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Mavis

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Tuesday, October 20th 2009, 11:18am

Keeping an open mind: C-Section vs. Natural Vaginal Delivery (NVD) in TWINS!

Dear all,
This isn't so much of a question, more of a long ramble! Please join in with my rambling thoughts...

I had my 24 week appointment with the consultant yesterday and I was asked again if I had decided on how to deliver my twins . She was pleased I was keeping an open mind, but told me a few things about NVD that concerned me. I guess I am leaning towards a c-section, and this has pushed me even more in that direction.

Anyway, the doctor said that I would automatically get an epidural for a NVD of twins. (Of course they can't do anything without my consent, but this is what they normally do). The reason being that usually twin 1 can be delivered safely and quickly, but twin 2 is at a higher risk of complications. For example, once twin 2 has the womb all to herself, she might go wild and move around a lot. So even if she was head down at the beginning of labour, she may become a breech delivery (hence the epidural). Or worse, she may have a transverse lie that can't be corrected by external manipulation, and then I guess its an emergency c-section.

I am really worried about putting twin 2 at risk...
But if both babies are head down, and there are no other complications apart from it being a multiple pregnancy, most doctors agree that a NVD is best.

Dilemma!
I want to stay open minded for as long as possible, because even if I do make up my mind, the girls get the final say depending on their final positions.
But in the mean time, any thoughts would be most welcome, and apologies for such a long ramble!
M
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Tuesday, October 20th 2009, 11:51am

RE: Keeping an open mind: C-Section vs. Natural Vaginal Delivery (NVD) in TWINS!

Quoted

Originally posted by Mavis

I want to stay open minded for as long as possible, because even if I do make up my mind, the girls get the final say depending on their final positions.



That seems like the perfect way to look at it.

The epidural really depends how strongly to feel about remaining mobile and whether the benefits of trying to keep a good position for both babies would outweigh the benefits of being anaesthetised just in case of twin two being in a bad position.

Maybe you could plan to labour 'au natural' and have an epidural if and when it's needed. Maybe plan to go for a vaginal unless the twins have other ideas and accept that it may or may not end up a section. The most important thing is that you choose to do what you're comfortable with and that you're confident with your reasons behind your decision.





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Tuesday, October 20th 2009, 12:10pm

Hi Willopants, I think it's great you're keeping an open mind. I'm glad I don't have the choice as have been told I have to have a c section due to previous surgery, so that's one thing less to think about. However, I have been looking up on this and the main downside of a c section is that feeding/ moving around afterwards can be more tricky, and if you are hoping to have more babies there could be issues with the scar tissue on the uterus. I guess you know all this anyway but thought I'd say what I've come across. I do agree that there would be concerns with twin two in a natural delivery, but lots of ladies do it fine. Maybe you couldjust wait a few weeks to see what position they end up in? x

After 5 years of endo surgery, clomid, 2 x MM/C, 2 x ICSI cycles and 1 PGD cycle,
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Tuesday, October 20th 2009, 12:12pm

Thanks Bells :heart:
I would absolutely love to stay mobile, but although no-one has explicitly said this, I have a horrible feeling I will be strapped down either way because they will want to continuously monitor the non-presenting twin.
My main concern with the epidural is that it might slow things down, and the longer things take the less likely a NVD becomes...
I guess I want either a swift NVD or a planned c-section, and no forceps/ventouse/emergency c-sections please. Doesn't everyone!

Well, its been less than one hour and I think I am now veering back towards a NVD :rolleyes:
An open mind it is!

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Tuesday, October 20th 2009, 12:16pm

And thank you Rossypants!
It does seem like the downsides for a c-section are mainly for the mama, and not for the babies. I'm not too worried about VBAC (or maybe I can't possibly get my head around being this lucky ever again). But the sore scar, no lifting, and milk coming in a bit late does worry me a little bit, but it can be done.

Will your DH be around to help 24/7? I think that would help a lot. How long can he stay home with you?

