VBAC with twins

Hi, I'm 14.5 weeks pregnant with twins and am trying to find somewhere, someway to be supported to have a VBAC with twins.
I understand that no independant midwives do homebirths with twins and have been told by a couple of independant midwives that I'm going to have an uphill battle finding a public hospital (we don't have private insurance) that will support my desire for this VBAC. Even so far as being told that at best I would have to agree up front to an epidural, manual uterine manipulation for the second twin (ob reaching in to break waters and pulling baby out!), drip, electronic fetal monitoring and trying to birth on my back with legs in stirrups - all very daunting prospects and not the birth experience I'm looking for.
So, would anyone know of anyone anywhere in the public health system that might support my journey or point me in the right direction?
In appreciation, Kate.

Hi Katie welcome to BB & congratulations on your pregnancy! Double the love, lucky you!!! :)

I can't offer much sound advice, but i will tell you what i do know...

Well, firstly, where are you situated? My mum recently (december) had a positive experience at the RWH Melbourne, but it was only twin birth - no VBAC, and she did still have to have the epi.

There are a lot of successful VBAC'ers on here that can probably point you in the right direction - hopefully they can help you out, but i'm not sure if we have had any with twins.

Are you identical or fraternal twins? Any problems so far? The hossy mum was at originally refused to let her have anything but a C/S because her identical twins developed the beginnings of twin2twinTS, but thats only for identical.

With a lot of twin births, i think you'll be hard pressed to find a hossy that won't force you to have the epidural. In terms of the epidural - the hossy says it is in your best interests - ouch if they end up needing to turn your second twin and if you need an emergency c/s for twin2 you'll also end up with a general and not get to hold your baby...

If you can get someone to support your twin VBAC - i highly suggest a doula. I think with a VBAC alone you need one, combined with the twins as well i think it's essential for you to havethe most positive birth experience you can! I myself haven't used one, but have a look around the forums and im sure you'll find some more info and great feedback. start with this article perhaps...
https://www.bellybelly.com.au/birth/...n-doulas-birth

Sorry i couldnt be of more assistance, hopefully someone else can shed some light on the situation fro you.

Good luck for a happy and healthy pregnancy!

Hi,

Where abouts are you?`I really hope you can find a hospital. After my 1st birth I am now thinking about the possiblity on a homebirth for number 2 (ttc in July) used to think it was VERY out there but now I think it's definitely a possibilty would you look at having a homebirth maybe?

Don't know how this works - if this reply will go to both jas and ashnant?
I'm located in Clayton only 10 minute walk from Monash Medical Centre. I'm booked in there and have only had one midwife appt. so far. I need to feel them out as to how supporting they will be with twin VBAC. I plan on making an appt. with the head of obstetrics - straight to the top I say! I feel though that I won't be supported there due to how I was treated with my first baby who was 14 days 'overdue' - ended up being induced then emergency c-section.
My twins are about an 18% chance of being identical but most probably fraternal so no chance of twin to twin transfusion. There are definately 2 placentas and 2 sacs.
I won't be able to have a homebirth as no midwife in Victoria does homebirths with twins (as far as I know).
I went to a VBAC seminar this week and heard about a woman having twins vaginally at RWH - maybe it's the same woman?
Thanks so much for your responses.
Best wishes, KT.

Hi Katie,

Sorry I don't know the area so can't suggest any hospitals. You may have problems trying to get an appt. with the head of obstetrics. I wouold recommend calling all the hospitals in the area and asking to speak to the head of obstetrics and ask about their policy on twin VBAC. Also as I said I don't know the area but I think Kelly (the creator of BellyBelly) is inVic so you could ask her if she knows any midwives that will do home births with twins. You can email her at info@bellybelly.com

Goodluck!

Hi Katie!

Congrats on your twins!! It's a totally different pregnancy experience from one baby! :)

I have had a similar problem to what you're facing. Although I had a vaginal birth with DD, I have been having a lot of problems trying to find somewhere that will support my decisions to have minimal interventions with my twins' birth. I have been in tears over the whole situation many times! At least you are getting it sorted early so you will have a better chance than me of finding someone to help you.

Like you say, most places will insist that you have an epidural 'just in case' twin 2 needs to be manually manipulated or you need a c-section (both highly likely if they make you lie on your back for the duration of your labour with an epidural and monitors... stupid doctors!!) as well as the drip, the continuous monitoring etc etc. And they will try and scare you with stories about the cervix starting to close once the first baby is born and twin 2's head getting stuck, they'll tell you about women who refused the epidural and lost the second baby... the list goes on - there's no end to the 'what could go wrong' scenarios they will present you with. As well as this, they'll want to insist on you being induced at 37 - 38 weeks.

