C-section woes

[Sugar&Spice]

Hi Ladies. I was talking to my OB-GYN yesterday and he told me that it's their policy to require a c-section if BOTH babies aren't head down when you go into labor. I assumed that as long as Baby A was head down and all else was fine, that I could have a vaginal birth with Baby A and then see what happened with Baby B (or do an ECV). Does anyone have experience with this, and do you know if this policy is customary? It seems really odd to me that it would be their choice, and not mine!

[Sakura]

In my experience, it depends on the practice. The first and second practices I talked to, they would only allow you to try for a vaginal delivery is both babies were head down. At the third practice (the one I went with), you could do go for vaginal if just baby a was head down. Baby b's position didn't matter. They were really good about giving me info and letting me make decisions. Ultimately, though, both girls were transverse and so I had a c-section.

[mla]

That's weird since Baby B's position can change after Baby A is born. They can both be head down, but when Baby A comes out, Baby B can turn breech or transverse. So, really, Baby B shouldn't be a deciding factor at all.

[The J Team]

My OB has the same policy. She also likes to take them out by 37-38 weeks, as she said she starts to worry about enough amniotic fluid....

[MxMomma21]

I was told it all depends on the size as well... Baby a is significantly smaller they usually won't allow vaginal also baby a has to be head down b didn't matter but that was my practice. It really all depends on how comfortable your OB is with delivering/flipping babies not head down. Some won't attempt it some on the other hand will.

[Racegirl766k]

My dr. was okay with trying a VBA2C with only baby A head down. It may also be the hospital policy though and not the Dr.'s.

[TripMomma]

My dr. was okay with trying a VBA2C with only baby A head down. It may also be the hospital policy though and not the Dr.'s.

That is really awesome...you sure don't hear that often.

[MaryJane]

It will depend on your doctor's level of experience, but if you want a vaginal birth, you might want to consider switching to a doctor who is willing to do a breech delivery or ECV/ICV on baby B. And there's nothing at all to support delivering twins early if everything is normal. There's no reason to worry about enough amniotic fluid without even doing u/s to check levels.

[Sugar&Spice]

Thanks for the input, ladies. It's good to know that a lot of others have similar policies.

MaryJane, unfortunately, I feel a little stuck because we have Kaiser and you don't get to pick your doc. You get whoever is there when you go into labor. They have some weird policies (well, weird to me) like requiring your entire L&D to be in the OR, no midwives for twins--even when everything is going well and you can have vaginal births, and the "both heads down" policy. I understand that they're trying to place it safe, but I also feel that I have very little say, and I am hoping to avoid c/s if at all possible.

[MaryJane]

Just remember that policy or no, you can still refuse a c-section. Delivering in the OR is unfortunately not an uncommon policy with multiples. But none of their policies override your right to consent or refuse any procedure you aren't comfortable with. Hoping your babies will cooperate and be head down. You may want to consider getting chiropractic care consistently during your pregnancy. That can increase your chances of having vertex babies.

[muncherbug]

So, with my triplets I faced the whole "it's our policy" threats. I always looked them in the eye and reminded them that they legally couldn't perform surgery on me without my consent. They didn't necessarily like me for it but we were able to get along fine through the pregnancy and they learned that their role is to lay out options for me and assist me with whatever decision I make. It isn't about their policy or conveniences. Just my opinion.

[twinmom34]

I had to have a c/s for my own health (history of a stroke when I was 27) so it was never an option for me. But, I always feel for women who are told you MUST have a c/s...it is your body, you consent to have procedures done and you can also refuse to have those procedures done. Go with your gut and don't you let them force you into anything you do not want to do. I know it is hard and worrisome. Also, I second MaryJane that there is no evidence that delivering twins early is better. I would not want my twins to go too far overdue but, I certainly am not in favor of early delivery b/c they "think" it is safe. Keep strong!