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Tuesday, October 20th 2009, 12:20pm

My DH will probably take 2-4 weeks off with me at the beginning and my Mum can be around alot too so I'm just hoping it will be fine and I can manage the feeding ok. My c section has to be a classical one through an existing scar which is worrying me too but as that is some time away I have other things to think of before then. I'm sure whatever decision you make will be right for you, can you just decide on the day or do they really need to know this far in advance? x

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Tuesday, October 20th 2009, 1:54pm

Hi,

i'm really pleased to find this thread as we are having the same thoughts....although we have not been given the choice to elect a C-section, instead it was implied that we would basically try for a NVD unless there was a risk. Can you choose to over-ride this and book a C-section even if both babies are head down etc? I'm completely open-minded as to how they are delivered although I would much prefer that they both come out the same way if you know what I mean..ie both NVD or both C-section. Just booked us onto a twins antenatal class so will hopefully find out more then....

Let us know what you/the babies decide!


May 4th & 5th 2009: 3rd Double IUI - :BFP: woohoo
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Mavis

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Tuesday, October 20th 2009, 2:01pm

Rossypants - you are so lucky to have your mum around, I am sure she will be a great help. Mums just get things done! Does she live nearby?

Marylou - I was actually offered the option of booking an elective c-section when I was only 14 weeks (!) But that was only if I felt strongly about it, they preferred the wait & see approach. I'm sure your twins antenatal class will be fab! Please let us know what you find out!

M
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Tuesday, October 20th 2009, 5:39pm

Hi Girls,

I personaly made my mind up from the moment i found out it was twins, and I am having elective C- section Tomorrow mornig, my worst fear was that i would have to have an emergency C section or that first one will come out normal and then second one would have to be a emergency c section. I knew that i will have my mum to help me for as long as i need her, so i guess i should consider myself lucky in that respect. I think we should all do what we belive is best for ourself.
Good luck to all of you. blowkiss

Eli
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Tuesday, October 20th 2009, 5:47pm

Good luck tomorrow Eli! Wow, it's going to be one amazing day for you. Great that your Mum is going to help. Mine lives two hours away but still does so much for us x

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Tuesday, October 20th 2009, 5:55pm

Hello Mavis,
My sister has a ten yr old daughter who was NVD (not a good one at that). Her son was born 2 yrs later. Again a NVD. This time it was an 'easy' delivery ie. very quick, no cuts or tearing.
She then became pregnant with twins. She did a lot of research about the best way to go regarding the birth. She had always dreaded a C-section and didn't even consider it for her first two.
After A LOT of research and consulting many people she decided that the C-section was probably safer for the 2nd twin (my beautiful Lola!). So that is what she went for!
After they were born she said that she wished that all 3 births had been C-section and told me if I ever get to that point, to have a C-section!!!
She recovered very quickly and breastfed both girls for at least 6 weeks (until an infection prevented her) and she had her two other young children to look after too.
She was 39 when the girls were born and her other children were 3 and 5 (or there abouts!)
I hope this helps you in some way. I know my sister really struggled with her decision but chose what was right for her in the end. I hope you choose what feels right for you. I wish you the very best of luck. :smile:
Fairyfallon

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Tuesday, October 20th 2009, 7:32pm

Hiya,

all these tough decisions we have to make X(

I really wanted a NVD with my son, 3 years ago. Although he was breech and my consultant was very unhappy about me attempting a natural birth, he obviously couldn't force me to have treatment I didn't want. In the end, after 23 hours of contractions, labour wasn't progressing and I opted for an emergency c-section.

Having gone through that experience, I'm leaning, in fact almost certainly, towards an elective c-section. I was dreading a c-section first time round. I was pretty body conscious prior to having my son (my priorities have shifted since) and I didn't want a scar, or the risks that a c-section can pose to the mother. In the event, the c-section wasn't a bad experience, my milk came in sooner than other NVD mothers on my maternity ward, I breast fed easily (with, if I remember correctly, the rugby hold to start off with) and I healed really well. I was up and about within 24 hours and "back to normal" within a few weeks.

Now, when I think of the potential risks to the babies of a natural birth, especially the second twin, I just think: get these children out of me, healthy and with perfectly formed heads :snigger: I had a friend who opted for a natural birth and ended up with all the interventions for the first twin (forcerps, ventouse, tear etc.) and then a c-section for the second. I've also had friends who've given birth to twins naturally with no problems, but I think I'm just more cautious this time round.

Having said that, if both babies were head down.... I might be tempted to try. There's no easy answer.

My main concern is to keep these babies inside of me for as long as possible. The biggest benefit to my son of me refusing an elective c-section was that he was born more than two weeks later than he would otherwise have been had my consultant chosen the date. I think this was a huge factor in how easy a baby he was and how well he was: he was properly developed! So for me, to c/s or nvd isn't the big issue it would have previously been.

