Pages

Friday, March 26, 2010

Seven Pounds of Funk (& of baby!)

Let me open by welcoming any Fatherhood Friday folks from DadBlogs & Question of the Week folks from Multiples & More.
Fatherhood Friday at Dad Blogs
Glad to see you and I hope you'll stick around! Now, on with the show.

We had another fantastic appointment yesterday, our 31 week check-up. The ultrasounds suggest that the boys are now weighing in at 3 lbs, 10 oz. each. Their growth is actually on track for singletons, but they expect that to start tapering off a bit soon. They both look quite healthy with strong heartbeats and tons of movement. Timmy is still head down, but Raiden seems determined to remain in a breech position.

We have a special affection for one of the doctors. She is about the same size as Amanda (5 feet even) and is extremely nice, but she was quite concerned with Amanda's "tiny torso" when we first saw her back around week 20. She has expressed pleasant wonderment and shock as Amanda's abdomen continues its outward trek, compensating for her smaller torso by demonstrating a fantastic ability to defy gravity. I'll post a new picture in the next couple days to let folks see this for themselves.

In any case, it seems that Amanda's body is handling this twin pregnancy perfectly. The single issue we'll likely face is Raiden's position. As such, we have to make some difficult decisions concerning birth. The ideal scenario, obviously, is for Raiden to turn and for Amanda to deliver both of these guys vaginally. Given that we have no idea if Raiden is going to turn, we're left with a few options:
1) Do a scheduled cesarean section, whether labor begins or not, after 37 weeks (probably May 7th, my mother's birthday).
2) Vaginal birth with Timmy, hoping that Raiden turns or can be coaxed to turn. If Raiden does not turn, perform a cesarean section.
3) Vaginal birth with Timmy and a planned breech extraction (they have someone well versed in breech extraction at our hospital).
Note that the doctors are advising the first option, at least presently. Also note that we will listen to the physicians the moment they say something is very strongly advised, but at present they just seem to be suggesting certain routes.

I worry about Amanda's recovery time from a c-section and Amanda is concerned with statistics that show lower chances of successful extended breast feeding with babies delivered by c-section and we both wonder about the medical profession and its tendency to push for c-sections out of convenience more than medical necessity. At the same time, the idea of a breech extraction scares the heck out of Amanda because of the many horror stories out there. I should note that, while discussing this issue, Amanda reminded me of one of the many reasons I love her by equating a scheduled c-section to cheating in video games. I said something like "Yeah, and it's not even like checking GameFAQs", to which she responded "No, it's totally an up-up-down-down-left-right-left-right-b-a-start kind of a thing." If you're not a video game junkie from the original NES days, you'll probably not get that joke, but here's a link to the reference. Translation: we're both giant nerds and our children are doomed.

In trying to make this decision, we're starting a "pros and cons" list for all options, but we're hoping to get some input from anyone who has birthed multiples or singletons via breech extraction. What was your experience? Would you advise others go the same route or a different one? Any input would be greatly appreciated!

And now because every post needs at least one picture, here's one of Thomas being subjected to torture helping me unwrap my present from the previous post:


He's pretty cute. Amusingly enough, up until about a year ago almost all of his photos were with him barking as he seemed to hate the camera. That phase seems to have passed. Yeah, I think we need one more.


Ok, now I have a proper post.

Again, any input on the birth plan issue would be really helpful. Thanks in advance!

13 comments:

citymouse said...

I stumbled over from SITS... glad did.

I have 5 sons, the youngest two are fraternal twins. My first two deliveries were C-section (the first unplanned, the second planned). My middle son was a VBAC delivery as well as the twins. My labor with the twins was induced at 39 1/2 weeks. Each of my deliveries was different.

I have some definite thoughts about birthing babies. You are welcome to send me an e-mail by replying to my comment and I will be happy to share them.

In either case, I hope things go wonderfully for you guys. I'm a sucker for a happy ending, so I'm now following your blog.

Chantal said...

Hello!