[ZsaZsa]

We asked our Peri abt delivering twins in the 37th week and he explained that stillbirths go up in singletons at 42weeks and data has shown the same result in twins at 38weeks. So doctors deliver singletons by the 41st week and twins by the 37th week to err on the side of caution. I thought this was interesting and would pass it on.

[Racegirl766k]

We asked our Peri abt delivering twins in the 37th week and he explained that stillbirths go up in singletons at 42weeks and data has shown the same result in twins at 38weeks. So doctors deliver singletons by the 41st week and twins by the 37th week to err on the side of caution. I thought this was interesting and would pass it on.

That is interesting that your Dr. told you 37 weeks. If my girls hadn't decided to come early, the soonest hospital policy allows you to have a scheduled delivery with twins here is 38 weeks. We had the girls scheduled for 38 weeks and 2 days, before I fell and they came at 31w3d instead.

[TripMomma]

I believe the new policy on twin CS is not before 38 weeks, unless there is a reason. I myself wouldn't go any farther...I have too many multiple Momma friends that had stills or cord issues and the endings were often tragic, or near tragic. Because of knowing families that had to go through loss, I always feel babies are safer out than in at the 37/38 week mark. I know this may not be a popular opinion, but I could care less about natural birth vs CS...and I would not keep a pregnancy going waiting on a natural. A healthy baby is so much more important. JMO.

[ZsaZsa]

I believe the new policy on twin CS is not before 38 weeks, unless there is a reason. I myself wouldn't go any farther...I have too many multiple Momma friends that had stills or cord issues and the endings were often tragic, or near tragic. Because of knowing families that had to go through loss, I always feel babies are safer out than in at the 37/38 week mark. I know this may not be a popular opinion, but I could care less about natural birth vs CS...and I would not keep a pregnancy going waiting on a natural. A healthy baby is so much more important. JMO.

Yes...our Perinatlogist says he knows the data and the data says to have them in the 37th week and so he delivers them at that time. He says more and more hospitals and doctors will be doing so once they read the data or are explained to about it. He says he doesn't care what others are doing as he knows what the data says and is going with it (he also happens to be a parent of twins as well). I'm most concerned with healthy babies, so if we make it to 37weeks we will be going in then for the section.

[mla]

I believe the new policy on twin CS is not before 38 weeks, unless there is a reason. I myself wouldn't go any farther...I have too many multiple Momma friends that had stills or cord issues and the endings were often tragic, or near tragic. Because of knowing families that had to go through loss, I always feel babies are safer out than in at the 37/38 week mark. I know this may not be a popular opinion, but I could care less about natural birth vs CS...and I would not keep a pregnancy going waiting on a natural. A healthy baby is so much more important. JMO.

We scheduled for 37w5d, but my doc was willing to go a week earlier or later, partly because my dates were a little wonky. Anyway, I wanted to point out that at 37w5d, even though twins are actually considered full term at 37wks, the hospital staff kept referring to my babies as late pre-term (as though the 2 day difference between when they were delivered and 38wks was a huge deal), and in my post partum stupor, it really sent me for a loop. I found myself questioning the decision to have them when I did. So, don't be surprised if the nursing staff refers to your babies that way, and don't let it bug you because it's really not true. Your babies are full term at 37 weeks.

[ALNMommy]

We scheduled for 37w5d, but my doc was willing to go a week earlier or later, partly because my dates were a little wonky. Anyway, I wanted to point out that at 37w5d, even though twins are actually considered full term at 37wks, the hospital staff kept referring to my babies as late pre-term (as though the 2 day difference between when they were delivered and 38wks was a huge deal), and in my post partum stupor, it really sent me for a loop. I found myself questioning the decision to have them when I did. So, don't be surprised if the nursing staff refers to your babies that way, and don't let it bug you because it's really not true. Your babies are full term at 37 weeks.

This happened to me as well and I had my girls at 37 weeks. It made me crazy!