter and then 45 minutes for my 6lb 9oz baby boy! I seriously only needed 4 percocet and then just ibuprofen for soreness and cramps. I showered the next day and felt almost 100%! Dh kept saying how he couldn't imagine how we would have survived if I would have been out of commission the first few weeks after birth,.

weareteame · June 2012

Both my babies were head down, so I opted for a vaginal delivery because I thought it was the safest choice for them. As it turns out, Baby A was stuck face up, and after 2.5 hours of pushing, Baby B went into distress (her heart rate dropped to the 90s). There wasn't enough time for an emergency c-section, so in an effort to get both babies out as quickly as possible, I ended up with a large episiotomy and two vacuum assisted births. Also, because my epidural didn't work, I felt everything--including my doctor reaching into my uterus to help pull Baby B out.

Luckily, both babies were fine, but the recovery was rough. After the delivery, I couldn't move one of my legs, and I ended up leaving the hospital with a walker.

According to my doctor, a delivery like mine only occurs 2-3% of the time. Knowing that, I don't feel that my decision to go the vaginal route was a bad one; however, I do think it's important to remember that while things often go very smoothly, complications can (and sometimes do) happen. I say go with whatever your gut is telling you. Good luck

nursemama2be · June 2012

I went vaginal. Both twins were head down and all went great. I would do it that way again

brookith · June 2012

Thanks so much everyone for the advice! I really appreciate hearing both sides of the story, good and bad of both.

I just feel like I am in a weird situation because there are 2 doctors that I really like at my practice. The one is really wanting a c-section because Baby B has been flipping the whole pregnancy and has not been consistently head down. Also, with the cholestasis he does not want to put any more stress on my body or the babies by inducing labor and having the potential of laboring for a long time which could put the babies into distress.

The other Dr. is the exact opposite and said vaginal is going to be better for the babies and I, even with having to induce at 36 weeks.

So I guess I am just a little frustrated with 2 doctors saying completely different things about the delivery. I have another appointment on Monday so I guess I will do some research this weekend of pros and cons of both. Thanks again!

tma1685 · June 2012

If I had the choice I would choose vag. My first 2 kids I had vag and they were so much easier to recover from. My dr wont do a VBAC and since I had a c-section with my 3rd. Im stuck with one now.

If you are scared of tearing you can always request for them to just cut you before you do tear. It seems to be easier to heal from too. Like everyone else has said it really is up to you. But it defiantly is worth the try.

GeauxTigers82 · June 2012

Uhh, that sucks. There are definately times when you just want the doctor to say "this is what's best for you and this is what we're going to do." It sucks that they disgree and that you like both of them. Too bad you don't dislike one of them because then you could ignore his/her advice!

GL in making your decision. Ask the doctor that's worried about Baby B's flipping if they would do an u/s before.

LottaLattes · June 2012

Eh, twin B variability doesnt mean much. My B kept in a different position until about 30 weeks at which point he stayed firmly in a Frank Breech (bum first) position until delivery. They tried to manually invert him (like, ow) and finally did a breech extraction in the end. I would find out how comfortable the doctors are doing a breech extraction (lessening the chance of recovering from BOTH), and what the risk of the placenta detaching after delivering A, putting B at risk. I had and have always had an extremely easy recovery from all of my deliveries, including the extraction one. So your body is different than anyone else's and what is hard for one won't necessarily he for you. Good luck figuring it all out!

Mrs. Alice · June 2012

If I had a choice it would be vaginal 100%. My c-section recovery was fairly easy but it was no walk in the park and I would rather not get cut open if I could avoid it. C-sections are also more expensive. A c-section was the only safe way for my babies to be born though.

LucyRicardo3 · June 2012

It's such a personal choice and either way you deliver doesn't make you any less or better of a mother.

I've experience one of each; My first was natural, my second was induced +epi, and I ended up with a csection with the twins. I had hoped to have a vag delivery with the girls.

Comparing "apples to apples", my csection was a much harder recovery, but I trusted my dr's advice to go with the csection when baby B went from cephalic to asynclitical/ undetermined breech at 9 cm.

