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Old 01-29-2010, 09:22 AM   #21
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

I'd ask the opinions of a few people are aren't directly involved in your care - like local homebirth midwives (even though you don't plan on going with them, obviously). I think they'll give you an honest array of what your options are, what the risks are, and good resources to check on for your situation. I'd have all this info handy BEFORE talking to your OB so that you can have an actual conversation with him/her and have a better idea of what he/she is talking about, what it relates to, etc...

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Old 01-29-2010, 11:14 AM   #22
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

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Just an FYI on the whole nurses know nothing vibe I got from some of the other posters an NP,Physician Assistant and a Midwife are ALL advanced practice nurses, they have the same amount of education and training.
They have the same length of training in different fields. Pharmacists go to school every bit as long as doctors, but I would never trust a doctor to sign off on my prescriptions. I would believe a L&D floor nurse over an office nurse based on experience if nothing else.
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Old 01-29-2010, 11:58 AM   #23
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

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Had to comment since I have b/g twins. He was 'A', she was 'B' and she was delivered breech.

I was SOOOOO where you are with the epi. I fought them until the last minute, and then told them to do it quick!! (I was put in the hospital at 34 weeks dialated to 4 cm before my labor stopped on it's own...so I got to sit around for two weeks right before Christmas..yay) By the time they finished the epi, I was 10 and ready to go (I was 6 when they started)! I did deliver in an OR, 'just in case'. Jake came out in I think 2 pushes, and my HR OB was doing an sono to see where Grace was. She was breech so the doc reached up there and pulled her out feet first. It was CRAZY! Mostly because I was watching it in the plastic face covering thing the doc was wearing and thinking to myself 'this should hurt and all I feel is butterflies! Awesome!' Both babies were fine. You don't have to have a c-section, so I would def talk to my provider and let them know you don't want one unless it's an emergency. But my advice is to always go in there open to anything....anything can happen.

The thing no one tells you is that you will have two docs, and two sets of nurses/docs for the babies, and the room will be FULL of people! That made me nervous, but it was all good. I have had 5 other deliveries without meds, and honestly the epi isn't that bad. (especially if you're addicted to baby story and watch all those mamas getting them, you know what the anesthesia doc is going to say before he says it!) For me, the worst part was the tape, since I'm allergic to it. They taped me from what felt like my rear end to my shoulder, and it hurt like crazy pulling that off.

Personally, I don't think they can tell so early whether or not they're identical. My twins had a fused placenta, and it weighed more than the two of them put together. If you've gotten into your second trimester, you shouldn't have to worry about VTS.

Good luck! If you have any other questions, just pm me!
oops, I didn't see your post before I went to bed last night or I would have commented earlier! One of my other buddies was saying it's too early for them to tell if it's identical twins too, even based on sharing a placenta. Probably for the same reasons you mentioned, it could be 2 fused together in the same area. what is VTS again? I'm bad with acronyms!

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Originally Posted by weintz8 View Post
I'm not expecting twins but have a clotting disorder. Are you on lovenox or any other thinners?

I have had three c/s and have never had a problem with the clotting. They stop the blood thinners 24-12 hours prior to surgery and start them up again 24 hours - 48 after. It might actually be because of the clotting disorder that the nurse says c/s. Since a scheduled c/s they know when to stop the blood thinners. It could be VERY bad to go into a c/s with your blood thinned out since that would greatly increase your chances of a problem.

All that aside - if you don't want a c/s I would fight for all your worth not to. Do your research - they are much more dangerous - why people in this country are obsessed with them is totally beyond my understanding.

Good luck and I am sure you will make a great decision for you and your babies
I'm one of the stubborn patients with this clotting disorder... I did a lot of research during my first pregnancy with DD about alternative therapy. I've been on alternative therapy since then (over 3 years now) and I tell all my docs I am happy and comfortable with what choices I'm making for my body. I've got strong feelings about the blood thinner injections - they're great if they help so many people, but are not for me, not right now anyway. That's part of what I'm scared of the injection thinners though, going into labor while on thinners - sometimes you just can't slow down or stop labor, and it's even harder to stop a hemorrhage! It's probably one of those things where if I'm on blood thinners, they will give me a bunch of dates - when to go off the thinners so the next day I can be induced, or get ready for a c-section. The thinners have a warning on the box that if you're taking thinners not to get an epidural, so I'm guessing most doctors plan when the mom will be induced to get her off the thinners in time.
*sigh*
But my perinatal doctor is dandy with my alternative therapy. We went over the "homework" I did for an hour one day and I think I convinced him I'm pretty good with being in charge of my blood health. He didn't argue with me like my ob/gyn did. ha ha. But I understand the doctors worry, and why they worry
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Old 01-29-2010, 12:02 PM   #24
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

