Should I find a new doc?

Hoosier722 · January 2014

I'm 15 weeks pregnant twins. I have 2 older sons I delivered with very easy vaginal deliveries. I would very much like to avoid a c-section with the twins (I'm scared to death of surgery). My doctor told me today that she will only allow me to attempt a vaginal delivery if both babies are head down. Most of what I read said that most docs will allow you to deliver vaginally if baby A is head down with hopes that baby B will flip if breech. My doc said that she will not do this. Otherwise, I love and totally trust my doctor. She delivered my last son and is great. I'm just conflicted because it sounds like my chances of delivering naturally is slim if I keep her as my doc. What do you all think? Especially those of you who have already delivered? Is it worth seeking out a different doctor, especially since I may end up with a c-section either way?

caden · January 2014

No I wouldn't switch docs over that. That policy was my OB's policy too and it has some merit. I know some feel differently but this is a debatable point. If your OB had advised something nutty that would be different. This is pretty normal.

xoexpat · January 2014

I wouldn't switch either. If you have a good rapport and trust your doc I would stick with her.

Burberry0421 · January 2014

Agreed with the first 2 responses. The reason they have that policy is because of the risk of complications with baby B delivering vaginally. I'd rather have a vaginal delivery, but the risk is high enough that it's not worth it to either of us. The chances that I will have a vaginal + a c-section is high, and that's just silly.

chickaboo1974 · January 2014

When I asked at my OB practice they told me that IF twin a was head down I was ok to deliver vaginally, then IF B was breech they could attempt to turn him- but if that didn't work then I would need a c-section. They (the whole practice) does not do breech extractions. I was even told that they are not even teaching it at med schools. I am sure it has more to do the the risks to baby and also the cynic in me also feels that the insurance companies also have a huge input in this.

I ended up with a c-section anyway- both were breech. My recovery was not bad at all- it was actually not very painful and I was up and moving like myself by time I released from the hospital.

pillowass · January 2014

I agree with all of the above. My MFM told me that the evidence is not clear on which method is safest, and as a result some docs will do breech vaginal deliveries with twin B and some won't. To me it would not be worth switching from a doctor that I love and trust.

DoublePortion · January 2014

My OB won't let me deliver vaginally unless both are head down, either. I asked him about a breech extraction on baby b and he said the ACOG (I believe) changed their reccomendations to advise against it. So basically if I insisted on a vaginal delivery and baby b didn't flip when a was out I'd be in for a double whammy.

ceechie · January 2014

My ob told me about 95% of twin pregnancies deliver via c-sec. I don't know if that's a real number or she was saying it to calm my nerves. But it seems (somewhat) true. My baby A was head down but B was transverse. I was bummed. I, also, had delivered vaginally previously. But the c-sec really wasn't super bad. And I really didn't want a double whammy. Plus, I got my tubes tied while she was in there....

StacyH0507 · January 2014

I would not switch either, my practice will allow a vaginally delivery is A is head down and B is Breech but he did go over every thing that could happen and told me I had some choices to make. I have decided that this is not something I feel comfortable with right now after hearing and reading more especially if baby B is bigger because we all know ultrasounds are not the most accurate. I think it is pretty common for most practices to be like yours.

somewhereincali · January 2014

I guess I'm in the minority but I would switch. Recent large randomized studies show that a vaginal delivery is just as safe for the babies, and this is the practice of the large teaching hospital where I delivered.
I would not want a provider who wasn't comfortable with a breech extraction doing one but I wouldn't hesitate to find a new doctor who is. I wouldn't want to sign up for surgery or the risk of twin B flipping. And frankly I want a dr who is up to date with the recent research on twin births and has lots of experience with them
And I ended up with a csection for other reasons but I'm very happy to have attempted a vaginal delivery.

somewhereincali · January 2014

Don't get me wrong, if you aren't comfortable with it then there is nothing wrong with not having one. But I wouldn't want it to be the drs decision

katieg314 · January 2014

I actually kind of agree with @somewhereincali. If it's something that is important to you, it's worth exploring your options. My baby B is Breech right now, and I am trying to decide what to do if he stays that way. I haven't yet decided, but I am glad I have the option and it's my choice.

carrotcake06 · January 2014

I don't know if it would be a hands down deal breaker, but I'd at least explore my options and look for someone a bit more open to a vaginal delivery.

My situation was a bit different - I was at the mercy of the two doctors on-call and there were maybe 15-20 possibilities. Some did vag, some did c/s only. We really never got too far down the road since my baby a flipped breech at 19w and stayed that way.

Fwiw, an MFM told me that 90% of the time if baby A was delivered vaginally, baby B would be as well. If vag had been on the table for me, the possibility of the double whammy wouldn't have stopped me from trying. I've had both types of delivery now and a c/s sucks so so so much worse.

