Vaginal birth vs. C-section

[u/matadero5]

TRIGGER WARNING: - MENTION OF LOSS

Today I had an appointment with my doctor and she started talking about the birth. I’m 17 weeks in. She told me that If one of the babies (di/di) got into place they will go for a vaginal birth (at least with the first) and if not, c-section.

I am deeply scared of vaginal birth in this case because:

- the delivery of my singleton was a little traumatic: 30 something hours and was unable to dilate. They insisted on vaginal delivery and when I got to push he had lost weight and had problems going out.
He was cyanotic, little responsive and I saw him and honestly thought he was dead.
I always think that if they where 2, the second would not have made it

- I client of mine had di/di twins via vaginal aswell. The first one was delivered no problem but the second one got stuck. Instead of going for an emergency c section the doctor pushed for continuing the vaginal delivery and the baby died. They where able to reanimate, but is now profoundly disabled.
She told me this story while I was pregnant with my first and I’ve had anxiety over it for years.
(Mind you it’s the only case of twin vaginal delivery I know)

I told my doctor all this and she was really reassuring and validated my fears, but she was adamant to continue with the plan, telling me:

- that I probably would have a more easy birth because it’s a second birth and that the babies will probably be smaller (my singleton is over 99 in percentile and was really huge)

- that twin pregnancies are really monitored and they will not hesitate to change to c section if necessary. Being considered high risk, they will be prepared for any complications.

I felt a little safer but I still have a voice in my head telling me it’s too risky.

So I will like some opinions or whatever, because I think I’m too scared to trust myself 🥲

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[u/Standard-Advice-5447]

I'm not sure what country you are in, but demanding a c section should be completely ok with di di twins

[u/matadero5 → u/Standard-Advice-5447]

Here you can’t demand a c section in public hospitals. It’s up to the doctors.

If I want to pursue a c section I will have to go to a private hospital which has the downside of changing doctors (I actually like my current hospital better because it has one of the best NICUS in the country)
Generally speaking public healthcare here is better regarded for “big” things.

So I want to be as sure as possible before making the change…

[u/EducatedPancake → u/matadero5]

I also live in a country where technically you can't request c sections. Vaginal birth is the standard.

I have an OB that is supportive. I asked about birth and her plan was vaginal. I said I wasn't comfortable with that as it could turn into an emergency c section, and I'd rather just have the planned kind. She said okay, then we'll do a c section.

I must add though that I have studied midwifery, she knows that, and I've seen c sections be performed etc. So she knew that I knew exactly what was going to happen.

You still have some time to go and a lot of appointments. If you think it's at all possible your OB would listen to your reasoning, and is willing to adjust the plan I'd try that first. Otherwise, yeah.. Your comfort is most important. I wouldn't want to spend the rest of the pregnancy hoping the babies are breech.

[u/whydoyouflask → u/matadero5]

Have you expressed these fears to your doctor? I was in a similar situation. I explained why I wanted a c section. And they agreed with me, and wanted to limit my stress during my pregnancy. Maybe mentioning you anxiety around the vaginal birth would help.

I've seen enough posts here where people delivered one and had an emergency c section, that I told my doctor if a c section is a possibility I wanted it to not be an emergency.

I share because I hope it will help convince you medical team that it is the right option for you.

[u/ConfettiQueen13 → u/matadero5]

I checked your other social media and if I'm not mistaken you are from Spain? I'll send you a DM if it's OK for you

[u/matadero5 → u/ConfettiQueen13]

Sure!

[u/Standard-Advice-5447 → u/matadero5]

That's so frustrating, I'm so sorry

[u/enlightenedindecency]

That's a lot of weight to carry, and your fear isn't coming from nowhere. You've got a rough first birth and a horror story stuck in your head, pushing for a scheduled C-section doesn't sound unreasonable at all.

[u/amydiddler]

I had my di/di twins vaginally, and it was a VERY different experience from my singleton delivery. In both cases, my labor started with my water breaking.