My twins (1 year now) were born vaginally and the second (my big boy) was a breech extraction. My daughter was head down the whole time and my son was a lazy man hanging out transverse on top. They hoped to turn him, but it didn't work. The Dr stuck her hand up there grabbed his feet and yanked him out. Dispite the horror it sounds like, I was relax and chill the whole time because my epidural was running strong.

The story: I wanted to have a vaginal birth the whole time. This being our first pregnancy, I wasn't a fan of having the c-section being "the option" for the rest of our pregnancies. So I was determined and let all the high risk doctors know that is what I wanted. I also did tons of research and talking to people in the baby business.

I was told that the older the doctor, the better. The older doctors did breech extractions much more back in the "old days" and they barely even cover it in medical school anymore.

I was also told that you have more success if the first baby is bigger, but this was not the situation in my case. My daughter was a nut compared to my son.

When my water broke and I was at the hospital I was told that the "old men" were not on duty. I was bummed. The high risk doctor on call was a little tiny lady and she wanted to do a c section because she didn't know if they would be able to turn my son. I wasn't thrilled. My husband and I decided to talk it over and get back to them.

We talked about how we felt and decided that we wanted to deliver my daughter vaginally and take a chance with my son on whether he would turn or if we would have to do #2 c section. The options were 100% c section or 50% c section.

Now you may here that recovering from both procedures is tough, but those I talked to (even a few who had both) said that it isn't that bad.

So we went into the OR and I delivered my daughter, they pumped up my epidural and tried to turn my son, his heart rate was starting to drop so the Dr told the 50 people in the room to prepare for a c section. I was calm and just going with the flow when all of a sudden my husband yelled "Oh My God! There's feet!" I was like "huh?" and then my son was out. The Dr decided to just go for it and he slithered right out. I didn't even push!

I was SOOOOOOO glad we took the chance. It was SO SO SO worth it!

Feel free to e-mail me if you want to know anything else!

Stacey said...

I had a c-section and it was no big deal. I was back to normal (climbing stairs, getting up from a prone position) when I got back from the hospital. The hardest thing was breastfeeding...not sure what you guys are going to do with that. It did take longer for my milk to come in which would be doubly stressful with twins :-) The thought of one vaginal and one c-section? I shudder. You'd both be exhausted from the regular labor and then have to deal with the c-section. Not my idea of an ideal situation.

Mommy, Esq. said...

Both my kids were breach and I was thrilled with a C-Section. The recovery was totally fine and it was nice just to put a pin in it and say "this is the day we are having our babies". I realized there is no extra points for vaginal or natural deliveries and we did what made sense for us as a family.

The key for extended BF is NOT the C Section but the amount of help she will get once you are home. Here is what we did - BF one, BF the other, then pump. Every 2-3 hours. All I did was try to get kids to latch, have to wake them up to see if they would suck, pump so we could supplement with BM and keep my supply going. Almost no rest, certainly no time to feed myself or take care of any diapers, etc. Eventually I decided to BF one, the other woudld get a bottle and sometimes I was able to tandem nurse. I drank TONS of mother's milk tea, took fenugreek, etc. It is a HUGE amount of effort and she needs to be mentally prepared - I spent more time crying about that than ANYTHING else in my entire life. Definitely get a hospiptal grade pump. And don't beat yourself up about it if you need a break once in a while (just pump even if both babies get formula bottles). Some moms skipped the pumping just tried to BF both, then supplemented with formula. Have a lactation consultant ready to come visit in that first week. Join a Moms of Twins group and talk to someone who has BF. I stopped after 5 months but that had a lot to do with returning to work (if your wife works at home she can run out to BF and then head back to work)and b/c my daughter had been refusing to eat anything and we needed to get her on track. The key is also a supportive husband - my husband didn't care if I BF or not so I felt like all the pressure was on me to do it and not complain about how hard it was. Also, if she pumps from day one after C-Section her milk will come in quickly. Some hospitals provide a pump.

