Mono-di pregnancy and birth advice and stories?

Hi, I am 15 weeks with mono-di girls, and other than this board, I am feeling a bit alone in the pregnancy world. Most women on other boards are having single babies. Even among twins, there are different issues depending on the type of twins you have. I have a hard time talking to friends about it. They try to understand but they've not been through this. One friend was listening to me voice some of the stresses or concerns about mono-di twins and I mentioned premature labor. She said, "Oh, I know what you mean -- my first son was soooo early!" Well...he was born at 39+1! My doctor won't even let me go past 37, and from what I've read, 35 is an average. It's just different.

Anyway I was hoping if anyone feels like sharing they might have some stories or advice on mono-di twins. Some of the things I'm contemplating right now are:

-Is it true that they need to be delivered by 36 to 37 weeks?
-Is a vaginal birth safe? Is c-section safer? I am so worried about the second one to come out and how the shared placenta will affect her.
-Would you aim to leave work by 30 weeks?

Thank you for any stories or advice you want to share!

 

I've seen conflicting reports about when they should be delivered, but I think I have seen recently that 37 weeks is the "accepted" gestation for mono-di twins. Hopefully Rachel will chime in with any info she has (she has a ton!).

The babies are just as safe via vaginal delivery as by section, but your healing is easier after a vaginal birth. If your doctor is comfortable going that route and it's something you want, go for it!

My plan was always to work as long as my body let me. I have an office job, so I propped my feet up and was perfectly comfortable. Depending on your maternity leave, you may want to do the same so you can save your time off for post-birth.

My girls were mono-di and they're now 3.5! You can do this. Please ask any questions you may have- we're all here for ya.

 

Hi,
Congratulations! We had mono-di twin girls 5 months ago. We were told 37 weeks was the latest they would let us go. I ended up delivering them at 35 weeks due to HELLP syndrome. My doctor told us the average with mono-di was 35 1/2 weeks. Our girls were born vaginally with baby B being born breech. She was head down during labor and turned after baby A was born. I worked as a nurse 12 hour shifts until 34 weeks when I was put in the hospital on bedrest for the HELLP syndrome. You can do it! We also have a 2 1/2 year old and 5 year old daughters.

 

I'm here!

Whether or not it's true that they "need" to be delivered by 36/37 weeks is kind of a hard question to answer - there are a lot of variables involved, including your health, the health of your babies, whether or not there have been any complications in the pregnancy, and the skills & comfort level of your primary care provider. It's definitely true that most care providers routinely recommend as their "standard of care" elective early delivery of MCDA twins. It's a valid option to consider but assuming there are no health complications with you or the babies it would not be considered medically indicated. Now, I'm going to throw a whole lot of information at you! These are studies that I've found that are there for you to look over the info yourself - I would also consider them a "jumping off point" for you to do further research on your own.

Delivery of monochorionic twins in the absence of complications: analysis of neonatal outcomes and costs.
Effectiveness of timing strategies for delivery of monochorionic diamniotic twins.
Optimum timing for planned delivery of uncomplicated monochorionic and dichorionic twin pregnancies.
What is the optimal gestational age for twin delivery (not MCDA specific)
Elective delivery of women with a twin pregnancy from 37 weeks' gestation (not MCDA specific)

As for how to birth them, assuming all things are equal and there are no complicating factors, vaginal birth is statistically safer for both mothers and babies. Here's some more for science for ya!

Effect of mode of delivery on neonatal outcome of monochorionic diamniotic twin pregnancies: a retrospective cohort study.
Planned C-Sections Provide No Advantage Over Planned Vaginal Birth of Twins, Study Suggests (not MCDA specific)

As for when to leave work, I think that depends on you, your babies and your care provider. If you are doing well and babies are doing well, then there is no reason not to continue working. In my case, I broke my foot at 24 weeks gestation so was off work at that point. Then at 27 weeks I was put on bedrest until I went into labor (more or less) spontaneously at 34 weeks gestation. I had an unmedicated, vaginal birth for both girls (MCDA). They spent 13 days in the NICU, mostly feeding and growing with a few minor health hiccups, and are now healthy, happy 5 year olds.

 

I'm expecting di-di twins but as far as work, I think you play it by ear. I went to work on a Sat and the next day had horrible ctx and the next day was admitted to the hospital and my NP said I could go off work (I wanted to any way and don't work many hrs) but that was just before 30 weeks. My doctor said from the first appt to not plan to work the last few weeks because I'd be too tired. I'm on bed rest now at 35 weeks and have been since 29-6 but I think he's right, I don't know how I'd have any extra energy to work now. But every one is different.

I researched and planned and wanted a vaginal birth but my OB won't deliver Baby A breech and he's been stubbornly breech for several months now so we are planning on a c-section. If they were vertex we'd be trying vaginal. I think it's worth researching anyway and asking around.

 

I had my mono/di boys at 38 weeks 3 days via scheduled c-section. My dr always told me 36 weeks was what we were aiming for, and we would see after that. I had a c-section due to Baby B being transverse. I could have delivered Baby A, who was head down and them hope Baby B came down correctly. I choose c-section - I didn't want to have one vaginally and one c-section.

I worked until almost 38 weeks. I, too, have a desk job. I missed my last scheduled day due to high BP.

Congrats on your twins! It's a wonderful adventure'n

 

Thank you so much, everyone! This was very reassuring. I'm sure I will post more as the pregnancy progresses. Thanks again!

 

Update -- just wanted to say thank you again. This gave me a lot to think about. Rachel, thanks for the great links!

I saw both my normal OB and my high-risk doctor this week. The babies are doing great. They are both the same size and have the same amount of fluid. I was a little overwhelmed when they filled me in on all the follow-up appointments (I'm seeing my OB every 4 weeks, the high-risk clinic every 2 weeks, and on top of that I'm seeing a pre-natal cardiologist in a few weeks.) But I am grateful that they are being so thorough. I'm starting to read about vaginal delivery of twins and thinking a lot about that. Of course part of that will be out of our control. My high-risk doctor said she would only do a vaginal delivery with a provider who had done a lot (at least 20 to 25) vaginal twin deliveries. I guess it is something to research.

Anyway, just wanted to say thanks again for the support!!

 

I'm all late and probably wrong here :laughing: and I'm not sure my twins were specifically "mono/di," they are fraternal, were in separate sacs but their placentas did fuse together. My doctor never said anything to me about having to deliver them by 37 weeks. She was willing to let me go until they were born or it just wasn't safe anymore. I worked (I had a sit down, desk job) until I was 39 weeks and they were born vaginally after being induced at 40 weeks. No complications, no NICU. Every pregnancy is different though!

Over the years, I have noticed a lot of OB's will just automatically do c-sections for twins, no matter their position, etc. so a vaginal delivery is something I would educate myself on if I were in your shoes. When I was pregnant with my 3rd son and went to the OB with him, I was told they wouldn't let me do a VBAC, I said I didn't have a c-section with my twins and the OB said "WHY would they put you through that?" with this horrified look on her face. I never went back to that office! Every doctor is different though.