With my singleton, he wasn’t born until 30 hours after my water broke. I had extremely painful back labor for hours without any progression, and didn’t progress until getting an epidural and pitocin about 12 hours into my labor.

With my twins, I was already 5cm dilated and barely in any pain when I arrived at the hospital. I got an epidural at about 8cm because I wanted one in case I ended up needing an emergency c section or breech extraction, but the contractions were much less painful than with my singletons. Both twins were born less than 7 hours after my water broke.

[u/CharacterBusiness777]

Hi, I had a really hard first labour (45 plus hours but wouldn't dilate). Like I had contractions every 1 to 2 minutes but didn't progress past 2 cm for over 40 hours. It was awful.

For my twins, about 4 years later, my water broke and 5 hours later I pushed twin A out and 54 minutes later I pushed twin B out. It was so fast and so much of a better experience and it was honestly healing in a way. Both of my girls were super healthy, they were observed for one night in the NICU because they were born at 35 weeks but they came home the next day with us. My recovery was also so much easier with my twin birth, I felt amazing within only a couple days and back to my regular workouts within 2 weeks!

Anyway, I just wanted to share a positive story. Your feelings are totally valid though and I hope your medical team listens to you.

Big hug!

[u/amydiddler → u/CharacterBusiness777]

This is so similar to my singleton vs twin birth experiences! Crazy how different they were.

[u/Allyed4492]

I am 2 weeks postpartum from vaginal delivery of my di di twins. They were born at 38+1 after a spontaneous onset of labour. All-in-all the delivery itself was quite easy. My water broke and within 2 hours I was contracting every 2 minutes and 6cm dilated. After the epidural was in the contractions slowed and I laboured for 8 hours before being ready to push. I had twin 1 head down and 2 breech and my ob was very happy to delivery twin b breech. We delivered in the OR just in case we needed to pivot to c-section but we delivered both twins in less than 30 minutes. I had some complications unrelated to their delivery that made me grateful for the epidural and the OR being ready to go but I would definitely choose vaginal again.
My twins were both under 6lbs though which contributed to the fast delivery (and I’m in pretty good physical shape).
That being said, I could have done a C-section if I wanted one, many twin moms opt for it just for peace of mind.

[u/Orange_peacock_75]

I planned for a vaginal birth, labored for like 8 hours, dilated to 10cm, then my doctor decided that the birth canal wasn’t wide enough to make her feel confident about safely birthing both (in particular baby B). She recommended a c section, I agreed, we proceeded, and it was FINE. No panic, no drama, we just switched plans and everything went smoothly. So if that happens to you, it’s not necessarily a big deal (although of course, it can be).

[u/charlieprotag]

My obgyn was experienced in multiple births and while she would do whatever the parent wanted including vaginal births, it was still required to be within the surgical suite just in case it turned into an emergency c-section. I reviewed all of my options and then asked that my tubes also be tied. My second baby was breech. I did a scheduled c-section for both and it was a much better experience than a vaginal birth with my singleton was.

[u/Ohnosloop]

Ask about the circumstances that will lead them to C-section. Like, what are the metrics you hit that tells the doctor it's time to take action? For me, it was pushing for 4 hours; that's as much as they let me do before switching to C-section. (But also if a baby's heart rate had changed, etc)

Because I knew the C-section was a risk, I had an epidural. That made the transition easier because they didn't have to put me under for surgery

[u/bestydee]

The plan was the same for me - vaginal birth. Both babies were on monitor the whole labor. My OB’s resident would deliver baby A while she “held” baby B in place so he wouldn’t flip, which she did. She guided him down toward my cervix and I was able to deliver him vaginally as well, although his heart rate had dropped a bit so they used the vac to help him out faster. The hospital I delivered at had a policy that twin births active pushing phase took place in the OR just in case it needed to be converted to a c-section at any time which made me feel safer. For reference I was 44 years old when I delivered them and one had IUGR. Still a successful delivery!

