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Revisiting Home birth again - Page 3

post #41 of 81
Quote:
Originally Posted by christyc View Post
I saw this the other day, and only now have a few minutes to respond.

I think the key is going into whatever you're doing eyes wide open, and in charge of all the information. Whether you choose a home birth or a hospital birth, you need to be prepared for what you are entering.

With regard to which is better suited to you, much of that is going to depend on your particular situation. First, your pregnancy. Are your twins mono/di, di/di? Is baby A head down (as you approach the final stretch)? Have you had any other complications with the pregnancy? I think a lot of people who don't know anything at all about twins assume all twins are "high risk," and equally so. The fact of the matter is that just as factors like type of incision, reason for primary, prior vaginal births, whether or not you're receiving certain interventions, etc., make VBACs run a HUGE range of risk from catastrophically risky to not risky at all, so too do these things about your particular twin pregnancy make twin vaginal birth run the gamut from higher risk (mo/mo, for example) to not very risky at all (di/di, both vertex, prior vaginal births, etc.). As a nullipara (I'm assuming), you aren't necessarily MORE risky, just a little more unknown, and I know plenty of nullis who have birthed their twins vaginally, at home, in hospitals, and birth centers, without any complications. Like them, you will have many factors that play into your decision of where to have your babies.

Another thing that will play into your decision-- your provider. How much experience does the provider you're considering have with VAGINAL twin birth? If all your provider has ever seen are scheduled cesareans for twins, they are less likely to manage your labor in preparation for a VAGINAL twin birth, as they will likely default to what they know. I was at a twin hospital birth last week where the doctor INSISTED that he's NEVER seen a baby B change position after baby A is out (breech to vertex, or vice versa), that he considers the risks of vaginal delivery of a breech baby B too high to accept, and that he felt an external version for a breech baby B would be unsuccessful if attempted, so he wouldn't even try. I know for a fact that baby Bs flip frequently after births as they have more room to move around, that external or internal versions of baby B are often incredibly successful because of that fact, and that the literature suggests that a vaginal TOL is warranted as long as baby A is vertex. Because the information he had was so far out from what I know to be true (I can read studies, too), I can only assume that he was not up to date on the research regarding twin birth, and that he's never seen many twin vaginal births. He ended up "allowing" the mother to push out her baby A as long as it was in the operating room, and then knocked her out under general to do a cesarean on baby B simply because of B's breech presentation, without attempting a breech "extraction" (much less a birth) or an external version. Moral of this story: make sure you know your provider has attended more than a few vaginal twin births.

This played greatly into my decision of where and with whom to have my babies, by the way. As evidenced by my story above, not many of the doctors in my area have attended many vaginal twin births, as it's so easy to scare most twin moms into unnecessary surgery when you play the "don't you love your baby enough?" card. The provider who attended my birth had attended dozens of vaginal twin births in hospitals before switching to a primarily homebirth based practice, and had attended almost 20 vaginal twin homebirths since then. I knew my care was being handled by someone who knew the research about twin birth, respected mothers' wishes and did her best to carry them out safely, had a TON of education on birth and nursing (the medical and non medical sides), and knew and wasn't afraid of the tricks for managing vaginal delivery of baby B. A lot of the "I/my baby would have died if we had been at home" stories? My provider has likely attended births just like that at home, and managed them well with no complications to mother or baby.