Good luck for tomorrow Eli and good luck to everyone else, whatever path you choose.

R x







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This post has been edited 2 times, last edit by "roxy7" (Oct 20th 2009, 7:33pm)


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Tuesday, October 20th 2009, 7:36pm

I just wanted to add that Claddagh (on here) delivered her twin boys naturally and although she doesn't get on much nowadays (I wonder why :innocent:) I'm sure she'd be happy to share her experience if you dropped her a PM/email.

x

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Wednesday, October 21st 2009, 9:00am

I've been wondering what to go for too...like Mavis I'm trying to keep fairly open-minded, only I'm leaning towards a c-section.

I've spoken to quite a few twin mums from the twins group, a few had good natural deliveries, a few had both and most had c-section. Those that had c-section actually found the recovery time to be shorter than anticipated and liked the easiness of the whole procedure. I guess I'm leaning towards that as I know I will have lots of people around to help in those early days.

However, if I go into labour naturally before the elected date and the twins look to be ok then I'll give it a go. Natural delivery is better for the lungs of babies...but I am also really worried about that as my DH has a HUGE head and I'd rather not tear or have an epesiotomy. My mum in her two deliveries had both and she said it wasn't pleasant. Then again, neither's having a great slice across your pelvis :rolleyes:

Oh, it's too complicated :snigger: I think I'll bury my head in the sand a bit longer and just get DH to pack the sledgehammer in my hospital bad. He can clonk me round the head with it and they can do whatever they like to me after thet rotf


Eli - wishing you lots of luck for today :D


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Wednesday, October 21st 2009, 9:01am

Hi Mavis,

Found this very interesting as I am also in a slight dilemma as to the safest way to deliver our girls..... I have to say that I am leaning towards a section, just seems so much safer for them, yes OK, it will be harder for me to recover but I feel that I don't matter as much as they do!!!
I know that it will be harder to cope with 2 and recover but it can be done.
I was concerned about the skin to skin contact & breast feeding with a section but the hospital said that neither of these things will be an issue.
I think after all that you go through to get these very special babies, I don't want to take any risks with them and a vaginal birth just seems to have too many unknown variables for my liking!!!
My hospital told me that it is completely up to me how I deliver them, the only thing they asked is that if I was to go into prem labour and all was progressing quickly & well, that I try to deliver vaginally as it is best for the girls lungs.

It is all very unknown isn't it?! I think that we just have to go with what we feel is right as a Mummy for our babies :D

:girl: :girl:

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Wednesday, October 21st 2009, 12:01pm

Hey Mave

You shoudl live in Nottingham; when I asked my midwife about what choice I'd have in the matter I was told, it all depends on your consultant !! :what:

Like many of you, if I do have a choice :shocked: , i'm undecided.

One of my friends has had two sets of twins would you believe and had a c-section both times having gone into labour early. She recovered from the second one a lot quicker.

The worst case scenario obviously is having NVD for the first twin and then needing a c-section for the second. That, unfortunately, you can't prepare for or know will happen, but it is a risk of course.

There are fantastic tales from the likes of Claddagh who breezed through her twin birth (as far as you can!) and was even at the pub the next day watching the footie :snigger: That's the sort of birth I would want! :D

Ultimately I guess the choice will be taken out of our hands if the babies aren't both head down so I guess in theory, unless you opt early for a c-section, the actual delivery procedure will be unknown till nearer d-day!

One final thing - I've been told I won't be "allowed" to go beyond 38 weeks. No idea if this is a standard thing with twins but I would guess that a c-section would be more likely shoudl I reach that stage and not gone into labour ?(

:pah got ages to think about all this stuff ! [zx062]

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Mavis

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Wednesday, October 21st 2009, 12:08pm

Eli.... wow! :faint: I hope today has been the most amazing day of your life!

And a big hello to everyone else, this is such an interesting thread! It seems like a few of us are leaning towards an elective c-section for the sake of the second twin...(me included).

I'm a bit confused though, I think I am going to have to grill my consultant for some numbers. Surely if the risk to the second twin was high, we'd all be having c-sections and that is not the case.

Plus in my twinny book (the TAMBA one, written by a GP), it said something like "98% of obstetricians agree that if both babies are head down, NVD should be attempted". NVD does seem to be the way to go... but why? I guess either the risk to the second twin in a NVD is relatively low and/or the risk of a c-section to mama and babies is relatively high.

