Advice please, another vbac question

[artlp]

2 1/2 years after my husbands vasectomy, I became pregnant with twins since he recanalized. I have had a c-section 19 years ago and have had four v-bacs. Although I do have health insurance, I didn't purchase maternity coverage and so am going to a high risk clinic(I'm also advanced maternal age, 37) at a residency program.

I know I will get good care, but these residents are driving me crazy. There is not a "set" resident I see, so every two weeks I get a different opinion on what is best for my labor. I've been told it is safe for a vbac, then I'm told I could rupture with as many live births coupled with a larger twin uterus.

I can't find anything on the internet about the safety of doing a vbac for twins on top of several (5) labors.

BTW, if I do have a c-section, I have heard putting demerol in your IV right after delivery helps with recovery.

Sorry for the long post....

Any one with experience on this????

[mommajoe]

I have only had lady partsl deliveries (3). Your biblical paraphrase on your post has much relevance to your situation---one concern I have is that you are pregnant with twins. Even if you are able to VBAC babyA you are not 100% sure that baby B will remain in a vertex position. At the hospital I work at you would be a c-section with no choice. So you have to understand my opinion is somewhat tainted due to the hospital I work at. I can understand that if you have already had several previous successful VBACs that you would want to try again. Let me know what you decide and I will pray for you and your nurse!!!!

[L&D.RN]

They wouldn't let you at my hospital either...the other successful VBACs you had weren't with an overstretched uterus full of 2 babies either, that definitely increases the risk. I guess IMO, it wouldn't be worth the risk to me, but good luck making your decision.

[mother/babyRN, RN]

Sounds like a csection might be best unless both babies are vertex and you had uncomplicated labors in the past..Now a days with sections, they often use duramorph or astromorph in the OR, which greatly reduces discomfort, and then you are covered with more meds as you need them for pain, when that wears off..If I were you, at your age and with twins, I would seriously consider having a planned csection, unLESS both babies are vertex at time of delivery, and you are otherwise healthy, without toxemia or other related difficulties...Many sincere good wishes for healthy babies and a healthy you, and congratulations...