There are providers like that out there, providers in both homes and hospitals. The trick is this-- in the hospital, that provider, no matter how good s/he is, is beholden to hospital policies that may or may not be in yours or your babies' best interests. At home, this is not the case, but surgery is not (as someone has pointed out) 5 minutes away. In many cases in which cesarean is overused or required only because of the negative effects of interventions, that might not be a bad thing. But rarely, it can be. You have to be aware of that, and it needs to play a big role in choosing a homebirth provider. Have you attended births (and approximately how many) where: it was twins? a cord prolapsed? Baby B was breech? Baby A was breech? a mother hemorrhaged? the babies "locked?" How did/would you handle these situations at home? For which ones would you consider transfer to the hospital our best option? Would you be able to transfer with me if we had to? What is your education relative to birth? Are you a: DEM? CPM? CNM? MD? EMT? Paramedic? Certified/licensed in your state? I know some of those sound silly, but you really want to know what kind of training they have. Do you have hospital backup to ensure continuity of care if we transfer? What kinds of medicines/herbs/supplies do you carry with you to home births? What's the earliest you would attend a twin birth at home? What extra people would you bring to my twin home birth? What if both babies needed resuscitation-- would you be prepared with extra oxygen tanks/masks?

The sad fact is that just as not all doctors are the same, not all midwives are, either. Some are incredibly competent with a somewhat medically-minded approach. Some are incredibly competent with an uber-crunchy holistic approach. And some, medical or otherwise, are simply incompetent and inexperienced. My heart goes out to those mothers who hired a midwife in good faith and with the best of intentions only to find out AFTER the fact that the midwife was not competent. Having no uniform licensing procedure yet (which some might argue is a good thing, but which The Big Push is trying to remedy) makes asking all of those questions of your homebirth provider REALLY important. Having no guarantees or protections against unnecessary interventions in the hospital makes them equally important to ask of an OB.

I like the idea of keeping OB shadow care during the pregnancy. I did not have that for my own twin pregnancy (for reasons that are more complex than this already-too-long post can address), and I lived in constant fear of going into labor early and ending up in the hands of whatever doctor happened to be on call. Maintaining OB shadow care, while it may be more stressful in some ways, will ensure that you have a reasonably secure backup plan if you go into labor early or need to transfer.

I also like the fact that you put intuition in (what I consider to be) its proper place-- as a part of the process, but not the process itself. That was how my pregnancy was-- I researched my butt off, took what I found out into prayer/meditation, and then made my decisions based upon many dimensions. I wasn't TOO analytical and nerdy, but I definitely wasn't any more woo-woo than was necessary!

Anyway, I'm sorry for writing the novel here, but this is an issue that is close to my heart. As a doula, I think all women deserve to be treated with respect during their births, whether they give birth at home or in a hospital. As a mother of twins, I think we should have those same rights.

Hope your path becomes more clear to you as it progresses.
everything she said. : Bow
post #42 of 81
: all of it!

It sounds like you are on the perfect track for your and your particular pregnancy. Best wishes for continued 'uneventfulness' and a peaceful birth!
post #43 of 81
Ok, I swear this is the last comment on this thread that I will make.
I am the "intuition" one. But I did have a perinatologist and all the bells and whistles that go along with their care. I just think that when you surrender yourself to relying on tests only, you lose your power. Towards the end of my pregnancy, I sat through NST and FHM sessions with care providers who were freaking out a bit that they couldn't find twin B, or sometimes A. Now, if I hadn't tapped into my intuition and my constant silent dialogue with my girls, I'm sure my blood pressure alone would have catapulted us into the hospital. Instead, I just chuckled to myself and told them that I would need to eat to get Baby A to move, (and nudge her a bit) as she was my serene one. And as far as Sierra went, good luck finding her b/c she has been turning somersaults here and loves evasion. But I knew my girls were fine, and yes, b/c it's more comfortable to have tests ultimately back up my information, I still think that valuing my intuition will always serve me and my family. And I do believe that on the day of the birth, you must feel 100% at peace before approaching a homebirth. That's where my intuition served me. For my DD1, I ended up delivering in a hospital when she came early, and I was grateful for having had midwifery care for the whole pregnancy, even though it did not end in a home birth. I do believe that we are not that far removed from animals who seek "safe" places to birth their young, in order to have the best possible outcome. That "safe" place is different for all of us. For myself, it was home. And by the way, I had strong intuition that my DD1 was coming when she did. But my brain said, "no, this is only 35 weeks", but I couldn't stop my nesting the nite prior, and when my membranes ruptured the next morning, I just laughed. And ran to call my MW.
Back to my original story of developing cancer and knowing something was really wrong (never before had I ever thought that), my doctor DID run a blood test, and wrote off my high white cell count as my having a cold. Back then I wished that I had more guts to follow my intuition and ask for either more bloodwork to be done, or to have pursued a second opinion. A year passed before I changed doctors and had developed a palpable tumor before I was diagnosed. Doctors make mistakes too, they are only human, and so I think to leave complete responsibility in the hands of someone else, (an OB, a peri, a MW) is not utilizing one of our great gifts.
And lastly, those of you singleton mamas who have stopped by to share your opinions, I know you do it with a sincere intention of helping. But if you have spent any amount of time on this board, you would realize that we are all here for eachother, no matter what birth plan we choose. If someone is interested in homebirth, we will share our experiences. And I think that every homebirthin' mama will attest to their experience only, and not make guarantees to another mama. So.........??????
post #44 of 81
Quote:
Originally Posted by mamaeliz View Post
I do believe that we are not that far removed from animals who seek "safe" places to birth their young, in order to have the best possible outcome. That "safe" place is different for all of us.