Like a previous poster, I too have a close personal IRL friend whose child was born with a neurological injury in a similar delivery situation (I'll spare you the details) and her son now has severe cerebral palsy and other related disorders. I did not want to put my girls at risk for this and made the decision to go ahead with the csection when I began to realize what was taking place. I knew I could recover from whatever as long as my girls were okay. Of course I didn't know it at the time, but there were complications involved and thankfully the csection allowed the girls to be treated/resuscitated immediately, whereas if i'd gone vag it could have caused more problems.

If I were you, I would chose the dr that is open to a vaginal, but ask many questions as to when he/she would make the decision that a csection would be necessary and see if you trust their advice on that.

Good luck..

PS.. I too went through cholestasis. I was given ursodiol to treat it until the girls were delivered. Almost immediately, it went away (amen)...

xoexpat · June 2012

I still have a long way to go but I think I'm deciding just to go with a c-section. Worst case scenario for me would be to deliver A vaginally then have emergency c-section for B. So to avoid that, I think I will just go with a c-section. As a FTM, I'm a little sad that I won't get the typical delivery process, but my dr. (who has a set of twins) is very supportive and I'm starting to feel ok with it.

McKenna04 · June 2012

Both of my boys were head down and I chose to deliver vaginally. The tearing was awful and it took quite some time to heal. I really wish I would have chose a c-section instead but c'est la vie. Everybody is different- what's difficult for one may have been easy for another. GL!

karebearmccroar · June 2012

I chose to go natural and vaginal with my DS, because the stats show NICU time is more and respiratory distress also more likely if you have interventions or a C-section. That being said, I had a very rough delivery. My son was 9 1/2 lbs, and after 28 hrs of labor I pushed for almost 5 hours. I had very bad tearing and nerve damage in my legs. I went home with a walker and was in physical therapy for 6 months. So I was one of those rare few that have so many complications from a vaginal birth. My doctors were pleasantly surprised that I have made a full recovery at this point. That is why I will have a C-section this time with the twins- it is very likely I would have permanent damage if I have another vaginal birth. But if it was my first again, I would still try to go vaginal because I think it is better for the babies and better for you in the long run for future deliveries. As long as you are not a rare case like me!

JoJoEspana · June 2012

I've had 2 successful vaginal deliveries (with singletons) so I plan to try for vaginal as long as both babies are in good positions, etc. If my OB feels that a c/s is my best option, I'll be okay with that too I guess, but also having to care for 2 other young kids, I'd prefer to forgo a major surgery if possible. I actually know several women who have delivered twins vaginally with no complications, so it's really not hat uncommon. But I agree w/pp that it is totally a decision to be made between you, your H, and your OB. Good luck!

ColleenS629 · June 2012

Both of my boys were head down but I had a c/s. I "chose" a c/s because my OB and MFM recommended a c/s... they said it was safer for the babies, as B was estimated to be 2 lbs bigger than A. Their placentas were fused and they were concerned about the risks of me laboring too long after A was born and the placenta detaching after A's cord was cut.

rinascita · June 2012

MrsOjoButtons:
The front side is my ideal outcome, the back side is the worst-case scenario. Ideally, I'd give birth vaginally without an epidural or pitocin.

I don't know why I didn't think of this earlier, my husband and I were really thrown for a loop when we found out we are expecting twins because of the type of birth/delivery we wanted for our child even before I became pregnant. With twins I have been debating what is best for the twins, for me, and all of us.

I feel selfish wanting a natural birth and possibly putting them at risk depending on their positions, but I really like the idea of having a plan for different scenarios, I can't believe I didn't think of that!! Thanks for the idea!

JenLC99 · June 2012

My Baby A was head down virtually the whole pregnancy, and Baby B was transverse. My doc was comfortable with a breech extraction though he was going to attempt a version on Baby B after A was delivered. He did just that and I had A and B vaginally, head first. This was my third pregnancy and these were my smallest babies, and my recovery was a piece of cake. I had a small first degree tear that required one stitch. I was induced with Cytotec but did not get Pitocin or an epidural. It was amazing!

MuseumMaven · June 2012

I had a vaginal delivery at 37w 1d. Technically it was an induction, but the cervical ripener was all I needed - I went into labor on my own after that, so no pitocin. It was a great experience. I would definitely make the same decision again.

C section vs vaginal delivery

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