Very tough question re old fashioned full vertical c section

[fatmama]

We've got some bad news. It looks like we might have conjoined twins

We can't be sure yet and I am praying they aren't, and that t hey will find a membrane so they aren't in the same sac either, it is possible.

But if the 7 week ultrasound is right and they are conjoined - my OB is strongly going to urge a termination (he told us this, though he held some hope its too early to tell for sure).

His reasoning is that a) conjoined twins overwhelmingly have huge problems b) they you have to have a full old fashioned vertical c section to get them out c) that means huge peritonitis risk unlike the transverse caesar, and d) risk of too much damage to the uterine wall to ever carry to full term again (not talking VBAC here, just getting to term) and e) some real risk of death which usually in this day and age is so miniscule you don't need to give it a second thought.

I still pray we don't have this choice before us, but I can't help t hinking about it. I can't imagine aborting my babies. I've never been very pro-choice in the political sense (though I don't fit pro-life either). I don't think it is something that's right to choose if there's no medical reason. I never had a problem with having it done for a medical reason and yes this is a good medical reason but for me, I'm still not comfortable with it. If someone else was in my position I could totally support her decision to abort, but I don't think I can bring myself to do it. Does that make sense?

On the other hand i do not want to not be here for my DH and DS (and hell, none of us wants to die anyway do we?). I really want to have another chance at a pregnancy, and I'm also worried if I'm critically ill and take months and months to recover that it will be extremely difficult for DH to manage essentially on his own with FT work and DS (and me). Add to that we could have very very sick babies, or grief at their loss, in our lives.

I was a bit shocked, because I know we've all heard the wonder-stories about conjoined twins being separated skilfully and ending up relatively ok (I know there's more to it but you kwim). But he was completely adamant that he would not want to deliver them for their sake and mine if they were conjoined.

Can anyone else share thoughts on this so its not just me with them rattling around in my brain?

[The[cookie]Doctor]

You know what? I wonder if you can get some professional counselling about the issue before you make a decision. I can't 'truly' understand the position you are in, so rather than just have us rattle off at you, maybe talk to a professional about how you feel and they might be able' to help you work through it? Do you think it possible at all?

I think in this situation, the clincher for me, personally would be knowing that my babies quality of life would suffer... I know that also to me a termination would be unimaginable but I think it is also the choice I would prefer.

I am praying that you get good news, but in the meantime, you might like to cnsider joining the termination support group, more people might be comfortable disclosing personal info in there... All the best

[boobaloo]

oh sweetheart, what a terrible decision to have to make, it would break my heart. i suppose you have to look at what is best for you and your family, and if that means terminating the twins, then that may be the best option for all involved (which i know is a terrible thing to say). your partner and son don't want to lose thier mummy, and the twins, if they were born, may have illnesses that see them suffer.

hopefully the next scan will bring some better news, and i hope that you have a lot of love and support around you. obviously, i have no personal experience in this, and can't give you any educated advice, but i wish you well.

[~clover~]

If you like you can join the termination support group. It doesn't mean you have to do it, it's just that there may be some extremely understanding support from others that have been in similar situations.
I wish I had some wise words, but all I can do is pray that when you have your next u/s everything will be ok & your babies will be perfect & healthy.
I hope every thing works out ok.

[fatmama]

Thanks! The thing is to me, while obviously its a huge thing if the twins were to be permanently in an awful quality of life- I had a condition as a newborn that my Mum was literally told, and I quote "let her go and have another baby, she's just going to suffer" and I turned out great. Yes I have lifelong health issues but they didn't stop me living a full and happy life so far..and are not likely to stop me appearing pretty normal until I'm like 80 or something. She begged for the treatment knowing I could have been in pain and suffering and disabled. I was actually in very traumatic care for 2 years and hse must have wondered if she'd done the right thing, but now we know she did (at least I think so!).

So I'm loathe to say "their lives aren't worth living" even if we knew what problems they faced, and when we only know the possibilities its even harder.

I guess I feel I don't fit on the termination board just because I have such a limited view of when its even appropriate to talk about having one - I suspect a lot of women on there are very pro-choice and I just don't see choice as appropriate word for a medical procedure, let alone this one.