Dunno! Just throwing that out there.
Today is a veering towards a c-section day, but that's probably just because its Wednesday :snigger:

blowkiss

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Mavis

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Wednesday, October 21st 2009, 12:13pm

Quoted

Originally posted by Duffymoon

One final thing - I've been told I won't be "allowed" to go beyond 38 weeks. No idea if this is a standard thing with twins but I would guess that a c-section would be more likely shoudl I reach that stage and not gone into labour ?(


Duffypoo, I was also told I was not "allowed" to go beyond 38 weeks. Its to do with placental insufficiency. They will book you in for a planned c-section (or I guess maybe an induction?) if things don't show any sign of happening before then.

But I've heard of some twin mamas holding on until their babies were ready to come out of their own.

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Thursday, October 22nd 2009, 7:29pm

Hi girls

Just wanted to add to this thread.

I really really wanted a normal delivery but was eventually bullied into a section by my cons. Twin 1 was head down and twin 2 breech but this does not matter as long as twin 1 is in the right position because they can easily turn twin 2 if necessary.

My cons said that normal is more risky for twin 2 but section is more risky for mum so I say you go with the decision that is most comfortable for you.

I am very cynical but it seemed to suit my cons that a date in his diary for the delivery rather than being called when didn't suit him. I have a big regret re my girls birth so if you can chose right way for you.

Recovery time from section is really quick as by day 4 when left hosp I was up and about no problem and able to look after girls by myself.
Heather

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Thursday, October 22nd 2009, 8:25pm

Hey there, ive only just seen this....
I havent read the full thread so apologies...

Bubble is correct, our boys were delivered naturally - No epidural, just gas and air...

I'd spoken with our consultant and said i would go with the flow but would like to give it a go, if all was ok - ie: both heads down....I wanted to stay as mobile as possible but once i was about 4-5cm dilated i was asked to get on the bed so that the twins could be monitored...

Anyway - the staff where great and like you've said, the 2nd twin can move once they have space.... There was a 2nd midwife around who actually held Twin 2's bum so that he wouldnt flip.... She was actually telling me when i was having contractions as wasnt feeling them for the 2nd one...

It was a great delivery and i know that we were extremely lucky... I would say deffo keep an open mind but let the staff know your thoughts....

If you want any info or talk about anything, give me a shout through PM... I dont get on too often but am happy to go through it....
me 38 DH 45 - unexplained infertility and ttc for 4 years ,Mar 07 -Missed m/c
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Friday, October 23rd 2009, 12:27pm

Heys ladies

sorry haven't read all the responses cos the chimps are ill and very clingy!

Anyway I desperatley wanted to have a natural delivery but it was not to be with Pip being breech and Squeak transverse and so I had a C section at 38 weeks and it was fine I was mobile (if a little wobbly) the next day! my milk took a few more days to come in but it hasn't prevented me breast feeding.

I did see a consultant midwife to discuss the issue of an epidural when I was hoping to go natural as I really didn't want one. However afterspeaking to here I realised my greatest fear was an emergency c section and so I would have opted to have one, I desperatley wanted DH to be there and for me to be awake when they arrived!

HTH
x


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Friday, October 23rd 2009, 3:43pm

Hi Indie, thanks for you post. It's great to hear that there's the possibility of getting to 38 weeks even if you go for an elective c/s. My biggest anxiety is to keep these babies in me for as long as possible. I realise I have all but no control over this if the babies choose to come early, but I don't particularly want a Consultant deciding that they are going to come early. As I said above, having already had one c/s, I'm pretty resigned to a second.

R x







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Monday, October 26th 2009, 1:48pm

Just found this link. Quite moving, although I'm still jury out!

http://www.youtube.com/watch?v=7E-wULAaD…1653A1C5C2E86D9







Me 41, DP 42
Diagnosis PCOS and old age!
DS 11/06 (clomid)
Mm/c of natural pg 03/08
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cs booked for 20/04/10

This post has been edited 1 times, last edit by "roxy7" (Oct 26th 2009, 1:49pm)


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Thursday, October 29th 2009, 7:58pm

How come I didn't look like that jolly in any of my after birth pictures :snigger:


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Friday, October 30th 2009, 4:22pm

I know, they are slightly surreal and hilarious. (Very American?) I confessed that the bump sizes absolutely petrify me. I'm only 1.55m and I already look about 5 months gone (compared to my singleton pregnancy) at 13 weeks!