Anyway, I highly doubt your chances of finding a hospital that will support what you want. But what you can do is hire a private midwife and give birth at a public hospital. I was put in touch with an independent midwife who made that recommendation. Your private midwife can do most of your antenatal care and will be there for the whole of your labour - at home and once you get to hospital. S/he can come with you to your appointments and argue your case and just generally support what you want - instead of what the doctors say you should want. I think this is what I'm going to do (still trying to convince DH that it's the best option!).

I think that would be your best bet at getting the birth you want. I know how you feel, I have been to 3 public hospitals and 3 private obstetricians who all treat me like I'm taking drastic and unnecessary risks just because I don't want to be lying on a bed hooked up to machines for my labour.

My other plan is to stay away from the hospital as long as possible - I'm not going near the place until I think I am at least 7cm dilated! You could always try that as a last resort!

Good luck! I hope you find someone to help you get the birth you want. And enjoy your pregnancy!

P.S I would also recommend checking out the Multiple Birth Association website and the group in your area. You might find someone there who can help!

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I went to a VBAC seminar this week and heard about a woman having twins vaginally at RWH - maybe it's the same woman?

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If it was a VBAC then no, not the same - but sounds promising - maybe its worth giving the head OB at RWH a call - they were really helpful to my mum, so crossed fingers they can help you out.

hannahfroodoo made some excellent suggestions - i hope you can get some more info too!

Keep looking for an independent midwife. There is a fabulous one here in Adelaide who births at home with twins etc. She posts on here occasionally - Sirhokko. Maybe put a call out to her on the forum, she might have contacts in Vic.

I do plan on having an independant midwife with me, as well as of my sister who is in her second year of midwifery studies.

On my to do list for next week are to call hospital to arrange some dialogue with the heads of obstetrics to feel them out about support for me and my babies. And contact the multiple birth association, all good suggestions - I'm learning lots!

Hannahfroodoo, have you seen the Davini Malcolm DVD on the lotus waterbirth of her twin boy & girl? It's really fantastic and inspiring. Have you considered homebirth? Maybe you'll have better luck than I would (considering mine is VBAC).

Don't get me started on hospital policy on what they want to do to us as a way of making life easier for them when it comes to the birth of OUR babies. I came across a stream of messages back and forth between obs and the way they were referring to a woman wanting a VBAC with her twins was astounding to say the least. It gave me some insight into what I was up against.
However, I'm feeling positive and inspired to stick to my guns.

Thanks so much everyone for your advise and thoughts. What a great site/forum this is!

How on earth do I save my ticker that I've created? Have tried about 50 times but can't seem to get my head around the technology.

Hoping someone can help please.

Hey KT -
When you're getting the ticker code make sure you get the BB CODE (i think that's what it's called) and not html.

You should be able to jsut go to User Profile > Edit Signature and drop it in there.

OK, thanks. Think i've got it now.

Best regards,
KT.

Hey KT

Have you had any luck yet WRT hospitals and VBAC & Twin Friendly OB's?

Hi, had a great and positive appt with Ob at Monash the other week. She seemed very very supportive of what I want to do (provided babies are in good position and healthy etc - fair enough). Even said she'd be my advocate at meeting with head of Obs at the hospital.

Couldn't even get an appt at RWH so that's out and have an appt at Warrigul with David Simon in early May, but I'm told he's in and out on sabbatical for the year so may not be around when their birthday arrives. Still, think I'll go see him for his thoughts and see how that goes.

Need to just take one day at a time and focus on the healthy aspects of my pregnancy and remember that at the end of the day the buck stops with me. I'll keep doing my reading and getting informed and enjoy they next few months before we go from a family of 3 to 5 overnight!!! How exciting.

Wow that's excellent news!
Kelly posted a thread earlier this evening about a female Ob very supportive of VBAC etc i wonder if it is the same one?
Keep checking in here!

Well after much deliberating, research, information gathering and talking to lots of people I've decided to birth my twins at home. I feel soooo much better for having made this decision and am really excited about the birth. We live so close to Monash Clayton (can sometimes walk there quicker than driving!) that a transfer is entirely possible if needed. I now have a GP/OB and 2 midwives as my caregivers who are all experienced in twins births, so I feel I'm in safe hands - as well as having a renewed confidence in my own body's ability to birth these precious ones. Hopefully everything will work out on the day/s to have this homebirth. :clap:

Hi just been reading your thread.

Good on you for organising the care that gives your twins the greatest opportunity to be born normally.