And lastly, those of you singleton mamas who have stopped by to share your opinions, I know you do it with a sincere intention of helping. But if you have spent any amount of time on this board, you would realize that we are all here for eachother, no matter what birth plan we choose. If someone is interested in homebirth, we will share our experiences. And I think that every homebirthin' mama will attest to their experience only, and not make guarantees to another mama. So.........??????
:
post #45 of 81
Thread Starter 
Quote:
Originally Posted by mamaeliz View Post
I do believe that we are not that far removed from animals who seek "safe" places to birth their young, in order to have the best possible outcome. That "safe" place is different for all of us.
Okay for me this statement hit the nail on the head. I grew up in and still am involved in the horse breeding business. I also raise sheep. In all my years growing up breeding horses and foaling out mares we never had any issues. We let mares foal in large pastures, without any lights or intervention. Meanwhile neighboring farms were having to pull foals out with chains, keeping night watches on mares that were in small stalls under lights. It just seemed so obvious to me as a very young child, that all that intervention had to be stressing to these mares.

The thought of being confined with monitors in an unnatural position (which would be required of me in a hospital) just reminded me so much of the neighboring farms who had all the issues.

And the thought of transferring to a operating room for delivery after laboring in another room seems crazy also. I would never move one of my mares or my ewes to a different pasture in the middle of their labor!!!!

This is why I think (if all is normal with our pregnancy) that it is healthier and safer to birth at home. I fully intend on taking advantage of wonderful modern medicine if need it, but I really think it can be avoided if we allow nature to take it's course.
post #46 of 81
Quote:
Originally Posted by DeannaK View Post
Okay for me this statement hit the nail on the head. I grew up in and still am involved in the horse breeding business. I also raise sheep. In all my years growing up breeding horses and foaling out mares we never had any issues. We let mares foal in large pastures, without any lights or intervention. Meanwhile neighboring farms were having to pull foals out with chains, keeping night watches on mares that were in small stalls under lights. It just seemed so obvious to me as a very young child, that all that intervention had to be stressing to these mares.

The thought of being confined with monitors in an unnatural position (which would be required of me in a hospital) just reminded me so much of the neighboring farms who had all the issues.

And the thought of transferring to a operating room for delivery after laboring in another room seems crazy also. I would never move one of my mares or my ewes to a different pasture in the middle of their labor!!!!