R x







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Friday, October 30th 2009, 6:00pm

:snigger: the bump sizes absolutely petrified me too! I'm taller than you Roxy, but still my bump is obvious and this time last week everyone we saw could see that I'm pg and were shocked that I wasn't due until May :snigger:


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Friday, October 30th 2009, 6:32pm

I just know we're going to have to deal with so many smart alec comments about our size in the next six months!

Glad your NT results were good. I'm over the moon about mine.

R x







Me 41, DP 42
Diagnosis PCOS and old age!
DS 11/06 (clomid)
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cs booked for 20/04/10

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Tuesday, November 3rd 2009, 2:24pm

LOL It's not so much the bump size but the bump shape that you have to worry about, Mine often looked like a cube!!! I had a couple of strangers ask me how far gone I was and they then exclaimed the likes of 'OMG really, are you sure you haven't got two in there' . . . . . . . errrghhh yeah, I have actually :snigger:


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Scan 09/09/08 - 2 [zx076] [zx076] TWINS!
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Tuesday, November 3rd 2009, 3:42pm

Hi Indie, I did notice some of them where rather cuboid. Looks really strange. Ah well, bye bye to my bikini wearing days, eh?







Me 41, DP 42
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DS 11/06 (clomid)
Mm/c of natural pg 03/08
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Indiechick

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Tuesday, November 3rd 2009, 4:47pm

Nah, you'll snap back in shape I'm sure! I'm up for wearing a bikini . . . . .my arse is so big no one will be looking at my belly!!!!

x


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Friday, November 6th 2009, 7:01pm

Hi ladies

I am 33 weeks with twins at the moment. I think it really does depend on your consultant and his experience. I told him that I was keen for a NVB as i had read that it was best for the twins lungs etc, and for my body to know what's happening, it just seemed like I should let mother nature take the lead. I didn't even think that I should expect a section or that I might be told to have one.

I met with my consultant and said that I knew I might have to have an epi because of the chance of complications with twin 2 and he stopped me straight away. He said, not at all. that I was more likely to end up with an emergency section with twin2 if I have an epi as it will slow things down. He said he will encourage me to keep mobile and only monitor when necessary. He said if I was to choose my closer, smaller hospital that I was twice as likely to have a section because of their lack of experience. He said that as long as twin 1 is head down we should go for it. He said twin2 being breech would not be a problem. He agreed with the report mentioned earlier that where possible a NVB was for the best.

Still, I worry! How do any of us know what will be? I will be gutted if twin2 needs a section after all and obviously feel terrible of twin2 is in danger because of my attempt at a natural birth. I do have a lot of faith in my consultant though and my body, so unless the twins say otherwise at my next scan, I'm gonna go for it..........

I think the most important thing is that we are all happy with and have reasons for our own decisions, what ever they may be, and that we don't feel we have been bullied into something we didn't want or understand.

Good luck all
xxxxxxxxx

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Saturday, November 7th 2009, 12:05am

Lennie, that is very interesting...
I thought that would be case, that having an epidural would lead to a higher chance of intervention because it does slow things down.

I'm still very much on the fence, but am feeling a little disheartened that my hospital has a high c-section rate, and my consultant has told me I would definitely have an epidural because it is twins. If I want to try for NVD without an epi, I am going to have to push for it.

But looking on the bright side, it is lovely decision to struggle with, because NVD is only really an option if there are no complications and the presenting twin is head down. Fingers crossed we all get to struggle with this decision!

M
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33

Sunday, November 8th 2009, 2:05pm

Lennie, my friend who had twins 11 years ago had a very supportive consultant and she had one twin head down the other transverse or breech, cant remember. Anyway, she managed the birth with just gas and air, so it is doable and they certainly teach at the nct that epidurals are more likely to lead to a c/s for the reasons mentioned.

R x







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Sunday, November 8th 2009, 2:18pm

Another thought. You're right that the lungs will be in much better shape if labour starts and progresses some. It's not the vaginal birth bit, it's the birthing hormones that help eliminate the (?) surfactant in the babies lungs.

With my singleton pregnancy, I had 23 hours of contractions (didn't progress much from 1 cm dilated because baby was breech) but, even though I had to have an em c/s, he didn't have a any of the breathing problems he might have experienced if I'd gone for an elective c/s. So I thought it really was worth it, starting the birthing process naturally, even though I didn't have a VB, as the outcome was so much better for him.

