Please Help, I am totally torn!

I was at my ob today (34 weeks). My BP has been an issue throughout my pregnancy, nothing major but they have been watching it. I am on 100 mg of Procardia and my bp was 170/80 today (bottom # not bad). I have an appt with the peri next Wed. and my ob wants him to check my bp there. If it is elevated they want to schedule a date which would put me at about 35 and a half weeks by the time I actually have them. My ob is willing to do a c/s or vaginal delivery he said it is totally up to me. Both babies are head down but my cervix is still very thick, long (4cm) and closed and both boys are relatively high still. My twins are sharing a placenta and I am worried about how easy inducing me will be and what kind of stress it will put on them, I don't forsee my cervix opening right up without some work. Will a hard labor also make my bp rise? I don't want to go through a bunch of labor just to have a c/s anyway. Plus obviously there are always the risks of what can happen after the first one comes out. I really want to do what is best for the babies. The doctor's agree that taking them a little early is less risky than dealing w/BP issues. I wanted to ask you ladies because I'm sure your deliveries are pretty fresh in your memory. I appreciate any input. I am young and healthy and feel that I will recover well whichever way I deliver I just can't seem to figure out what to do :umm:

~Ericka~

 

Just from my birth experience.....I was induced and they broke my water at 38 weeks and 1 day. Within a few hours I was still dialated at 4 cm (which I had been for a month), my blood pressure skyrocketed to 180/230, my platlettes were dropping into the 800 level (they should be in the thousands)....next thing I know I am rushed in for an emergency c section and was in the hospital for a week on mag sulfate to prevent seizures as my blood levels balanced out again. I was not able to really do anything with the babies for the first week in the hospital because I was SO out of it with low blood levels and the meds I was on. My mom and DH with the nurses took care of the boys. I do not know if this will help you but, it was the experience I went through. Good Luck!

 

Since you are already having a BP issue, I think a c-section would be better. Given the circumstances.

 

I am not sure what I would do in that situation. In my experience, a vaginal delivery is definately easier to recover from. But with a twin birth, hbp, and the fact that you are having them early, I would almost lean toward a c-section. :hug99:

 

I ended up with a c-section, and looking back I don't think i would of changed it. Like you my girls shared a placenta and at the end of my pregnancy my BP went sky high. The way I looked at it was, my girls are going to be better off (less stress) if they just took them. I was a little concerned with TTTS during delivery so that was a deciding factor also. Good luck, and go with what you feel is best for you and your twins.

I also want to say I had a very easy recovery. The day I left the hospital I went for a mile walk and took the girls shopping.

 

I had my choice as well. I didn't have any of the BP issues that you are having but I decided on the C/S. The recovery for me was not bad AT ALL and I was very worried about having to give birth both ways. I am glad I had the C/S because baby B was WAY up there and since it was baby A's water that broke I don't think that B would have come very easily.

Good luck with whatever you decide.

 

I just wanted to say that you might not need to worry about the cervix issues. My cervix was long and closed throughout my pregnancy up to where you are, and then very rapidly it thinned and opened up. By 36 weeks I was 1 cm dilated, by 37 3 cm. So, yours just might open right up without issues.

 

The sharing a placenta would concern me for a vag delivery. With all your issues, i would personally opt for a section. I had twin a head down and twin b transverse up high. They gave me 50/50 that I would end up with a section. But they were very willing to try a vag delivery and to manipulate twin b in to position after I pushed out twin a. Well twin a Zach came out relatively easily with just a little pushing. But when I tried to push twin b Josh but he went in to distress and I ended up with an emerg vertical section put totally under anesthesia. Not what I would recommend. But they got Josh out in time and I healed up pretty quicklly. I was up and around feeling ok by 10 days old.