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They have the same length of training in different fields. Pharmacists go to school every bit as long as doctors, but I would never trust a doctor to sign off on my prescriptions. I would believe a L&D floor nurse over an office nurse based on experience if nothing else.
I'm with you on trusting the opinion of a L&D floor nurse. They usually have seen it all. And no Pharms do not go to school as long as doc's yeah as long as a A nurse but not a doc.
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Old 01-29-2010, 12:16 PM   #25
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

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I'm 17.5 weeks As for people, tell them to shut up! This makes 7 + 8 for me! But honestly, I have people tell me I CAN do it, more than I can't. I'm the one that needs convincing I'm so tired all the time, I wonder if I can do it with two more! But God is my strength, and He knows!

My Dr. just said that once the cervix opens for baby 1, its easier to deliver a breach baby then...the only thing I'm worried about is laboring for one, then having to have a CS for # 2 if he's in distress, I'd rather have one or the other, NOT both! So I'm still deciding, and will probably wait till the end to finalize it. But with identicals, they tend to take you early because they are sharing the same placenta, and it can demise quicker because of the demand of two babies on it, so I heard that 34-36 weeks is the longest they'll let me go.

Are yours in the same sac? Mine were in the same sac, sharing a yolk sack early on, so they told me they were 95% mono-mono. Talk about a scary month till I had my next US at my Perinatotologist. He was able to find a thin (VERY thin) membrane separating them so I have no worries of cord entaglement. I prayed so hard that month that a membrane would grow! The Dr.s still say they don't know how the "Missed" it, but I say they didn't it wasn't there, but God grew it! All the research says that twins who share a yolk sack will be mono-mono...so I have the ultrasound to prove there was one yolk sack, and NO membrane. I still believe in a miracle working God!

Anyways, you are blessed with an easy twin pregnancy then! I almost had to be hospitilized with IV fluids, I was that sick...thank God that part is over, now I'm just tired, and have horrible heartburn and headaches. But they will be worth it all!

when's your next appointment?
OHHH I see, now it makes complete sense why they are okay with the first baby being heads down and the second being breech, if it opens the cervix up for the second baby to come out. Well that's cool, and good luck! Lots of prayers that the second baby will be fine (not distressed!) and you'll have an easy delivery
7 and 8, you lucky lady! I told my family I think I am done after these twins, and will probably get a tubal. I love kids, but I think I'm done having kids of my own. I'm a preschool teacher, so I get to be around kids all the time and they are enough for me

I'm not sure if the twins are sharing a yolksac or not - during my first ultrasound, the doctor said each twin had its own yolksac. But then I went to the perinatal doctor for the "big" ultrasound, and the perinatal doc didn't say anything about the yolksacs either way. I'm assuming there are two, but I'm still confused as to how that all works with twins.... maybe I need to read something that explains how many yolksacs, placentas, and membranes there are (or lack of). I'm still a newbie when it comes to all this!

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Originally Posted by rachaeljohnson View Post
i hear you on not wanting a cesarean but, i think it is the safest if they are sharing a placenta, bc as the first is being delivered he can pull it loose and you could lose the other one. They can see the placenta and the umb. cords both going to it, even this early. My advice is get a 2nd and 3rd opinion and if you have to have a csection, to have an empowered one with immediate nursing/skin to skin. Just focus on what is honestly best for your 2 sweet boys!
aww, you think I'm having boys too?! weird, cuz I just have this feeling they are boys! and my DD will be a proud big sister!
thanks for the comment, I didn't think of it like that... the first babe could pull the placenta loose. scary, I'll definitely talk to the doc about all this.

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Some obgyns are less likely to do a natural birth b/c they know all the things that can go wrong, add in the identical twins and blood clotting issue and at this point they are probably considering you high risk.
All that being said that's not to say that you couldn't deliver naturally. I am sure that you doc will be open to that option and see how things progress.
Congrats to all of you on the babes, twins are special.
yeah, I'm definitely "high risk" according to all the docs. I was high risk when I was pg with my DD, just for having the clotting factor. the midwifery wouldn't allow me to give birth at their birth center for that reason. it's so early on, I guess I shouldn't get my undies in a bunch about anything just yet. I worry a lot!
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Old 01-29-2010, 12:28 PM   #26
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

Talk to midwifes!! find some online or somewhere close to you if you dont like the one's around you.
Get some reading material Find support make a decision tell you doctor "the way it is going to be" and stick to it!
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Old 01-29-2010, 12:30 PM   #27
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

Congratulations on your twins! I am 26wks pregnant with my second set.