I had a homebirth (first baby and only one child) and it was awesome!

Feel free to come and pop in the homebirth section

Sending great birthing vibes your way

wow what a great decision youv'e made. Please let us know in september how it all turned out. (when you find the time)
I'm moving to Melbourne soon could you please tell me the name of the supportive female ob you saw at Monash. I have just finished an ivf cycle with two embryos put back :pink-babydust: So fingers crossed i'm going to pregnant with twins.If i am, i want all the hospital stuff taken care of long before the due date. Goodluck with your Birth and congrats on extending your family. Double the pleasure.
Thanks for your help
Renae

Oh best of luck that the transfer takes. We tried for 8 years all up to have our first baby, the last 2 on IVF - 5 cycles and alway had 2 embryos tranferred, so we were always open to the possibility of twins. I know what the 2 week wait is like. I'm sending lots of positive thoughts your way.

Funny how things turn out because after all that trying for our first, I fell pregnany naturally last year (little angel went on it's journey at 12 wks), then fell pregnant again naturally exactly 12 months later (last December) and this time with twins. You just never know what's around the corner.

The OB's name at Monash is Danielle Wilkins and she was recommended by some homebirth midwives as well as the GP/Ob i'm seeing. Also Euan Wallace...he's the head of obstetrics at Monash and from what I hear was supportive of my plans to birth vaginally at the hospital (before I'd decided on the homebirth).

Good luck!

KT.

Oh wow, totally missed this thread update!

Congratulations on your decision to have a homebirth.
I hope it all goes spectacularly for you KT!
Do let us know when the time comes!

Congrats on your decision to have a home birth!! How exciting!
I am sure everything will go swimmingly!! :D

Tanya

Thanks Katie I will go write down the obs names. Were moving in August. I've never been to Melbourne but were going to wing it. (My step mum has family there). So thought i'd get the ball rolling for when i find out. I'm looking forward to the first ultrasound to see the stenographers face if it is twins. I love my stenographer he's a laugh. Goodluck once again with the safe arrival of your babies. :clap:

Great thread and great outcome! Good luck for the birth and keep us updated!

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Thanks Katie I will go write down the obs names. Were moving in August. I've never been to Melbourne but were going to wing it. (My step mum has family there). So thought i'd get the ball rolling for when i find out. I'm looking forward to the first ultrasound to see the stenographers face if it is twins. I love my stenographer he's a laugh. Goodluck once again with the safe arrival of your babies. :clap:

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Just been reading over this...how did the last cycle go?

Not good i think i was too stressed. My parents were moving to melbourne around the that time. So we decided to wait till we've settled to try again this time with Monash IVF. I move to Melbourne this Friday with my daughter then my husband will join us in mid august. So many changes.

Oh, so sorry to hear that Renae. I really do know how it feels. All I can say is hang in there and keep your hope going. Sounds like a busy time for you and even though it's not a psychological condition (if I had a dollar for everytime someone said, don't stress and it will happen...), it's a physical one, I'm sure stress and other big life events going on don't help.
A natural health practitioner once told me I need to visualise the most optimum, healthy and welcoming uterus for a new being to come into, like good nutrition and a healthy and ready mind, and to imagine I was the little embryo...where would I want to be? Doesn't help if one is feeling guilty but it was a good analogy for me. I also did acupuncture for the last round (the one that was finally successful) with a lady in Bentleigh (not sure where about in Melbourne you're living), she's specialises in fertility and IVF support and has a great knowledge of working with the hormones that are taken through each cycle. Let me know if you're interested and I can pass on her details.
Good luck with the unpacking and settling in.
KT.

Did I miss something? I notice that you've had your beautiful twin girls and wonder how it all went?

Hi, not sure if your still planning your twin VBAC at home but if you are there are 2 good stories on youtube. If you search Twin VBAC or Twin HBAC they should come up. Very inspiring.

Congrats on your twin pregnancy....i just wanted to let you know, that if you do end up going to Monash..its a GREAT hospital!

I had both my DD's there and will be delivering #3 in Jan09 as well!!

All the best for your VBAC homebirth!!

Katie - how did it all go?

Would love to read your birth story if you have written one!!

Hi there,

Just wondering if anyone heard how KatieKoo's twin homebirth went? Is she still posting on the site?

I have been following this thread, and although it was posted a while ago now, am extremely interested in the outcome. I am 28 weeks pregnant with twins and am not entirely happy with the options ahead of us through the Ob/private hospital although feel we have the best Ob available. Was considering trying to set up a home birth, and trying to do some research. We are a bit nervous about this would like to hear from someone who has done the same relatively recently. We are in Melb. Thanks.