HTH B)

 

I was in a very similar situation at the end of my pregnancy. My doc originally wanted to just go the c-section route but when we learned that both babes were head down I asked her if she'd be opposed to trying a vaginal birth and she said we could try it but if any obstacle got in our way, we'd go straight to c-section, placenta was fused btw. When I developed preeclamspia, I was admitted to the hospital and the doc decided to induce right away. My peri had delivered my older daughter so we knew what my body did and didn't like, that was a big help. The induction went great and fast, we did the epidural and water breakage right away and it went quickly. The delivery went really well. After Baby A was out, B's cord came down but I guess it was fine because I only heard, "we have cord" and then nothing after that. We had two docs making sure Baby B wouldn't turn, then we broke B's water and out she came.

So the actual delivery went well but I ended up being knocked out afterward because of severe pain, ended up hemorrhaging and no one knew until I had been up in my room for a while because I had been lying down and the blood had been pooling inside of my uterus. Apparently that's a huge thing to watch for with twin pregnancies, that would be the one thing I'd advise to be aware fully aware of.

 

I had a scheduled c-section - in my opinion it is much better to do it that way than to risk having to have an emergency c-section. I have delivered both ways (I have 3 older boys) and my 1st vaginal experience was just as bad of a recovery as my c-section. my next 2 were great - no pain like 2 days later. my c-section with the twins(3 months ago) was my 1st major surgery - and it was (I won't lie) a painful recovery - but once I realized that if I took my pain med every 4-6 hours faithfully I did fine - as a matter of a fact my dh went back to work when the girls were 5 days old (because he is very insensitive ) and I had to drive myself to the doctor because a few staples had come undone!! WITH BOTH BABIES and I was fine ( I did not take pain med that morning!)- once they take the staples things are much better!!

 

I went into my pregnancy thinking whatever needs to happen in delivery to get them here safely was fine with me and I told my doctor so. I knew a vaginal birth would be a quicker recovery, but I also knew that it doesn't always work. In my case it didn't. I was induced, labored for 14 hours, pushed for 1 1/2 hours and then had a c-section. Looking back I almost wish I had a scheduled c-sec but there is just no way to predict sometimes what's going to happen. Good luck with your decision and with the rest of your pregnancy!

ETA: By the way, I ended up with high bp at about week 32, on bedrest with preeclampsia at 34 and delivered at 37.2. I do have to say that I was told my bp was very high in the delivery room and as a result was medicated and remember hardly anything of the birth. That is one thing that deeply disturbes me I didn't have that "Oh! Look at her!" moment because I was so drugged up. After the delivery, I was kept in L&D on mag sulfate because of the high bp during delivery. So, just another thing to think about. I thought my case was extreme, but I have heard of a few others suffering the same.

 

I had three c-sections. I recovered fairly easily. I was up right away with all of them. With the twins, the day after I left the hospital I drove in to see the one we had to leave in NICU, carried baby A in her car seat - did everything anyone who had a vaginal delivery would do. You want healthy babies and as stress free and happy a delivery as possible. For your situation I would opt for a c-section.

 

I had a very easy full term vaginal delivery with my older DD and was determined to try with the twins. My OB's said if Baby A is vertex, you can try vaginal.

I ended up with pre-e and HELLP Syndrome diagnosed at 34w3d. By 34w6d, they wanted the babies delivered. I was maybe 1 cm dialated and 20% effaced - so not very far. They started with cervidil and Mag Sulfate at 7pm, started pit at 11pm broke baby A's water at 1am and I was fully dialated by 9am. I got the epidural around the time the water was broken so I didn't feel any of the very strong contrax.

The Mag is nasty - I would have had that with a vag or C delivery.

Annalise arrived at 9:06am after a few good pushes. Jillian decided to hang out for another 1.5 hours. She arrived butt first kicking and screaming. At just over 4 pounds - neither was difficult to deliver.

I did have bleeding complications after delivery. Between extrnal pressure, a D&C and a bunch of drugs, they were able to slow it way up after 20 minutes. I lost a ton of blood. I could tell the Drs were scared. Apparently 2 placentas and Mag Sulfate along with HELLP are not a good combo. This would have been a complication with the C as well.

If you get the epidural early, you won't feel most of the labor - if you do go on to have a C, you'll need the epi anyway.

I didn't have a stitch so within 24 hours, I felt wonderful. As long as you are monitored closely, you can try for a vag birth, even with twins and complications.