First off, just FYI - I'm not sure why some peri's don't seem to tell patients this, but...just because they share "one" placenta does not guarentee they are ID's. It's is highly probably, but not definite. Here is why: frats placentas can fuse to look like one. It's not super common, but it happens. In fact, at my last u/s, the tech tried to tell me I only had one. I told her "then they fused." She got a second tech. I do have 2 placentas but they are so close they are practically touching and might fuse. It also happened to my SIL. She had triplets. She was told the 2 girls were definitely ID's. Her peri told her they only had one placenta and were sharing a sac (only ID's can do that). Well, they were born and behold, 2 sacs, 2 placentas fused and they are definitely, no question, not ID's. (one is blond with very fair skin and the other is dark brown with olive skin.) However, that said, it doesn't really matter if it's 2 fused or one placenta. My understanding is it poses the same risks. So, for the purposes of TTTS and such, it doesn't make a difference. So, it's highly likely they are ID, but not 100% until they are born. That's all.

Okay, as for the C-sec. I had a vag with my first set. Some drs don't want to do vag deliveries for twins. Most will not do it if both babies are not head down. However, some will do it as long as baby A is head down, such as a few others have said. One of the reason I ended up switching this pregnancy was that. I want a vag just as much as healthy babies. It's VERY important to me. So, last time, I was mislead a little until it was too late to change. This time, I made sure he was on board with a vag delivery even if B was breech. I only had a vag delivery at the last minute last time because my Baby B was awesome enough to turn in early labor before I let them prep me for my c-sec!!! If he hadn't turned, I would have had a c-sec and I would have been devastated knowing other OB's would have delivered me vaginally. So, my suggestion is talk to you OB, not a nurse. Ask very direct questions about it. Make sure he says "yes, I will do that," or "no, I won't," not "we'll see how things go." Everyone knows that with twins, in the end, we do have to just see how things go. But, you need to know if he is willing to deliver you vag and under what conditions. If my babies NEED a c-sec, I will get one, but I want to make sure my OB isn't going to give me one just because they are twins. If you find in talking to him, some hesitation or the answers that are not what you want, look around, go elsewhere. (I would go with an OB though since you have one placenta.) If he says you definitely will need a c-sec, do listen to why he thinks that. I don't know anything about your blood disorder, so it very well could be the best option. I don't *think* you need a c-sec just because you only have one placenta though. I've never only had one though, so research that a ton and be informed. Knowledge is power.

BTW - My OB (this time and last time) was a male. My current one does have a MW partner who I see sometimes too. I'm totally excited because she said she will definitely be with me through my whole labor, epi or not and vag or c-sec. She may deliver the first baby, but he will definitely be there to deliver baby B. It's like I have a built in doula and I really like her.

What I have found to be profoundly important when having multiples is knowledge. Read, read, read. A great book to start with is When You Are Expecting Twins, Triplets or Quads by Dr. Barbara Luke (and another lady). It gives you great info and practical advise. (It talks about the ID v. Frat thing too.) Go from there and learn as much as you can. I have been amazed at the misinformation out there, even coming from Drs. and u/s techs and nurses. The more you know, the better off you will be.

Keep up the great work and baby cooking!!!
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Old 01-29-2010, 12:34 PM   #28
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

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DON'T listen to what a NURSE says about your delivery regardless of your situation. I was going in for a regular weight check/ baby check and saw a nurse practitioner. She reviewed my chart (for the first time, I had never seen her before!) and asked if we had scheduled my c-section. Um, I'm not having a c-section, I'm having a VBAC. This "woman" TOLD ME I was having a c-section because I had one OVER SIX YEARS AGO even though I have already had 3 VBACs since then!!!! I don't flipping think so lady! My hoohaa, my say-so! Urgh that still ticks me off...

So yeah, don't listen to office nurses about delivery.
that would rub me the wrong way too! it's funny how some of the medical professionals think they know everything about you based on a few words scribbled down on a chart. that's like the doctors see my charts and how I have a blood clotting factor and assume it is my death sentence, especially considering i'm pregnant and on alternative therapy. they think I will die if I do not take the injection thinners. after my DD was born, the on-call ob/gyn at the hospital I gave birth at (with my midwife), she made the comment, "if you do not take [the blood thinner injections], you WILL die and your baby will become an orphan." that was just 2 hours after my DD was born!!
it's like the doctors automatically do not trust that I have done my homework on my clotting disorder, assume I am stupid and crazy, and try to scare me into blood thinners. I'm more scared of the thinners because I could bump into a table and have internal bleeding that can kill me! it's kind of like I can't win, given the circumstances. I either get a clot and die, or I bleed to death on thinners.
but yeah, just saying I feel you on the chart stuff and what medical staff can assume... this is why I'm glad I have several months to get informed about c-sections, twins, and everything in-between!