Heirloom28 · January 2014

I would switch. All six MFM doctors in my practice would deliver baby B breach. They told me that if baby B was breach the risks were 50/50 and it was my choice. The morning of my delivery baby B was breach and my doctors were very supportive of a vaginal delivery. I had a breach extraction with baby B that went great. I recovered very quickly and was very glad I did not have a c section.

Ylvelill · January 2014

Arg

I just switched to a new ob and I am now in a similar situation. She does not want to talk about a vaginal delivery period. She says my body won't be ready at 37 weeks to deliver naturally do she wants to do a CS rather than induce....

eandk18 · January 2014

I would not switch just for that sole reason either. I attempted a vaginal because both girls were head down but ended up with a c section because I developed a fever. If you like your OB and your care I'd stay. Just because another doc will let you attempt a vaginal does not mean you will get it because there could be unforseen circumstances during delivery.

FWIW- people say they are so scared of c section recoveries but mine was not bad at all. I had a great recovery and was up moving around just like moms that delivered vaginally. I know not everyone has that experience but it's certainly possible.

LegallyBlonde217 · January 2014

ceechie said:

My ob told me about 95% of twin pregnancies deliver via c-sec. I don't know if that's a real number or she was saying it to calm my nerves. But it seems (somewhat) true. My baby A was head down but B was transverse. I was bummed. I, also, had delivered vaginally previously. But the c-sec really wasn't super bad. And I really didn't want a double whammy. Plus, I got my tubes tied while she was in there....

Yeah, umm....your OB is lying to you. It's supposedly right around 50/50, but it seems to me like it's really closer to 70% c/s 30% vaginal.

As long as you're comfortable with having a c-section, I would not change OBs if you already love yours.

ceechie · January 2014

LegallyBlonde217 said:

ceechie said:

My ob told me about 95% of twin pregnancies deliver via c-sec. I don't know if that's a real number or she was saying it to calm my nerves. But it seems (somewhat) true. My baby A was head down but B was transverse. I was bummed. I, also, had delivered vaginally previously. But the c-sec really wasn't super bad. And I really didn't want a double whammy. Plus, I got my tubes tied while she was in there....

Yeah, umm....your OB is lying to you. It's supposedly right around 50/50, but it seems to me like it's really closer to 70% c/s 30% vaginal.

As long as you're comfortable with having a c-section, I would not change OBs if you already love yours.

Yeah, I kinda thought it wasn't a true, real world number. Maybe it was the percentage for her practice....
I think the hard thing with twin births, is there are just too many variables. Babies sizes, positions, Drs available and their skill/comfort levels. It's a good call to always trust your gut. I loved and very much trusted my ob. I had to make decisions that were good for me and my babies.
It's hard to know what to do. Good luck!

MrsP419 · January 2014

I am pretty sure my OB will not do a breech delivery of Baby B. I at first considered whether I would switch over this, but then I talked to one of the nurses in the practice. She said this particular OB is the one who is most up on the techniques and most well-versed in surgery and robotic surgery, and if he suggests something, it is normally a pretty good idea to go with him. He is not trying to sway me one way or the other, but I mentioned today that sometimes I wish I was going to be "forced" into a C-section due to positioning so I did not have to choose. I am more afraid of the double whammy than anything. He said that is not an uncommon way to feel, and with twins, he thinks a planned C-section is not necessarily a bad thing.

My Baby A has been feet down for weeks now. I know she could still turn, but if she stays how she is (with B transverse), I won't have to choose.

JocelynB0911 · January 2014

It was important to be to deliver vaginally but obviously I wanted the boys to arrive the safest way possible. My ob was fine with doing a breech extraction of baby b and attempted it but due to his size (4lbs) he was unsure what part of his body he was grabbing and then his heart rate started dropping and not recovering. I delivered baby a vaginally and baby b via csection.

It doesn't hurt to explore other options on doctors and if you find one you trust and want to switch to great.

Mama-Bear · January 2014

For me to deliver vaginally both had to be vertex and A had to be bigger. I had a c/s.

Hoosier722 · January 2014

Mrs.Lee - out of the 6 docs in the practice, only one will do breach, so the odds are against me.

I read somewhere that only 40% of twins are both head down. Does anyone know if this is true? I'm going to talk to my MFM Wednesday and see what he suggests. Thanks!

ceechie · January 2014

MrsLee04 said:

ceechie said:

My ob told me about 95% of twin pregnancies deliver via c-sec. I don't know if that's a real number or she was saying it to calm my nerves. But it seems (somewhat) true.

WRONG. It's 50/50. And it's only 50% c-sections because of all the fear of delivery vaginally (fear from the OBs and patients). If more people wouldn't rush into c-sections without medical necessity, that stat would be higher in favor of vaginal.

Sorry! Should have double checked number before posting. I think she was saying percentage in the obs practice, not in general. I'm really tired over here...

Should I find a new doc?

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