Best of luck with your decision and delivery.

 

I had a vaginal delivery with no complications in the exact same situation you are in now. I had pre-e (fairly severe), my twins shared a placenta, both were head down, etc. I just want you to know it is possible to have a great vaginal delivery with twins, however it is more risky. You have heard from PP's about some of the complications already. I would ask your Dr or Dr's what their success rate is for a twin vaginal delivery. How often do they find they need to move to c-section or how often have they had to do both. I made sure I knew all this about my Dr's before I made the decision to try vaginal induction. I was induced at 36 weeks with my first son for pre-e as well, so I knew it was possible and I was a little less worried about the induction part. With twins that share a placenta, it can be more risky to try and deliver vaginally. Baby B could have issues after baby A is delivered, do talk to your Dr about what he would do *exactly* if issues arise. My baby b's heart rate slowed a little after baby a was out but it only took one contraction to get him delivered so it did not become an issue. My Dr also had his hand on his head holding it in place after A was delivered. He did not want him to move and make things more complicated.
So, here's what happened with me- keep in mine, this was my second delivery which tends to be easier and faster than a first. I went to the Dr, BP was super high for like the 5th week in a row, I was 35.5 weeks so he sent me straight to the hospital to be induced. When I arrived, I was about 2cm dilated, they started the pitocin and labor began quickly. (With my first son, it took 22 hours to deliver him with an induction) About 3 hours into labor I was 5cm and asked for the epidural. The darn thing never worked even after they re-placed it twice. That worried me a little because I knew if I couldn't go vaginal I'd have to be put under for the c-section. Less than 5 hours into labor I was complete and wheeled down to the O.R. to deliver. It took like 3 contractions to get Jacob out and only one to get Nathan out. There was a tiny delay in my contractions restarting after Jake was born, but it was less than 5 minutes. My BP remained high for about a week after delivery and my platelets were really low for a day or 2 after delivery. This is a complication of pre-e, not of delivery. I had no serious bleeding after birth either.

Talk at length with your dr's and find out exactly what they think. They will not make the decision for you but they can help you understand the risks involved. As for your BP getting really high during labor, if you have the epi and it works, it does help to lower BP. Some women have really low BP after the epi. If your bp gets too high, they will put you on meds or it will be decided to go to c section. Every delivery is different, just as every person is different. I hope I have helped some. I did want you to know it is possible to try and vaginal delivery and be successful without complications. But honestly, I'm not sure I'd want to take the risks if my dr's weren't very experienced with twin deliveries with a very high successful vaginal rate. Good luck with your babies. I hope everything goes well and the babies are very healthy!! I hope I didn't bore you with my long story!

Kelly

 

Okay. I had one head down and one head up. At 38 weeks 3 days, they broke my water and I walked to bring on labour. That's all they had to do. After 7 hours it was time to push. Three pushes and Bree was out. I pushed twice more (one to dilate again and one to push Zack out. (He turned by himself). My twins were 12 mins apart.

As for recovery, with my singleton it was vaginal and I was walking 15 mins later and never took one pain med. With the twins I walked two hours later and took the pills twice and then stopped. The only the I found more intense was the lochia/bleeding after there was a lot and it lasted over two months.

I have to admit my greatest fear was to have pain both ways as in one vag and one C/S but I guess I was determined and lucky.

Good Luck on your choice.

 

With a long cervix and the babies still being high, the chances of a successful induction aren't good. In my opinion, it's still worth it though because your recover will be so much easier than with a c-section.

My first induction was unsuccessful and I ended up having a c-section. It was 2 days before I could eat, 5 days before I could stand up straight for a moment, and a couple of weeks before I was moving at a pace near that of pre-csection.

My second induction was successful but took a 2 days (a long time induction wise) and I felt great afterwards. The labor never had any effect on the baby's heartbeat (therefore he was never stressed) and he came out healthy as can be at a little over 9 1/2 lbs. I was eating and walking around within an hour and at nearly 100% recovered within 4 days.

In my experience, I would never have a c-section unless it was absolutely necessary but you need to do what is best for you and go with your gut. Good luck with your decision!