Question about delivery of twins

[elbenn]

My OB said she will not do a vaginal delivery with twins unless both are in the head down position. Is this a common position for doctors to take? I would like to avoid a c-section if possible and I'm trying to figure out whether most doctors would take this same position.

[Melaine]

That was my doctor's position as well. I did have a c-section in the end, although i think that my girls were both head down by the time we got down to the wire anyway. I think if you want to do a vaginal delivery, then find a doctor who is comfortable with it. My Dr. specialized in high risk pregnancies, which was good in a way, but on the other hand, he seemed a little over-cautious to me. I'm sure you'll get lots of helpful feedback from other MoMs.

[hez]

I think if you want to do a vaginal delivery, then find a doctor who is comfortable with it.

This. I have a coworker who delivered her twins vaginally & without any pain meds at ~40 weeks this summer. One twin had been breech before the delivery. She's my hero, and so is her doctor.

[BeachBum]

My doctor will not either. I had a vaginal unmedicated birth with my first, but he really put his foot down about delivering a breech baby B. He really feels like it is dangerous...
That said, there are a lot of doctors that will do it. From what I read online it can be safe....if the Dr. has a lot of experience doing it.

My baby B just flipped to vertex at 35 weeks! So keep your fingers crossed for me....I'm hoping to avoid the C-section as well.

[gatorsmom]

My baby B just flipped to vertex at 35 weeks! So keep your fingers crossed for me....I'm hoping to avoid the C-section as well.

I'm not trying to push the c/s route but I wanted to say this: with my first pregnancy I labored and ended up with an emergency c/s anyway. To put it lightly, it sucked. I would NOT want to labor, deliver one twin vaginally and then end up with a c/s for the second twin. And THEN have to try to come home 4 days later to take care of them both. (or possiby come home with just one baby and have to try to make it back daily to the hospital to visit the other in the NICU which is a real possibility with twins). Just something to think about.

[mamaoftwins]

I delivered my boys vaginally at 35wks - DS1 vertex/DS2 breech. I got my epidural after DS1 and before DS2 b/c they knew it would be tough to deliver a baby feet-first without any meds, and I would need an episiotomy. (and there's only 3 min btwn the boys, so you can see how fast they got that epidural in and how quickly we got DS2 out!) I missed the window in the beginning for the epidural - progressed from 2cm to 10cm in 30min, so we had to deliver DS1 without meds.

I would not have done it this way had I not had the docs that I did. I went with high risk docs and the doc that delivered me pretty much does all of the multiple vaginal births in the area. Most of that high-risk practice will deliver vertex/vertex no problem, vertex/breech is reserved for that one doc, and no one was really comfortable with breech/breech. My docs left it up to me whether I wanted a c/s or not - when my water broke and I went into the hosp, we had 3 of the high-risk docs in my room at once, and we all discussed c/s vs vag for the last time - our decision after weighing everything (which was fully supported by our docs) was to try vag, perhaps attempt to turn DS2 to vertex after DS1 was delivered (didn't do this, everything just happened too fast and we wanted the boy out!), and have a low threshold for c/s if anything went out of the ordinary. I delivered in the OR (most places make twin deliveries go to the OR automatically) and there were like 20 people there: my doc, several residents (some just to observe!), 5 pedi residents (2 for each boy, and one to float), a nurse anesthestist, an anesthesiologist, and 5ish nurses. The room was crazy full!

Also, both of the boys did great. DS1 was completely fine and came to the room with us, DS2 had to hit the special care nursery for a few hours so they could observe his breathing - he was grunting a little after he came out, due to being pushed/pulled out feet-first. He was fine after a few hrs and did not need oxygen at any time. Came to our room then, and we all went home 2 days later.

So, to answer your ques, yes, I think most regular OBs will only do vertex/vertex vag deliveries. If you'd like a vag delivery of something other than that, find a high-risk OB practice and talk to them to see what they can do for you. I would not have asked my docs to do a vag delivery unless I knew they had done them before. My regular OB was only comfortable with vertex/vertex, which I was fine with, but I got sent to high-risk b/c I went into labor at 24wks.

Sorry for the very long story. Good luck!

[mamaoftwins]

I would NOT want to labor, deliver one twin vaginally and then end up with a c/s for the second twin. And THEN have to try to come home 4 days later to take care of them both. (or possiby come home with just one baby and have to try to make it back daily to the hospital to visit the other in the NICU which is a real possibility with twins). Just something to think about.

I was worried about this, too - I'm in a very large metro area and according to my high-risk docs, this does not happen nearly as often as people worry about. I suspect that it happens less often with high-risk docs, not that they are necessarily "better", but they are often more experienced at out-of-the-ordinary births.

Anyway, yes, something else to consider.

[mamaoftwins]

My doctor will not either. I had a vaginal unmedicated birth with my first, but he really put his foot down about delivering a breech baby B. He really feels like it is dangerous...
That said, there are a lot of doctors that will do it. From what I read online it can be safe....if the Dr. has a lot of experience doing it.

My baby B just flipped to vertex at 35 weeks! So keep your fingers crossed for me....I'm hoping to avoid the C-section as well.

Congrats to you for making it this far!! If B just flipped, he/she is probably too crowded now to flip back, so it sounds like you are good to go! Good luck! We'll be waiting for your announcement post!

[Kindra178]

I delivered vaginally at 37 5 and 6. Yes, my guys have different birthdays. My baby B was breach, and my high risk practice was comfortable. In fact, even my non high risk doc was comfortable - he said you reach up and grab the foot and pull it down. I guess you can control the pace of delivery that way. My guys are about 35 minutes apart and B came out feet first. I too was afraid of having a vag delivery and c section, and I guess I was about 10 minutes away from that. I had an epidural for both, but it was turned way down for the delivery of baby A and WAY up for the delivery of B. There was no way they could have done what they needed to without an epidural. I did have an episitomy, and my immediate recovery was pretty bad. I actually got morphine afterwards, which worked wonders! In the end, I am happy it worked the way it did. One more thing - I also delivered in the OR in a major metropolitan hospital, level three NICU. They had an us machine in the room.

[fivi2]

I delivered vaginally at 37 5 and 6. Yes, my guys have different birthdays. My baby B was breach, and my high risk practice was comfortable. In fact, even my non high risk doc was comfortable - he said you reach up and grab the foot and pull it down. I guess you can control the pace of delivery that way. My guys are about 35 minutes apart and B came out feet first. I too was afraid of having a vag delivery and c section, and I guess I was about 10 minutes away from that. I had an epidural for both, but it was turned way down for the delivery of baby A and WAY up for the delivery of B. There was no way they could have done what they needed to without an epidural. I did have an episitomy, and my immediate recovery was pretty bad. I actually got morphine afterwards, which worked wonders! In the end, I am happy it worked the way it did. One more thing - I also delivered in the OR in a major metropolitan hospital, level three NICU. They had an us machine in the room.

That is fun that they have different birthdays! They wheeled me into the OR at about 11:20 PM, so I thought we might end up like that, but they came too close together!

To OP, I did have a vag delivery in the OR, but both were in the right position. I honestly don't remember what she had told me about what she would and wouldn't do. She was very much in favor of a vag delivery if at all possible, though.