R x







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Sunday, November 8th 2009, 3:08pm

Hey fellow twin mummies :D

Just a wee update to say I chatted about the dreaded B.i.r.t.h word at my 20 week appt on Friday with someone from my con's team. Quite surprised and pleased to hear that it won't be a foregone conclusion to have a c section. In fact it sounds like decisions aren't made until 34 ish weeks.

Just to reiterate what Lennie said above as well that for a NVD both babies don't need to be head down - just twin 1 !

I feel more comfortable knowing that they're open minded and I guess as time goes on I'll be able to probe a little more into how realistic an NVD is.

It must be on my mind as I had a dream last night i had a c section only i had one cut in the normal place and one above my belly button all the way across and I was telling people it was because I had twins and they were in different places :snigger:

At the mo my twins are making the shape of a number of 7 - head to head i.e. twin 1 is breech (a little diagonally) and twin 2 is transverse. Probably why i'm getting such bad rib aches!!

xxx


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Tuesday, November 10th 2009, 8:37pm

A quick question for all you lovely mamas, do you know when it is determined whether the presenting twin is head down or not?
I know with a singleton, the baby can flip right up until the last minute. But there is less space with twins... I read somewhere that 32 weeks is when you know? ?(

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Monday, November 16th 2009, 11:03am

Hi Mavis

My consultant said that depending on their size they shouldn't be able to move much after 34 weeks, so that's when you would be able to tell what the score is.
Having said that my last scan was 32 weeks and I'm 35 weeks now and not having a scan until next week..... so as you can imagine I'm dying to know where/how they are lying and what our future is!
I'm also worried that i wont get as far as the middle of next week and might start labour with two breech or transverse etc!

xx
Lennie

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Monday, November 16th 2009, 12:11pm

Ooooo Lennie, that is soooo exciting!!!
Have you tried to have a feel to find their heads? I think it is easier to find them if they are breech (you can feel extra firm areas under your ribs) than if they are heads down.
Many MANY congratulations for getting to 35 weeks, that is the hardest part done. I spent ages last night comparing birth weights of twins to singletons, and up until 35 weeks they are pretty much the same. After 35/36 weeks, the singletons keep getting fatter but twins less so, so I can see why the docs don't want us to go all the way to 40 weeks.
But you've made it to the important stage already - respect!
M
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Tuesday, November 17th 2009, 11:08am

I haven't got a clue what's what! My tummy goes like something out of alien every night at about 11pm and bits pop out all over the place but there seem to be so many that I can't work out what's a leg or a hand! It is amazing isn't it? I think I have one head down at the moment but twin two has been hiding very high up and behind twin one for the last month, they couldn't find it on scan or doppler, I had to lie on my side in the end and they almost scanned my back! If they had been natural I think i would have been one of those ladies that didn't know it was twins until labour day.
Sometimes I think I can feel twin two's head on the left under my rib, but it could be a bum!

As for getting to 35 weeks, nothing to do with me! I know I've been lucky as I was originally worried, like all of us about going early. Have you had the cervix checks? Once you have passed them and got to where you are then I'm sure you'll be fine. 28 weeks is all looking great, good for you! Two girls too, how perfect.

x

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Tuesday, November 17th 2009, 12:08pm

Quoted

Originally posted by Lennie
I know I've been lucky as I was originally worried, like all of us about going early. Have you had the cervix checks? Once you have passed them and got to where you are then I'm sure you'll be fine. 28 weeks is all looking great, good for you! Two girls too, how perfect.

x
Prematurity is my big worry. What are the cervix checks????

R x







Me 41, DP 42
Diagnosis PCOS and old age!
DS 11/06 (clomid)
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1st IVF 02/09 (ectopic)
FET 08/09 :BFP:
cs booked for 20/04/10

This post has been edited 1 times, last edit by "roxy7" (Nov 17th 2009, 12:09pm)


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Tuesday, November 17th 2009, 12:18pm

Quoted

Originally posted by roxy7

Quoted


Have you had the cervix checks? Once you have passed them and got to where you are then I'm sure you'll be fine.

x
What are the cervix checks????

R x


Some women have their cervix checked to make sure it's closed. It's not something that's offered routinely and nor are they particularly useful unless a Mother is experiencing some kind of problems. Most women in the UK won't have their cervix checked until they're in established labour but with twins your midwife may feel there is merit in checking your cervix 'if' there's a good reason to do so.