This is why I think (if all is normal with our pregnancy) that it is healthier and safer to birth at home. I fully intend on taking advantage of wonderful modern medicine if need it, but I really think it can be avoided if we allow nature to take it's course.
I just wanted to tell you I'm so jealous. I've always wanted to work with horses.
post #47 of 81
Quote:
Originally Posted by mamaeliz View Post
And lastly, those of you singleton mamas who have stopped by to share your opinions, I know you do it with a sincere intention of helping. But if you have spent any amount of time on this board, you would realize that we are all here for eachother, no matter what birth plan we choose. If someone is interested in homebirth, we will share our experiences. And I think that every homebirthin' mama will attest to their experience only, and not make guarantees to another mama. So.........??????
Amen Mama.
post #48 of 81
Quote:
Originally Posted by DeannaK View Post
Okay for me this statement hit the nail on the head. I grew up in and still am involved in the horse breeding business. I also raise sheep. In all my years growing up breeding horses and foaling out mares we never had any issues. We let mares foal in large pastures, without any lights or intervention. Meanwhile neighboring farms were having to pull foals out with chains, keeping night watches on mares that were in small stalls under lights. It just seemed so obvious to me as a very young child, that all that intervention had to be stressing to these mares.

The thought of being confined with monitors in an unnatural position (which would be required of me in a hospital) just reminded me so much of the neighboring farms who had all the issues.

And the thought of transferring to a operating room for delivery after laboring in another room seems crazy also. I would never move one of my mares or my ewes to a different pasture in the middle of their labor!!!!

This is why I think (if all is normal with our pregnancy) that it is healthier and safer to birth at home. I fully intend on taking advantage of wonderful modern medicine if need it, but I really think it can be avoided if we allow nature to take it's course.
this. Respect for ALL mamas.
post #49 of 81
Thread Starter 
Just thought I would update you on yesterday's visit with midwife #2. (since it's 3am and I can't sleep)

Okay, I liked her very much. She seems easy going, sweet, and passionate about her profession. I think I could be very comfortable with her in a labor/delivery experience.

Hubby liked her a lot also, but felt based on some of her answers to questions about prior birth experiences and how things were handled (ex: baby needing to be resuscitated) that she seemed a little bit too kicked back.

I'm a bit concerned about her experience. She's been a MW for 4 years. She's young herself. Not yet had children. (which isn't a big deal, and my mind tells me male docs NEVER give birth and are fine at their job, but my heart says, Wow, she's young and never given birth). Silly I know, but I can't seem to shake it completely. And I know this is not a fair way to judge her on her skills. So I'm taking it off my "con" list.

She's never delivered twins and has only attended one twin birth as an apprentice midwife. She trained with the midwife that I first interviewed who I didn't care for. Again, not something I'm judging her on. But it did cross my mind. That midwife is one of her back ups but in my case, since I didn't feel comfortable with MW#1, she would not be one of her back ups.

I don't think she's been a primary midwife for more than 100-130 births. Still a lot I realize, but compared to the next midwife I'm going to interview, not very many.

Her transfer rate is about 5% and most of the time it was for "failure to progress". She expanded on this saying, that failure to progress isn't necessarily her call, rather it is the laboring mother who decides she's had enough.

I can honestly say I don't have any issues with the answers she gave us, and I felt very comfortable with her. But I still worry about the experience issue. I meet with MW #3 on Tuesday.