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Originally Posted by sallyjean View Post
Hello! I'm pg with identicals too, girls. I'll be delivering sometime in the next 10 days because they want to induce at 37 weeks if I don't go on my own. I'm going for a vaginal delivery because they're both head down so hopefully that works out.

Nurses are great, but they aren't docs and she really should have kept her mouth shut about your delivery. My friend had clotting problems and was on heparin for her pregnancy, her doc didn't say she needed a section but he did schedule an induction at 38 weeks because he didn't want her to go into labour on her own out of the hospital. Apparently, there's a risk of bleeding out when you're on blood thinners so they want to make sure you're already admitted before you go into labour.

I hate to say it but this is probably just the first of many stupid things you'll have to deal with just because you're having identicals. Even if your entire pregnancy is flawless you'll probably still be treated like a ticking time bomb. Try to relax and enjoy the ride, it's truly and amazing thing to nuture two little beans at once!

Best of luck to you!
oh for sure, I've kind of expected to be treated like my clotting disorder is my death sentence by most of my doctors. just with my previous pregnancy and all the experiences I had then. LOL... I think for now I'll just sit and sponge as much information up on c-sections and twins, and options I might have. I've got about 5 or 6 months to get as much info as I can

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Originally Posted by tygr2410 View Post
random thought, if you are only scared about the spinal, demand a general..it might be slightly more risky, but if you are THAT scared about something in your spine, i'm sure they'd opt for a "safe" c-section then a potentially complicated natural delivery without an epi in place to start with.
oh, they have an option that doesn't involve a needle going into my spine?! I always thought that was only for emergency c-sections. it really does terrify me about having a needle in my spine, it's hard to explain the fear of something like that, especially when epidurals are so common... people look at me funny. I should just get used to that though, lol

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Originally Posted by Mrs.Rusty View Post
Until your OB says you need a c/s I wouldn't stress it at all. The nurse probably said it because someone with your clotting disorder and a shared placenta it is HIGHLY reccomended. Take a few deep breaths and write out ALL of your questions and concerns and bring them to you next appt and ask the OB himself.
I think the idea of a midwife is great but with the kind of complex case you have I think you should stick with an MD.

Just an FYI on the whole nurses know nothing vibe I got from some of the other posters an NP,Physician Assistant and a Midwife are ALL advanced practice nurses, they have the same amount of education and training.
thanks, i'm making that list as we type! this is going to be a lonnnng appointment....

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Originally Posted by ErinMartin View Post
I'd ask the opinions of a few people are aren't directly involved in your care - like local homebirth midwives (even though you don't plan on going with them, obviously). I think they'll give you an honest array of what your options are, what the risks are, and good resources to check on for your situation. I'd have all this info handy BEFORE talking to your OB so that you can have an actual conversation with him/her and have a better idea of what he/she is talking about, what it relates to, etc...
good ideas. i'm still working on the basics of all this information gathering, so I guess it will be a while before my doc and I have the big "c-section" discussion. Its probably better for me to wait until the pregnancy progresses anyway, things can change in an instant.
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Old 01-29-2010, 12:39 PM   #29
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

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i'm almost 12 wks preg with twins. apparently the doctors already know they are identical twins, after my ultrasound 3 weeks ago. they said the babies have a shared placenta, and that's how they can tell identical twins from fraternal twins this early on (???)... this was at my perinatal doctor, btw.
i have this blood clotting factor in my blood, so the doctors see me more often to check my health (since pregnancy increases my chances of getting clots).

but here's the weird thing. surgery increases my risks of getting clots too. one of the nurses a couple weeks ago mentioned i'd "need a c-section" since i am having twins and have this clotting factor in my blood.
so, i understand by having twins, my chances of having a c-section go up (as opposed to a singular birth)... but why on earth would they be telling me this early that i should have a c-section, considering i am more prone to clotting after a surgery?? i would think they would steer more toward no unnecessary surgery if it's possible (and it is possible!).

i'm just... confused, and kind of upset about it. is this going to be one of those things i'll need to argue with doctors over?
oh, and i have an ob/gyn this time around. when i was preg with my DD, i had a midwife but every appointment with the midwife i left in tears because of her comments on my weight gain. i gained 60 lbs, was really active, and was eating healthy. i did everything she told me to when it came to my diet, and still gained 60 lbs. she just was not a good match for me, and there are no other midwiferies in the area. my ob/gyn now is nice and gentle for the most part, and so far we are getting along great. if i were going to sit down and have a talk with him about no c-section, what are some good things to discuss? anyone have any resources they can share with me??