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Tuesday, November 17th 2009, 12:34pm

Thanks!







Me 41, DP 42
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FET 08/09 :BFP:
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Tuesday, November 17th 2009, 12:55pm

Hi Roxy,
You can have an internal US scan to measure the length of your cervix. (A shortened cervix increases your risk of a premature labour). Some hospital trusts do this test, others don't.
My hospital doesn't do it because if a scan showed a shortened cervix, they wouldn't do anything differently... regardless of what the scan showed, they want me to vigilant about signs of early labour, to come get checked if I have any worries, and if labour has started early they will do what they can to stop it. But there is mixed evidence on what can be done to prevent early labour from starting in the first place...

The treatment options to prevent premature labour include:
1. Bedrest - not shown to work in uncomplicated twin pregnancy, one recent Cochrane study actually showed it increased the risk of prem labour!
2. Cerclage (basically a stitch in the cervix) - the risks of this procedure outweigh the benefits when given for uncomplicated multiple pregnancy (i.e. the only risk is the fact you are having twins, there are no other risk factors). The stitch can induce labour, the very thing you are trying to prevent, because it can introduce infection or break your waters. But it is very useful in women who are at higher risk of premature labour because of previous cervical surgery or previous second trimester miscarriage. Those women should consider having the stitch at around 16 weeks in pregnancy (ish! not sure).
3. Steroid injections to help mature the lungs - some hospitals automatically give this to twin pregnancies at a set date e.g. 32 weeks. Mine doesn't because the steroid injection is only useful for a limited time, and although it can be given again, it can also slow down fetal growth if given repeatedly. So it is better to reserve it and use it when really necessary, e.g. when there are signs of early labour, and not on the basis of a scan result.

Sorry, that was a long'un!
Every trust does seem to be different, which makes this all so much more interesting! But if you are worried, its definitely worth asking your consultant what your hospital does.

M
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Tuesday, November 17th 2009, 1:52pm

I didn't realise that it wasn't standard?! I know that I had a scan to check the length and it was long so I was marked low risk, then I had two checks at about 20 and 24 weeks. After that I've had no more checks on it.
I presumed that if they had thought I was going to be prem they would have offered the stitch etc. I did get the impression that if you get past your 24/25 weeks then you're only likely to be prem by chance and not for any weak cervix reasons. So those of you who are past that should relax a little I would think. I have met several women lately who had twins at 32 weeks and all have very happy, healthy babies and I read somewhere that the average for twins was 35.5 weeks........ which would give me two days! It's also less likely with those of us who are having non identical twins, which I presume a lot of us are due to IVF. I don't think mine are going anywhere at the moment. One is 4.5lbs and the other about 5.5lbs approx......
Have just hoovered the front room and will now have to rest for an hour! Is this what it's going to be like when we're 80?

x

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Tuesday, November 17th 2009, 2:10pm

Thanks for your replies. I was pretty clued up in my singleton pregnancy but feel a total novive about twin pregnancies! Am I likely to have a problem with a weak cervix if I've already carried one baby to 42 weeks?

I'm very impressed by your ability to hoover at this late stage, Lennie!







Me 41, DP 42
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DS 11/06 (clomid)
Mm/c of natural pg 03/08
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FET 08/09 :BFP:
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Tuesday, November 17th 2009, 2:17pm

Your twins are fab weights Lennie!
And I am sure when you are 80, your twinnies will do your hoovering for you so you can rest up :snigger:

And yup, I don't think the cervical scan is standard for twin mamas, but lots of aspects of antenatal care do vary depending on the hospital trust. It's a bit scary, but so many things go in and out of fashion too. I believe ventouse was all the rage 10 years ago, but now forceps are making a comeback...!

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Tuesday, November 17th 2009, 2:21pm

Quoted

Originally posted by roxy7
Am I likely to have a problem with a weak cervix if I've already carried one baby to 42 weeks?


Nope!
Quite the opposite in fact. Your cervix has been tried and tested and passed with flying colours! :D

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Tuesday, November 17th 2009, 2:21pm

...

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Tuesday, November 17th 2009, 4:02pm

You're joking! That's a cervix made of steel, tried and tested. Relax
xxx

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Wednesday, November 25th 2009, 11:56am

Ooooo Lennie, you haven't posted for ages and ages.... any news?!!!

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