So, any thoughts on this. Am I justified to be worried on her experience level. Twin birth is not that different, but it is different! I'm just sort of confused at this point.
post #50 of 81
Well, I had a similar experience with a midwife. NO twin experience and very laid back. I decided that if I were going to be that laid back I may as well save the money and go unassisted. I would be wary of someone without extensive twin experience. If she were a second (or fourth) midwife on the team that's another matter but I think that she probably isn't the best choice for a primary. One midwife I interviewed uses 3 midwives at a normal birth and 4 at a twin birth (one midwife for mom, one for each baby and one to go for help if warrented). The complications that can go on with baby B really needs someone with more experience IMO.
post #51 of 81
If it were me, then the reasons you listed would not deter me from using her. When I had my twins, one of the mw's was young and had not yet had children of her own. She had actually only just received her certification following the birth of my 2nd child (which she was my mw's apprentice). I found her to really be knowledgable and actually more knowledgable in certain areas than my other (and more primary) mw (such as herbal remedies). That being said, I did have a birth team of 3 people - my primary mw (who had some twin experience but not tons - I'm not sure the number), her business partner (the young one), and an apprentice. However, I didn't have all these people out of *my* need for them. On the contrary, I wanted as little people as possible involved and essentially that's what I got. My primary mw checked heart tones and did a VE once or twice after baby A was born to check on position and for possible cord prolapse of baby B, and that was it. Everyone else stood back. However, I did hemmorage after baby B was born and it was handy to have the other two mw's there to help manage me. So will she have anyone else attend the birth with her? That's something worth considering.
post #52 of 81
Thread Starter 
Quote:
Originally Posted by 2+twins View Post
So will she have anyone else attend the birth with her? That's something worth considering.
Yes, herself, a second MW and an apprentice MW.
post #53 of 81
100% honestly? i would be nervous about the lack of experience with twin births. my original plan was to deliver in the hospital with a midwife (thwarted b/c of incompetent cervix, but anyway), and i made sure that the person who i picked had a lot of twin births under her belt... for a hospital birth... if i were planning on a homebirth, i would be double as concerned. please don't think i'm biased, i'd love to birth these babes at home, but it would have been impossible where i live.

none of the other issues bother me, just that one... but in a BIG way.
post #54 of 81
Thread Starter 
Trust me it bothers me too. It is not only the lack of twin birth experience but the lack of total experience. (4 years isn't that long IMO). So I'm glad for your honesty.

The problem is, I don't think there are many midwives within 200 miles of me who have much twin experience. I'll see what Tuesday's midwife says. It's a lot to consider.
post #55 of 81
Quote:
Originally Posted by dividedsky View Post
my original plan was to deliver in the hospital with a midwife (thwarted b/c of incompetent cervix, but anyway),
Kinda off topic, but I know we have a mom on here somewhere who had IC and had a cerclage in place, got the cerclage out at some point, and then carried her babies past 40 weeks, if I remember correctly, at which point she had a homebirth. She was in my twin childbirth video.
post #56 of 81
Quote:
Originally Posted by christyc View Post
Kinda off topic, but I know we have a mom on here somewhere who had IC and had a cerclage in place, got the cerclage out at some point, and then carried her babies past 40 weeks, if I remember correctly, at which point she had a homebirth. She was in my twin childbirth video.
Wonderful video!!!
Seeing is believing, great job on collecting these, I'm bookmarking it!
post #57 of 81
I'm not a MOM and I don't want to crash your thread. I just saw it on the main page. But if you are concerned about the distance from your home to the hospital, how about a hotel room birth? If you aren't prone to quick labors, then you could find a nice room near the hospital (maybe even with a huge tub!) and your labor team can scrub it down for you once you get there. Then if you do need to transport, you wouldn't be too far away.

