Ages ago, I posted about how my OB thought my pelvic inlet was too narrow to attempt a vaginal delivery after about 35 weeks. And that it was really upsetting to me, and I would revisit that topic with her later. Then with the cervical funneling and growth scares and such, it dropped to the wayside. So it wasn't until yesterday that I brought it up again, and go some full answers.
The first thing is, she still thinks my inlet is narrow, but has said she will let me attempt if it's what I want, no matter how far I make it. So I guess that's a non-issue now.
The larger issue is positioning. She actually does breech extractions on twins. BUT she will not do it if a Baby B is more than 15% bigger than Baby A. I am fine with this--I understand the reasoning behind it and agree that it's in everyone's best interest. In my personal situation, Baby B is my Damien, and he will almost certainly be more than 15% larger than Atticus.
My OB will do an external version (sp?) on a Baby B once Baby A is born, regardless of size. But she says that versions are really hit or miss. She can't give any concrete answers, but after talking with her and with my doctorsister, I am left feeling like, if Damien is frank breech, it's probably not worth an attempt. If he's transverse or head-down-ish diagonal, then it might be worth trying. The caveat there is that he can switch position after Atticus is born, and it could be good or bad.
My OB has also stated that I would need an epidural in place (though not running meds unless I choose) in case we need to go to a section. She says I can labor in the labor rooms, but once I start pushing and for the rest of delivery, it will happen in an OR. I'm agree with both of those calls.
So, where I really am right now is thinking: If Atticus is vertex and Damien is transverse or leaning towards head-down, I'll try a vaginal delivery. If Damien is breech or should Atticus switch (he's head-down vertex now), I'll do a c-section.
Does this sound like a good plan to you, or do you think I'm being irrational? Both my OB and my sister have stated that I really need to decide how important my "birth experience" is to me.
My sister says she personally would just do a section and try for a VBAC next time. Which is all well and good until you throw infertility in. I mean, we can't even say for certain that we want a third child, but I can say for certain that wanting and getting don't necessarily go hand in hand. And deciding to do IVF again, and how many to transfer and how many times to try before throwing in the towel while being responsible for 2 small children in every way (including financially) is probably a very different situation than the one we were in with zero children. So I really don't want to put any eggs in the "next time" basket.
But I really do want to experience vaginal birth. I really do not want to place either of my kids in any danger (understanding that all forms of delivery have some risks). I feel like my OB (and my sister) wouldn't be on board with an attempt of labor if they felt like it was the WRONG decision. (Which isn't to say "the best", just that it's not pure evil.) And my OB did mention several times that she has had many twin moms go vaginal on Baby A only to end up needing to section B. That sounds like a difficult thing to recover from...but I'm not sure if it would be worth it or not.
I think I might just play it by ear--see how the babies end up positioned and when I do go into labor. The main thing, after all, is to keep them inside and, fingers crossed, avoid NICU stays.
And I didn't gain any weight at all in these 2 weeks, which bums me out. Especially since I do have gestational diabetes. Well, I had one abnormal and one "borderline" result. It takes 2 to fail, so I technically passed, but my OB says that, since GD almost always gets worse as pregnancy progresses, and since I am carrying twins, she wants me to meet with the dietitian, which will happen next week. My OB has told me she doesn't want me going on any medications, but to follow carb limits and increase protein intake...while keeping my total calories the same or even increasing them. Sounds fun.
5 comments:
I think your plan sounds like a fine one. It is always pretty much "wait and see". If you already have an epidural on board and you are in the OR, they will be ready with a surgical option at the ready. I personally think it is always better to try a vaginal birth first, if it is at all possible. I wasn't given the vaginal option at all, and I wish I had been.
Sounds like a reasonable plan. As chickenpig said, in your place I'd at least try a vaginal delivery, provided baby A stays vertex (as I'm guessing he will), since you really have no idea what will become of B's position once he's the solo occupant of the frat house... and I'd be game for trying the version then. If that failed, (or if baby A was not exiting, or if the things went pear-shaped,) I'd happily commence with a c-section.
Two birth modes isn't what anyone hopes for, but I really didn't think the vaginal delivery recovery was particularly tough (mileage may vary, of course), so it wouldn't be a huge add on to the c-sec recovery. And you'd get to experience it... and it's at least a good story if nothing else!
I think you have a good plan. I am all for trying vaginal delivery, but my husband wants me to have a c-section, because he thinks it is safer for the baby. I can understand the desire to deliver vaginally. I think it is good to keep your options open and not have too many expectations about the birth, except that your babies are healthy.
Regarding your borderline GDM. Time to eat alot of nut butters, veggies and salads with lots of salad dressing (full fat version), hard bolied eggs, and apples/pears with cheese. I know this has got to be hard.
i feel for youl i just delivered my twin boys last week. i was to have a scheduled section but that about four weeks before delivery they boht turned head down. i really wanted to try vaginal simce i was sucessful with my daughter. when all was said and done with the twins i easily delivered baby A will Baby B was an emergency section.
recovery has been rough. not what i expected. i totally would do it agin though.
regarding the gd, i habe type 1 diabetes (insu
n dependant) so not really the same thing but you can do it. just takes a lttle eztra planning. it will be so worth it once your noys are safe on the outside!
I delivered identical twins almost three months ago, and would be happy to share my insight if you want to hear it.
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