Just a question I had

I have a question about wether it is expected that mothers have c/s when gving birth to twins. This is a genuine question that I have been wondering about for a while.

On huggies I have read a few times about how you can't have a normal vaginal birth when expecting identical twins. I was wanting to know if anyone had had experience with having a vaginal birth with identical twins or knows of someone who has.

The reason why I ask this is because I know two ladies who have done this and know of one other who has as well. Im just wondering wether it is a new recomendation and why it is that this reccomendation has been made.

This question is not ment to in anyway undermine anyones experiences at all or be anti-c/s, its just my curiousity and this is a great place to get feedback about these type of things smile

I dint have twins but i had a breech baby and they told me that woman with twins normally have c-secton because one baby normally always breech.
Obstricians dont like having breech babies born naturally so they give you a c-section. ( i dont know why because I was lucky enough to have my DS naturally and we had no problems)
Although in saying this it does depend on who your obstician and midwife is. Some obstricians wont give you a choice at all while others will let you have a choicE and support you.

I had thought that most twins were CS too, until a friend of mine had her twins. There was no question the whole pregnancy, it was just assumed that she would have a vaginal birth. And she did. Her problem ended up that it was such a quick birth that her body went into shock!

I believe it is all to do with the care providers perception of risk, their skill level and experience. I believe it has nothing to do with how safe twin vaginal birth is in reality. Many women are not offered the option of a vaginal birth - this in itself is the core of the problem!

I had a vaginal birth with twins...I had been labouring for 2 and a half days and the docs pushed for a C section.... On the advice of my midwife and student midwife I went the natural option and to this day Im very happy that I did. I had fraternal boy girl twins.

There is a difference with bith options for fraternal and ID twins.

Fraternal twins are considered "safter" to deliver vaginally because there are 2 palcentas (althought they can merge, no BLOOD vessels can merge), so it is really like 2 separate singelton births, one after the other.

The risk in ID births is do to with the SHARED placenta, thus the sharing of blood vessels and blood supply. Twin To Twin Transfusion Syndrome (TTTS) is a rare, but extemely dangerous disorder of the placenta in identical multiples. It happens when there is uneven blood distribution between the twins. One twin becomes a donor and the other a recipient. 10-15 years ago, this diease was not detectable let alone treatable and many twins died inutero or during vaginal births. Detection is via ultrasound of linked blood supplies. If detected before 16 weeks, nothing can be done and most twins die. Between 16-25 weeks, laser surgery can be performed, but this is dangerous and only some pregnancies survive. The uneven blood vessels are lased away to make the flow even. If TTTS is detected after 25 weeks, delivery is the only way for the twins to survive.

Then there is the Acute form of TTTS. This form can happen literally within hours. The blood flow reverses rapidly and both twins can die within hours. One day you may have a routine scan with no detection and 24 hours later the babies can be dead. Luckily I had a scan at the right time when acute TTTS was detected and I had my girls 20 minutes later. My recipent twin had a liver 3 times normal size and had begun organ failure. I am blessed both girls survived.

The danger of vaginal births with ID twins is that the acute TTTS can actually happen during the delivery. The babies are not safe until the second twin is clamped. Because they share the same blood supply, twin one may be being born and the blood supply suddenly reverses and twin two will pass away before being born. It can happen and does happen that quickly. There is a TTTS support group with many very sad stories like this. TTTS is not given the coverage it should, many GPs are unaware if it and every pregant woman should try to have a scan at around 11 weeks to measure the membrane to see if they are ID twins. If they have, they should be monitored by a TTTS specialist and have weekly scans.

I hope that explains why doctors are cautious about vaginal births with ID twins...TTTS doesn't happen with every ID birth, but if you are unlucky enough to have experienced it, you go the safest option.

There is a difference with bith options for fraternal and ID twins.

Fraternal twins are considered "safter" to deliver vaginally because there are 2 palcentas (althought they can merge, no BLOOD vessels can merge), so it is really like 2 separate singelton births, one after the other.