Good luck with whatever you choose. I can't wait to hear your birth story! Even though I'm not a MOM, I'm so fascinated with twin (or more!) birth stories.
post #58 of 81
Hmmmmm..... there is something I learned, and felt often during my twin pregnancy, "It just can't be easy, can it?" I didn't want to have a "negative mantra", but it felt like everytime I turned around, I was having to navigate my way through plans C, D, E......and so on. I couldn't believe just how challenging my birth choices were. Quite honestly, I probably would have gone the hospital route w/a midwife from the hospital after learning that it was twins, but I quickly learned that that wasn't an option. Twins got OBs or Peris, but not midwives anymore (at least here in Portland). I knew if I was in the hospital I couldn't labor in water, and really couldn't birth in water, and that I'd be in the OR. I think you are having the same mind experience as I was. So then it becomes finding a midwife whom you like and Also one who has twin experience, and experience in general. So hard!!! I really wanted twin experience from my MW, and I learned that in Portland, most of the MWs had about 12 twin births under their belts. My MW told us about some of them, and the one that stuck with her was the double footling breech baby A (sound familiar, Chantel?) and the baby B coming 4 hours later w/posterior presentation and some other complications. They might have used oxygen on the baby, or babies, I can't remember, but in all cases, there were no long term consequences from the births. My MW and I agreed that we wanted vertex/vertex babies, and even checked by u/s the morning of the birth. So, long story short, I personally felt good about my MW's experience. I think she had been in for 17 years or so, and had twin births, and challenging ones, under her belt.
So back to my "it can't be easy" statement, my dear friend pointed out that maybe the universe was getting me ready for multiples, and not just in the "it's hard" sense, but in the sense that there was more physical pursuing of research and facts as well as continuous mental debating going on and ultimately basing your decisions on all the facts and how they resonate in your being. I think that twins are really special, and at the risk of sounding sappy, I think that mothers of multiples are faced with really tough choices and are really special as well. It's hard to hold such an openness to all possibilites from homebirth to hospital birth to c-sections, and so on. Kjoy was always great about affirmations, and I think that this would be a great time to employ some, so that the perfect birth scenario will present itself to you (and hopefully w/o much work). Keeping you in my thoughts.....
post #59 of 81
Thread Starter 
Quote:
Originally Posted by mamaeliz View Post
I knew if I was in the hospital I couldn't labor in water, and really couldn't birth in water, and that I'd be in the OR. I think you are having the same mind experience as I was. So then it becomes finding a midwife whom you like and Also one who has twin experience, and experience in general. So hard!!! I really wanted twin experience from my MW, and I learned that in Portland, most of the MWs had about 12 twin births under their belts.
Oh you are so right on with your post. Seriously, you pegged me exactly where I'm at.

The problem I have is NO midwifes have even 12 twin births under their belt. I'm curious about the MW I meet with tomorrow, she's pretty experienced. She's been licensed since 1989, has had all three of her own children at home and has been a teaching MW for many years.

I can honestly say, in our rural area of So. Cal, home birth isn't something most pregnant ladies even think about, especially if you have twins. The C-Sect rates are hight at all the hospitals within an hour of us. I mentioned home birth on the forum for the Moms of multiples club I just joined and it was amazing how there were no comments for a long time, then one person said, "she didn't think it was wise and would never consider it" and then the flood of negative comments came. They were worded as to try to be supportive, but is was so obvious that they thought I was a nut job. Now I'm sort of feeling unwelcome in the club and I could really use some support for when the babies to arrive.
post #60 of 81
I haven't read everything but wanted to reply.

My midwife for my first 3 babies was retired when I was pregnant w/ #4 (which became #5 too). Thinking I was only pregnant w/ 1 baby, I decided to use the midwife who pretty much did everything at my third birth (at the time she was apprenticing w/ my now retired midwife). So, she did not have a lot of experience let alone twin birth experience. When I found out I was having twins, recovered from the shock, realized I didnt haveto have the babies at a hospital, I stuck with my midwife-- who did not have a ton of birth experience and had only helped out at a triplet homebirth. She had only had extensive classes about twin birth at The Farm w/ Ina May. And what they are told there is "Please stop sending us your twin birth mamas, twin birth is simply a variation of normal".

So, what I did was made sure that the other midwives that would be her team were VERY experienced midwives with a lot of breech presentation and twin birth experience.

Honestly, it was so up in the air b/c of positioning, the homebirth wasnt a complete go till the day of the birth. My babies were transverse up till the last few days. Looking back, my team was perfect. : But b/c I did not have a for sure head down twin A, not one other mw in my area would help at my birth. The super experienced mw's came up from a city an hour away.

Also, if I had my pick, i would want my mw to have had children herself. i think experiencing labor and birth on a personal level has a lot of importance.
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