Hi Maxunya,

Right. The birth. Was planned homebirth. I had two independant midwives and a GP/OB booked. My second midwife and GP pulled out when I was 36 weeks, she claiming my gestational diabetes diagnonis and he claiming that our relationship wasn't established enough. His reasoning I can understand because I had heard that about him and had only seen him twice in my pregancy. But her reasoning left me purplexed to say the least as any dialogue we had had she always came across as supportive, albeit playing devils advocate, but supportive. They word together.

So at 36 weeks I was stranded and left with not much choice but to go to hospital to have the babies. I wasn't comfortable having only 1 caregiver at home and nor was my remaining (primary) midwife. There was a last minute offer from several other midwives to support us at home, but I didn't know any of them and felt it was all getting way too stressful and late in the day to be forming relationships with new midwives. So once we were comfortable with the decision to go to Monash (what else could be do anyway???) I went into labour (37wks).

I should first ad that the week following my meeting with the midwive and GP/OB I met with the head of OBs at the hospital to get him in the loop (he had previousley called me personally to encourage me to have the babies at hospital and said he would do everything to support my wishes for a vaginal delivery and that nothing could be done that I didn't consent to. Once he heard my wishes and realised that I was very well informed about the birth, the risks etc I think he may have gained some respect for me...even admitting at one point that the reason they want to intervene has nothing to do my my body's ability to birth 2 babies, even after a previous c-sec, but that it's all about public liability - bravo!

My waters broke just before 4am on Monday morning (8-Sep). My sister turned up around 7.30am and my mum about 8.00am. I think my midwife (K) arrived not that long after as things were really speeding along. The plan was to stay home till I was about 5cm. K did an examination at about 9.30am and said I was 8cm!!! I fully expected her to say I was 2 or 3. She also commented that the baby was still high up. I was really enjoying and welcoming every contraction though and it was NOTHING like labour when you're induced.

K said we could move onto the hospital at any time so we packed up straight away and headed off. I had a couple of pushy contractions before we left and the walk out to the car really moved things along. I fully felt like I was going to give birth in the back of the car and was screaming "there better not be a f*cking train" as we approached the level crossing between my place and Monash. Once we got there I think DH went to get a wheelchair and I was pretty much rooted to the spot, wanting to push out a baby there and then. I had to breath through till we got to the birth room. Once in there a registrar asked to examine me to make sure I was ready to push. She said I was still 8-9cm but she thought she could feel a foot! We were all dumfounded...how could this baby, that had been head down for nearly 3 months (and evident on a scan only weeks before) turn, especially since there was another baby on top to restrict whatever movement s/he had???!!! They got the ultrasound machine in to confirm that not one, but both were now breech. The OB came in and said his recommendation was caesar (of course) and as B1 was not only breech, but tranverse breech (facing sideways) rather than front or back I was reluctantly in agreeance with him. So off we went to theatre for spinal block. F*ck...that was the hardest moment in labour, fighting off the urge to push when it's all my body wanted to do. Once numbed up the OB did another exam, as if I was fully dilated and baby had moved down then he suggested going ahead with a vaginal delivery. I didn't want this as I knew it would mean an instrumental delivery (forceps - too rough) and more traumatic on the baby. I was still 8-9cm and baby was still very high up.

I was barking orders about no-one in that room mentioning the sex of the baby/s and lowering the curtain because I wanted to see my babies being born. I didn't want the cords cut until they stopped pulsating but OB couldn't agree with that. This is something I'm still bitter about.

So, at 11.29am our boy Eden Dominic was born - bum first, then at 11.30am ANOTHER boy - Augie (Augustin Vincent) was born. When DH said Eden was a boy I was floored. I was so convinced that he was a girl and even though...right, got it wrong, it must be the one that's the girl, then Augie appeared - head first.

Recovery was much more difficult second time round. I was carrying such a huge load. Eden was 7lb 3oz and Augie was 6lb 12oz - singleton size babies. I seemed to take alot longer to get on my feet.

I'm coming out of the fog/adrenalin 5 months out and am analysing the birth and the way it went and wondering whether things could have been different:
What would have happened if we stayed at home?
Of course I'd agree to a caesar right at transition...anyone would!
Why didn't I fight more for keeping the placentas attached.
Where were my advocates when surgical delivery was suggested...they all knew how important vaginal birth was too me.
I'd played it out in my head (natural, vaginal birth) not only since Xavier's birth, but since I can remember. Now I'm obsessed with getting pregnant again so I can have that birth. This has become a bit of journalling and is cathartic in a way. I feel I'll need to speak to someone. Rhea Dempsey (childbirth educator) does birth debriefing. It's something that I need as I feel the rot setting in a bit like it did after Xavier's birth. At the time, because of Eden's position I felt like my decision was the right one, but now I wonder...