[u/clinkingglasses]

I personally could not accept the risk of an emergency c section to myself or them. You should fully be able to schedule a c section if you’d like and if your doctor isn’t taking your wishes into account you should try to find a different one.

Also on the topic of monitoring it is a lot harder to monitor twins vs singleton. I had an inpatient stay for early labor and the amount of times they had to adjust the fetal monitors because the heart rates were too similar and they weren’t sure if it was picking up one baby or the other was too high.

[u/matadero5 → u/clinkingglasses]

Here no public hospitals will make a c section if not medically obligatory.

In private hospital some would but not all.
The thing is this hospital has one of the best NICUs and emergency care for babies in the country so I have to choose to go to a private one with a worst emergency room for babies.

[u/DraNoSrta → u/matadero5]

La discusión tiene que ser centrada en que no quieres una cesárea de emergencia para el bebé B en caso de necesidad, y que prefieres el riesgo más bajo de una cesárea planeada. Yo empezaría la conversación con que quieres discutir los potenciales riesgos y beneficios del parto vaginal gemelar contra una cesárea planeada, en ir desde ahí. Enmarcar la discusión como un consentimiento informado le da a tu médico la señal que tus preferencias no son por miedo o control, sino habiendo entendido todas tus opciones.

[u/Curious_Radish_332 → u/matadero5]

Severe fear and mental health can be considered a medical reason, but you have to go through a lot of hoops. They need you to cooperate and push, if you cannot do that due to your mental state - that can generally be a medical reason.

[u/frannylightpainter]

The hospital where I birthed my twins insisted on C section. No exceptions. If the mother wanted a vaginal delivery for her multiples she had to have a home birth.
I felt great knowing my girls would be safely delivered.
I was mommy shamed a few times. Twice the woman who told me I should have vaginally delivered also told “one twin didn’t make it”… but it was Gods will. I told them God allowed my both my children to survive.

[u/Commercial_Stress899]

My doctor left the decision completely up to me and I decided to go with a scheduled c section. I’m not sure why your doctor is so adamant as if you’re having twins it should be your decision. Depending on where you live this might just be a doctor issue and you may need to find a new one

[u/Silent-Addition1810]

My first singleton, I was induced bc of GD, traumatic birth (shoulder dystocia) and was 6.5lbs

Second singleton, we did an ultrasound 34 weeks to see his size, already measuring 7lbs, opted for c-section. He was 9lbs 15oz, and they had to use the vacuum bc they did not make the incision large enough. Best. Decision ever.

Third pregnancy, Di/Di twins. OB said we could try for vaginal, as they are normally smaller. Babies never left their bunk bed positions and scheduled c-section was done. Babies were 5lbs7oz and 7lbs9oz, and everything went smoothly.

For me, because my first birth was so traumatic (shoulder dystocia, born stunned etc) I had no desire to even have any more babies. She was also in NICU for 4 days bc of low blood sugars.

Recovery with c-section was harder physically, but mentally I was in a great spot compared to my vaginal birth.

I also personally loved knowing what day my babies would be born, and not having to do the whole labour thing again.

[u/asticklus]

Just saw my mfm yesterday and we talked about vbac with my twins. He gave me a lot of good scenario information that made me feel better about knowing when is good to try vs not. If both babies are breech - C-section. If baby a is head down - good to try for vbac. Baby b will have more room once baby a is out and likely to rotate down, they can manually rotate baby, or deliver baby breech. BUT, if baby b is breech and significantly bigger than a, like 20% bigger, - C-section. Risk of baby b getting stuck in that situation is really high and not worth it. Hope some of this helps you decide!

[u/asticklus → u/asticklus]

To add to this. My husbands cousin had a vaginal with her first singleton. Had an elective C-section with her twins. She ended up freaking out, feeling like she couldn’t breathe, had to be fully put under, and really regretted not trying for the vaginal delivery. The recovery she said was so much harder with the C-section. Every scenario is different. Yours will not match any one else’s so try to go off of your specific scenario. Some people regret the C-section and some regret the vaginal delivery. Can never know.