Has anyone had a full caesar? Would you share anything you were told about them? I know I have to factor in my med history as well but even knowing what you were told would be great.

[Mildez]

I am sorry to hear you are going through this.
I guess at this time its hard to tell exactly what is going on as its still a bit early to really tell what your dealing with. Once you know you will be able to better find out your options and make a decison about what to do.

I don't have alot of experience with classical c/s however the three I have seen have being fairly uneventful and recovery has being good. I think the risk to you would not be severe as in this day and age when they are prepared for things to go wrong they have everything ready to ensure things are treated as it happens. For example your more likely to haemorrage but they would have blood ready and drugs and devices to treat that as it happens. Also if your looking at delivery of conjoined twins you will be in the best hands possible to ensure the safest delivery possible.

As for the babies (if they are conjoined) I think a large part depends on where they are joined and if they share vital organs like the chest area (heart, lungs) or somewhere not as severe. Survival of conjoined twins and the health outcome really depends on this. So basically its too early to really know what is going on and what the best outcome could be. Fingers crossed they are wrong and they are not conjoined or else if they are it is an area that means they each have their own organs. I hate to tell you this but I think at the moment you are best to know what is possible and what is not. Obviously it is an area not many people have alot of knowledge about so when you know more I am sure you will be educated and given the best advise by people that know the most.

As for more pregnancies afterwards it would depend on how demanaged the uterus is from the c/s. If its fairly uneventful with time to heal then there would be no reason you could not have another child in the future. It would not be known though until after the birth of the likelyhood of another pregnancy or when it would be safe to ttc.

Thinking of you and hoping your babies are not joined. or if they are they are joined at the findertip or somewhere minor.

[fatmama]

Thanks Emmy, you're right its too early to decide, but I feel like it would be so hard to decide that I need to at least think, or get it out, so I know where I'im starting from if it is the choice we face. Having never thought about it before it was a big shock.

The scan was at 7 weeks and they didn't have limbs so we can see IF they're joined its on the trunk (heads are definitely separate thank God).

[Rach75]

oh I'm so sorry to hear this all is AOK at next scan

but just so you know my mum had 2 c-sect the old type vertical scars 21 mths apart 34 and 32 years ago sure she had some problems afterwards but that was just infection nothing to do with the actual op and the fact she had 2 21 mths apart tells me it couldn't have been to bad HTH!!!!

[AnyDream]

FM - sorry I don't have any knowledge about the classic-style CSs but I did want to pop in and just say a few words of support. You will find there are other women on BB who have needed to make really difficult decisions during their pregnancies, and I hope you find everyone a wonderful source of supportive and respective information no matter what happens, what decisions need to be made along the way. I wish you every blessing and strength as you face what is utterly unthinkable for most of us. All the best. xxx

[~clover~]

I guess I feel I don't fit on the termination board just because I have such a limited view of when its even appropriate to talk about having one - I suspect a lot of women on there are very pro-choice and I just don't see choice as appropriate word for a medical procedure, let alone this one.

Thats ok, I totally understand.
You will find alot of support here. The support groups are private if you change you mind.

[Rach75]

I meant to say I had to make a heartbreaking choice at 21 weeks with my daughter so I know how you are feeling about cutting you pg short ( i do know a greta website which is specifiaclly for people who have had to make the heartbreaking choice due to medical conditions)

[blessedatlast]

I am so so sorry fr the decision you may have to make.. No other words just lots of I have had a classical C section (vertical) to deliver my premmie twins though and I have been told definitely no VBAC but subsequent pregnancies are fine.. There is a higher risk of uterine rupture and I was advised to wait at least 6 months before TTC.. Preferably a year.. I hope that helps.. I hope you don't have to go through such a heartbreaking decision.. I know this is different, but my babies survived for 8 days before having massive brain bleeds that got worse over the next 4 days.. We agonised, spoke to doctors, social workers etc before making the decision to turn off their ventilation at 12 days old as we were advised they would not have any quality of life.. It was the hardest decision..