They are a treasure and so completely different! The look different and personalities are so different as well. Eden is a cool little dude and happy to sit and observe, as long as his tummy is full etc. Augie seems alot more highly strung and it most comfortable being held in my arms/DH's arms. He does have reflux though I think and had his 3rd session with the chiro today.

I'm feeding and that's getting better. They've been having one bottle at night since they were 6 weeks old as I found that my supply was pretty low by the end of the day and being soooooooooooooooooooooooooooooooooooo incredibly exhausted wasn't helping with that. I'm still dealing with the guilt of giving them that bottle but I just have to get over that as better that than hungry babies being awake every half hour during the night (which is what was happening). When they're 6 months old I plan on dropping the bottle as they should hopefully settle better once they've started solids and I'm getting a tiny bit more sleep than what I was. I've met quite a few twin mums who dropped bottle feeding and when to exclusive breast, and they were comping far more than what I am, so I know it can be done.

DH had 2 weeks off when they were born. The first week when I was in hospital. Then my mum came over every day for 2 weeks to clean my house and feed me etc. Since then I pretty much pack the car by lunchtime and head over to her place, feed that babies, settle them then I go nap with my oldest boy and if one of them stirrs then she deals with it, this way I get some uninterrupted rest most days. That's happening less and less as they're settling a bit more. Second time round I'm not afraid to ask for help as I know what I'm like if I'm too exhausted and get completely intolerant of the kids.

PS - I wrote this in an email to a friend when the babies where 3 months old (2 months ago). Since then I've shed some of the bitter feelings and wonder more about the universe playing it's part in the way things turned out. I can't blame anyone for what happened or have ill feeling towards my advocates.
Throughout my pregnancy I was always comfortable having B1 head first and B2 head first or breech but if B1 was breech then a decision would be made at that time. If I can give any advise it would be to have every scenario covered with regards to your birthplan.
If you are going to hospital to have your babies, be prepared to stand strong and remember that you have to consent to any intervention that takes place. Read up, watch videos and be as informed as you can be. It's your body, your babies and your birth.

My aim was to have natural labour which is got. I'm grateful for that experience and can understand why women go back for more. I welcomed every contraction and looking back feel like I enjoyed the pain of contractions. I made sure my jaw was relaxed and open during every surge (relax the jaw, relax the floor my Mum always says - and she's been through it 5 times!) which really helps.

If I was guaranteed ONE baby girl I'd go back for a VBA2C, but my chances of having another set of twins are just too high - 1 in 10 so I'm told and 2 more boys (making that 5 all up) would be the end of me!

Good luck with the birth of yours. Please contact me if you want need to any more information.

KT.

Thanks KatieKoo

Oh thank you so much for this wonderful and detailed reply. What an interesting journey you had! Your story is very helpful to me. I am bowled over by your honesty and would like to reply more fully when I get home from work tonight.

Thanks again, Maxunya

Hello Katiekoo,

Sounds like you did a very good job at your birth to me (the un-initiated), and that ultimately it went really well. You seem to have done everything in your power to have the birth you were after, with the bubs all well and sound. It feels like you are giving yourself a bit of a hard time about some aspects of it, which I'm sure is undeserved :)

More and more I'm realising that twins seem to be such unknown territory, you really don't know what can happen by the sounds of things. So good advice about flexible birth planning.

Thanks for sharing your story, we saw our Ob this morning, and asked some harder questions about what exactly would happen. The Ob is a lovely person and means well, and is certainly the best we have found, but there is an underlying feeling that things can (will?) go wrong, and that they don't trust either the mother or babies to look after themselves without interference. The whole thing will be controlled from top to bottom, in anticipation of a problem. It seems a real shame that we can't just assume it will go well and then step in with the epidural and interventions if there are any problems.

It is hard to question the medical industry though, when I am really coming from a complete lack of experience compared to them. Big exercise in trust and faith perhaps, in both ourselves and them.

I would really like to know who your home carers were going to be, as they sound like they might be some of the ones we have been in touch with when researching homebirth options. I'm pretty sure it's not ok to post names on these types of forums though. Is there a way of having a quick chat in private (chat rooom virgin here)?

Thanks, stay well, and here's to you getting lots of rest!

Maxunya

Quite right, not really PC to publish names. Feel free to call me on 03 9511 0450. Not sure what virgin chatroom is...which must mean I don't have it!

Look forward to hearing from you Maxyuna