thanks!!!
Haven't read any of the other responses yet. My ID twin girls are going to 9 next month. I had a pg clotting disorder as well. I delivered my twins unmedicated Vbac. A was vertex, and B was transverse. They wanted to do an epi just in Case we had problems. Unfortunately, or fortunately how ever you want to look at it. My blood was too thin for the epi dispite stopping my heparin pump more than 24 hours prior to induction. It can be done. Maybe interview a couple docs and see what they say.
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Old 01-29-2010, 12:41 PM   #30
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Re: this is crazy... i'm preg with twins and don't want to have a c-section

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Congratulations on your twins! I am 26wks pregnant with my second set.

First off, just FYI - I'm not sure why some peri's don't seem to tell patients this, but...just because they share "one" placenta does not guarentee they are ID's. It's is highly probably, but not definite. Here is why: frats placentas can fuse to look like one. It's not super common, but it happens. In fact, at my last u/s, the tech tried to tell me I only had one. I told her "then they fused." She got a second tech. I do have 2 placentas but they are so close they are practically touching and might fuse. It also happened to my SIL. She had triplets. She was told the 2 girls were definitely ID's. Her peri told her they only had one placenta and were sharing a sac (only ID's can do that). Well, they were born and behold, 2 sacs, 2 placentas fused and they are definitely, no question, not ID's. (one is blond with very fair skin and the other is dark brown with olive skin.) However, that said, it doesn't really matter if it's 2 fused or one placenta. My understanding is it poses the same risks. So, for the purposes of TTTS and such, it doesn't make a difference. So, it's highly likely they are ID, but not 100% until they are born. That's all.

Okay, as for the C-sec. I had a vag with my first set. Some drs don't want to do vag deliveries for twins. Most will not do it if both babies are not head down. However, some will do it as long as baby A is head down, such as a few others have said. One of the reason I ended up switching this pregnancy was that. I want a vag just as much as healthy babies. It's VERY important to me. So, last time, I was mislead a little until it was too late to change. This time, I made sure he was on board with a vag delivery even if B was breech. I only had a vag delivery at the last minute last time because my Baby B was awesome enough to turn in early labor before I let them prep me for my c-sec!!! If he hadn't turned, I would have had a c-sec and I would have been devastated knowing other OB's would have delivered me vaginally. So, my suggestion is talk to you OB, not a nurse. Ask very direct questions about it. Make sure he says "yes, I will do that," or "no, I won't," not "we'll see how things go." Everyone knows that with twins, in the end, we do have to just see how things go. But, you need to know if he is willing to deliver you vag and under what conditions. If my babies NEED a c-sec, I will get one, but I want to make sure my OB isn't going to give me one just because they are twins. If you find in talking to him, some hesitation or the answers that are not what you want, look around, go elsewhere. (I would go with an OB though since you have one placenta.) If he says you definitely will need a c-sec, do listen to why he thinks that. I don't know anything about your blood disorder, so it very well could be the best option. I don't *think* you need a c-sec just because you only have one placenta though. I've never only had one though, so research that a ton and be informed. Knowledge is power.

BTW - My OB (this time and last time) was a male. My current one does have a MW partner who I see sometimes too. I'm totally excited because she said she will definitely be with me through my whole labor, epi or not and vag or c-sec. She may deliver the first baby, but he will definitely be there to deliver baby B. It's like I have a built in doula and I really like her.

What I have found to be profoundly important when having multiples is knowledge. Read, read, read. A great book to start with is When You Are Expecting Twins, Triplets or Quads by Dr. Barbara Luke (and another lady). It gives you great info and practical advise. (It talks about the ID v. Frat thing too.) Go from there and learn as much as you can. I have been amazed at the misinformation out there, even coming from Drs. and u/s techs and nurses. The more you know, the better off you will be.

Keep up the great work and baby cooking!!!
aww, you're just a breath of fresh air!! thank you!!
you've given me a lot of new (new to me) information, especially with what the doctors and medical staff might know (or think they know). you're absolutely right about the more I know, the better prepared I will be. I'm going to look for the book you mentioned so I can get a better understanding of my situation (or what my situation could become, etc)...
I'm just glad there are more mommas on here than I thought, who are experiencing the same things I am. or have previous experience to share with me. I feel so blessed.

thanks everyone!!
off to hunt for books!
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Booty Cubes, Postpartum Mommy Cubes, Hand Sanitizers & MORE!
Mommy to Merinda and identical twin boys Adrian & Dorian
Big pouches of Booty Cubes for sale!
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