Here is a book I recommend:

http://www.amazon.com/Mothering-Multiples-Breastfeeding-Caring-International/dp/0976896931/ref=sr_1_1?ie=UTF8&s=books&qid=1269615342&sr=1-1

I am more than happy to talk to your wife and if she wants some recommendations of twin moms I know who BFed I am happy to pass on their emails.

Chantal said...

I was a successful breastfeeding MOT and can also give TONS of advice if you want it.

I agree that pumping is KEY and husband is KEY. My husband was with me 100% in not wanting our babes to have a drop of formula, and they never have. Our babes went to the NICU for about 10 days so I was a pumping momma for quite a while. I would pump EVERY TWO HOURS with the hospital grade pump for 30 MINUTES at a time. So I would get a 90 minute break between pumping sessions. It was exhausting, but SO WORTH IT. For about 36 hours while I was pumping after giving birth I got NOTHING. ZIP. ZILCH. ZERO. I suddenly wondered what I was doing all that for when nothing was happening. But then when my milk came in, it flooded in! Once it came in I would allow myself one 4 hours stretch at night, but then would go every 2 hours. A few days after my milk came in and it was established, I would stretch in to every 3 hours and 5 hours at night. I wouldn't go more then 5 hours though for along time. I would also pump after each nursing session.

After about 3 or 4 weeks when I knew that I was well established I started to regulate according to the babes.

My babes also had tiny mouths and had trouble latching so I used nipple shields, which are amazing. They are a wonderful tool and I would recommend having some on hand just in case. They are great in case there is soreness.

Take advantage of the lactation consultant at the hospital and ask for them often. Every time she nurses, ask for the lactation consultant to be paged to stop by. And have the name and number of someone to call after you are home if she needs help.

I worked to hard at getting my supply that I was able to feed both my babes and pump a supply for a local baby that was adopted. So it is possible!!

Melissa Ann said...

I am SOOOOO jealous that you have a doctor willing to do a breech extraction! Mine looked at me like I was crazy for wanting to breech deliver my supposedly 3lb baby A. They told me C-section or nothing. Made me angry.

That said, if you do have a C-section as a prior poster mentioned it's not too terribly bad. Getting out of a flat bed is the worst part of the whole ordeal. My c-section tips are here: http://bumblebeegrace.blogspot.com/2009/09/my-c-section-tips.html

My milk came in strong on day 3, but the girls had trouble latching so we did have to supplement for those three days while I pumped like a mad woman. After that they got my milk in a bottle. Any way you do delivery EBF twins is hard work!

Josh and Nancy said...

My twin pregnancy was twin. I was induced at 39 weeks (both head down). Baby A was stuck, after 2 hours of pushing I had a C-Section. I BF until they were a year and we found out we were pregnant with #4(VBAC). Milk came in fine before I left the hospital. We did pump and supplement BM at the beginning because B wasn't latching. If you're willing to try I say go for Vag. but that is the type of person I am. If you have more questions feel free to respond to this comment. Just remember everyone is different and what works for one amy not work for another. I had enough milk nursing for 3.

JO said...

Hi - I too am a veteran of c-sections. I had triplets and in our case, it was the only option, so it didn't matter where every one was positioned. That said, it was 11 years ago and it really wasn't too bad. Once those babies have arrived, it won't matter how they got here.

jo

www.teensandtriplets.blogspot.com

Dolli-Mama said...

Found you through Multiples and More. You're funny!

Ok, so I am currently pregnant with twins and am having a planned C-section. Yeah, it may be cheating but I don't care. :) I also don't really have a choice, as one baby is breech and the other is transverse and I have had a C-section already.

My baby (one, boy, single) was born via C-section after 16 hours of labor and 4 hours of pushing. My recovery was not that bad, and I was walking the next day. However, pushing and then being cut open totally blows! Even though no baby came out, pushing for that long added something to my recovery. I, personally, would not want to push out a baby and then have a C-section anyway.

If I was pretty sure I wouldn't have to go with option b, and option c would be the most likely outcome, I think I would try it.