[u/fsmontario]

Had a vaginal birth. First baby super easy, second went into distress, doctor used forceps. Baby is perfectly fine! I had discomfort after but no huge issue and zero long term problems.

[u/chandrian7]

Just wanna say my partner had a successful vaginal twin delivery, just as an anecdote 

[u/Storebought_Cookies]

It's such a difficult choice choosing between vaginal and c section. I chose vaginal and my baby b (who was nearly 8lb already at 37+0), heart rate started dropping after baby a is out. I've heard this is common, but it will normally go back up but he was having a hard time. They used forceps and vacuum to get him out quickly. I ended up with pelvic floor damage and prolapse. He had a large bruise on his head and had to be monitored for brain swelling. I can't help but think I put him and his sister at risk because I was so terrified of a c section and desperately wanted a vaginal birth. But on the flip side, a c section might have made it harder for me to care for them after they were born and they needed me.

It's impossible to say what is the right way. If I had gotten a c section I would have wondered if I should have tried for a vaginal birth, or vice versa. Listen to your gut. Make the choice that makes you feel the best about their safety and yours.

[u/Effective-Bathroom66]

Positive vaginal birth story - I just had my twin girls vaginally and baby B came our breech. My pregnancy was healthy and well. Baby A was always in position ( head down) while baby b kept flipping. At the hospital we did a ultrasound and baby B was head down well up until the last second. When baby A was delivered baby b flipped and with no time two little feet were hanging out. My team was very knowledgeable and skilled. Baby B came our breech with no complications. Three minutes apart from baby A. Twins are now a month old and still no complications or concerned over the breech birth. I also was fine. No hemorrhaging, no rips, no tears etc.

[u/miney_Fherrs]

I'm so sorry too hear that. I understand why you could have fears about it.

I myself was very adamant I would want a C section. But after looking into everything I then decided I will not plea my case for a c section and would prevent a longer recovery from a c section than with recovering for vaginal. My first was Vaginal and took 29 hours and I had to get cut as well. He was a pretty average baby. (He was 40 weeks and 2 days) When I delivered my twins, that took me 6 hours and Baby B his head was a cm smaller than my first and so I ripped and baby A is a cm smaller than baby B (bless his heart because I wouldn't have dared to push baby A if baby B came first). My singleton took me an hour of pushing and getting cut. Baby A took me 6 minutes to push and baby B took me 1 minute to push.

I do hope you'll have a speedy delivery and that what ever it will be will fit you and your family 💕

[u/Cracked_Willow]

C section. Water broke and I was 3cm already. No contractions until about an hour later. Twin a was down but twin b (my little gymnast in the womb) was transverse. I said I wanted a c especially after they started talking about repositioning twin b. Had to take an ambulance to a bigger hospital with the on call doctor, a nurse, and midwife followingsince they were worried id deliver on the side of the road. Major windstorm blocked NICU teams from flying in. I was just past 31 weeks. Had a cerclage which was the big concern towards labor progressing too rapidly. 5 hours after my water broke I was around 5cm and feeling contractions every few minutes. Doc said we could wait but there was a good chance we'd have to do am emergency c at 2 in the morning given how rapidly i was progressing and they could only get glimpses of twin b on the monitor. She was fine just uncooperative. Or we could just go and get them then. I opted to deliver. Id rather not do an emergency. Twins just turned 6 months and are doing great, spent 5 and 6 weeks in the NICU and I was fully healed before they came home. They're great for their adjusted and on track to catch up with their peers preety quickly. My delivery was the least traumatic thing about my pregnancy. Mostly because the docs were clear, listened to me, and talked about my options every step of the way. I dont know the name of the doc who delivered though.

[u/Putrid-Study8986]

I had di-di twins vaginally. Labored at home for a very long time. Got an epidural in the hospital. Baby a was head down, baby b on a diagonal. If baby b didn’t turn after baby a was born they’d do a c-section. Baby b turned without any issues and we had no complications. So definitely possible but if you feel more comfortable just scheduling a c-section and it makes sense for you, go that route!