The risk in ID births is do to with the SHARED placenta, thus the sharing of blood vessels and blood supply. Twin To Twin Transfusion Syndrome (TTTS) is a rare, but extemely dangerous disorder of the placenta in identical multiples. It happens when there is uneven blood distribution between the twins. One twin becomes a donor and the other a recipient. 10-15 years ago, this diease was not detectable let alone treatable and many twins died inutero or during vaginal births. Detection is via ultrasound of linked blood supplies. If detected before 16 weeks, nothing can be done and most twins die. Between 16-25 weeks, laser surgery can be performed, but this is dangerous and only some pregnancies survive. The uneven blood vessels are lased away to make the flow even. If TTTS is detected after 25 weeks, delivery is the only way for the twins to survive.

Then there is the Acute form of TTTS. This form can happen literally within hours. The blood flow reverses rapidly and both twins can die within hours. One day you may have a routine scan with no detection and 24 hours later the babies can be dead. Luckily I had a scan at the right time when acute TTTS was detected and I had my girls 20 minutes later. My recipent twin had a liver 3 times normal size and had begun organ failure. I am blessed both girls survived.

The danger of vaginal births with ID twins is that the acute TTTS can actually happen during the delivery. The babies are not safe until the second twin is clamped. Because they share the same blood supply, twin one may be being born and the blood supply suddenly reverses and twin two will pass away before being born. It can happen and does happen that quickly. There is a TTTS support group with many very sad stories like this. TTTS is not given the coverage it should, many GPs are unaware if it and every pregant woman should try to have a scan at around 11 weeks to measure the membrane to see if they are ID twins. If they have, they should be monitored by a TTTS specialist and have weekly scans.

I hope that explains why doctors are cautious about vaginal births with ID twins...TTTS doesn't happen with every ID birth, but if you are unlucky enough to have experienced it, you go the safest option.

That is very interesting, thankyou for taking the time to answer the question so well.

I am glad that the experience ended so well for you.

I really enjoy learning new things smile

That is very interesting, thankyou for taking the time to answer the question so well.

I am glad that the experience ended so well for you.

I really enjoy learning new things <span class="emoticon smile">smile</span>

No problem! I had to find out a lot about identical twins when I found out I was pregnant...and I knew nothing of twins before that lol! I was really glad I understood the need for a c/section and although drs are hesitant to tell you about the acute form (because you would just freak out the whole pregnancy), it helped me understand what MIGHT happen.
Here is a link to the TTTS foundation...it has a forum section divided into different stages...during pregnancy, after, loss of one, loss of all, etc...TTTS Foundation

No problem! I had to find out a lot about identical twins when I found out I was pregnant...and I knew nothing of twins before that lol! I was really glad I understood the need for a c/section and although drs are hesitant to tell you about the acute form (because you would just freak out the whole pregnancy), it helped me understand what MIGHT happen.
Here is a link to the TTTS foundation...it has a forum section divided into different stages...during pregnancy, after, loss of one, loss of all, etc...TTTS Foundation

Wow you really did do a great job in answering that! A year ago I had my baby ID twin girls! ALL the odds were against us coz they were MCDA twins, suffered with growth restriction and growth discordance and worst of all Acute TTTS + many other things... Thankfully after being told for 30wks neither would survive...we got both girls here alive via C/section. So nice to here of another MIRICLE happening xx

My sister had her fraternal twins naturally, and I do knw of a huggs mum that had her identical twins naturally

No problem! I had to find out a lot about identical twins when I found out I was pregnant...and I knew nothing of twins before that lol! I was really glad I understood the need for a c/section and although drs are hesitant to tell you about the acute form (because you would just freak out the whole pregnancy), it helped me understand what MIGHT happen.
Here is a link to the TTTS foundation...it has a forum section divided into different stages...during pregnancy, after, loss of one, loss of all, etc...TTTS Foundation

My friend had her identical twin boys naturally at32 weeks. Maybe it depends on the hospital???