You are right, Doctors are a little C-section happy. While the recovery is not bad for a C-section (in my opinion), I would rather have a natural delivery. But I personally would not do both (natural then C-section) if I could help it. That sucks.

Sadia said...

You're so wise to be planning and thinking about the possibility of a C-section. I have twin daughters who were both breech and delivered by C-section at 33 weeks gestation.

I can tell you about my experience; I'm not a medical professional! I recognize that my daughters were not strong enough at their gestational age to handle all that would go into repositioning for a successful vaginal birth. They are healthy, vibrant almost-4-year-olds today in part because the doctors made the right call on the day of their birth.

I, however, was left deeply scarred, psychologically, by the C-section. I had my heart set on a chemical-free vaginal birth, and I didn't bond with my daughters for several days. I hadn't quite prepared myself for the realities of prematurity and C-section recovery, or the powerlessness and violation I would feel on the operating table. It took years for me to let my husband touch me again, and even now, 4 years later, the trauma of being cut open and having my children removed causes problems.

That's probably not what you were looking to hear. Plenty of women have relatively complication-free C-sections, and plenty of twins make it to 37 weeks. Still, the recovery is time-consuming for all of us. Mom won't hopping up to pick up a dropped bottle or to position baby #2 on her breast for the first 2 weeks. It's major abdominal surgery, and it's taken most of my friends who've had C-sections 2-3 years to regain nerve function at the incision site.

May you have a healthy and happy first meeting with your little ones!

KimnSteve said...

Found you on M&More, here's my two cents:

It won't matter how they got here once they're here!

I, too, had my heart set on a vaginal delivery of my twin sons, born May 2009. Baby A was vertex, Baby B breech - all the way. My doctor also wanted to do a C if B didn't move for the safety of the baby. While I was disappointed, I came to my senses before they were born; that meaning, they just need to get here safely. Like another poster wrote: there are no extra points for a vag birth.

My water broke at 35w3days at 5:30 am. My doc was on call and offered to do an ultrasound to see if B had moved. I could still feel his head in my ribs, so I decided no ultrasound - let's get this over with! At 9:30 am, the boys were born healthy, strong, and B was breech as can be. Thank goodness there were no pushing or contractions because the recovery was tough enough. That might have been b/c I was driving back and forth to the NICU, though, instead of resting at home.

It took 3 days for my milk to come in - like others, I pumped like crazy and credit my helpers at home for getting me through the first difficult month. Because they were preemies, they had to have fortified bottles for weight gain, so consider that as a possibility as well.

One of my boys weaned himself around 9 months and the second I just weaned this week at 10, so it's possible to breastfeed long term. I wasn't ready to quit but they were, so we are.

However it happens, just get them here safely!

Apok said...

I partly already commented in dadblogs forums but i just wanted to add, Scheduled C-Sections FTW. With twins, you know it could happen anytime. Just get them out of there and get it over with.

Sonora said...

I am so glad to hear everything is still going well with the pregnancy. What a relief to make it past 30 weeks!
It seems everyone's experience is a bit different, but here's mine. I didn't want to have a C-section and I remember going over the scenario you discussed a million times. I was terrified of having to recover from having one vaginally and one via C-section.
In the end, one of the boys was breech and due to the TTTS we decided it was safer to go with C-section. In our case, it saved baby A, who was supposed to be baby B but came rushing out as soon as they got me open. If he hadn't, we would have lost him. As it was, it took them 10 minutes to resuscitate him.
I believe in doing what feels right. Listen to your doctors and do what you feel is right and you will be fine.
As far as C-section recovery, for me it was much longer and harder than from my other deliveries. The breastfeeding wasn't a problem, in fact the nurses were amazed at how much I had and how quickly. The problem was the boys spent 3 weeks in the NICU and I couldn't be there that whole time which led to pumping. I was only able to keep that up for 3 months. I honestly believe it wasn't the C-section, but the time in the NICU, the pumping, and then the stress and exhaustion of twins that was the problem.
I hope none of this scares you. It will work out just fine. Hang in there you guys!