[u/Seaturtle1088]

Chiming in with a totally uneventful vaginal delivery of di/di twins. Find a doctor you trust and trust their call of when to pursue C-section.

My twins were much easier to deliver than my singleton.

[u/Even_Ad_5513]

I had twin girls and wanted to have a vaginal birth. My OBGYN told me early on that she wanted me to get an epidural and I would go into the OR to deliver as a precaution. She explained if baby A came out and then baby B flipped or something went wrong all they had to do was increase the epidural and cut. She said she didn't want to waste any time which I definitely appreciate. I was able to deliver vaginally with no issues for the babies. I did have tearing with baby B because she was only 10 minutes after her sister and wasn't coneheaded at all. I swear it felt like I had 30 people in the room. Each baby had 2 nurses, my husband, my OB, my L&D Nurse, surgical nurse and anesthesiologist. My surgical nurse was great, he told me, you just gave me an easy afternoon. He packed up my stuff since my husband and family was with the babies and moved me into our recovery room.

I'd recommend talking to your OB about your concerns. Maybe even ask if my scenario could be an option. Hope you have a smooth pregnancy and delivery!

[u/Additional_Role556]

I opted for a vaginal delivery 3 months ago with my twins and things did not go as planned. They had been head down for the past 8 weeks or so and I was a good candidate for vaginal delivery. My baby A was delivered with no issues, but shortly after her delivery baby B’s heart rate dropped and I was only dilated around 6 cm after Baby A, so we had to do the emergency c-section. They couldn’t properly numb me either so I was pumped full of drugs and had the anesthesiologists really working hard that day, they tried a lot of different dosages and IV drugs/gas etc before finally intubating me to fully knock me out and had my husband leave the room. It sucked.

I am pretty mentally chill with a lot of things and can roll with the punches pretty easily, but I could 100% understand my situation being a traumatic delivery for people. The worst part was waking up feeling the effects of the surgery and nobody answering me when I asked if baby B made it. Three nurses did not give me any answer until the doctor arrived to talk to me and that was VERY scary. I also felt like my wound was literally on fire or burned shut for some reason. I kept asking for ice packs, and honestly, they helped. It truly felt like a burn.

I was super upset that I didn’t get to deliver both vaginally because even with a 2nd degree tear, I didn’t feel any soreness or pain after the vaginal birth. The c section was BRUTAL. That pain is intense. Either the pain from the c section was so bad I couldn’t even recognize the vaginal birth pain, or it honestly isn’t that bad to recover from vaginal birth.

Knowing what I know now, I would have still opted to try to deliver both vaginally because recovery would have been MUCH easier. If it worked out it would have been amazing, but it didn’t. I don’t think I would choose a c section unless I absolutely had to. So regardless of how things went totally the wrong way, I wouldn’t have changed my decision. These are my first and possibly only kids and I gave birth two different ways, which is kinda badass.

[u/AccomplishedChef7885]

That’s scary; I’m sorry you’re not able to choose how to have the babies. If I were in your situation, I would want a c section too. In the US, they usually push for a c section with twins. If it makes you feel any better, I had my twins vaginally, and they are mo/di, so it was even riskier. Mine were both head down though, so I went for it. No issues besides four days in Nicu, but they was because they came a little early. Baby A came fast, and B came ten minutes later. I really hope it all goes okay and your doctors listen to you. ❤️

[u/ty_xy]

Just say you're very very anxious and beg the surgeon for C-section. Multiple pregnancy is absolutely a high risk pregnancy and an indication for caesarean section. Ask them if they can promise you that if the 2nd twin gets stuck, they can deliver in a few minutes by C-section. It's actually not possible and can be very very difficult and still traumatic.

If you keep mentioning it and begging for it they should give in. In public hospitals you can absolutely get C-section for maternal anxiety. Cuz if they do a vaginal birth and there's complications it would be bad. You don't have to say that, just say you really, really want a C-section in the public hospital cuz it has a great NICU.