Twins -- C-Section/Vagina - Page 2

[thepoet]

Originally Posted by L.A.Mamma

Talula: "If it were me, I'd do everything in my power to get those babies out of my vaj, even going so far as traveling to a midwife who will do it naturally." I respect that. Unfortunately, I don't feel comfortable with having a midwife delivery vs. an OBGYN. I have too many doctors in the family that have shaped my way of thinking. Not to disrespect midwives -- it's a wonderful service they provide, unfortunately not for me.

So you're letting your family's opinion shape yours of midwives? May I suggest that you actually meet with a midwife for a prenatal visit so you can form your own opinion of them instead of using someone elses.

[Jilian]

I didn't read all of the replies but here are my thoughts:

- There are far more complications that can arise from a cesarean for both mom and baby, which makes it a lot more risky

- With a cesarean birth a majority of the time you don't get to see the baby for quite some time after. In our local hospital it is a minimum of 4 hours until you can see the baby, this is common.

- On average twins tend to be smaller than singletons, and a smaller baby usually reduces your chances of tearing.

Tearing: I swear that my vagina is made of paper because it rips to shreds during birth. But they stitch me up, I invest in earth mama angel baby bottom balm, and do pp soaks and all is well. It is really only a PITA for the first 5 days or so. After 2 births and two pretty hefty tears all is well with my va-jay-jay. BTW, a 4th degree is very, very uncommon unless you have a vacuum delivery, forceps delivery, and/or episiotomy. DO NOT OPT FOR AN EPISIOTOMY EVER!

Honestly, I think vaginal delivery is a pretty damn awesome experience. I've done it without meds twice and it wasn't so bad. It feels good to know that your body can accomplish such an amazing thing. Nature made babies come out of vaginas for a reason, cesareans are best left as an emergency and life-saving tool.

[snowmom5]

Originally Posted by ChichosMama

That being said I would never have a baby in a hospital again. Its totally unnecessary, it saddens me that you think otherwise.
It seems to me you have not truly researched the possibilities. You need to read up. Mothering has great past articles where they actually cite sources. You need to research both sides without bias. This is so important.

I think it's going a little too far to say that birthing twins in a hospital is totally unnecessary. Without getting into a large debate (not my intention), at least consider the fact that half of all twins are born pre-term and thus it's possible that, in fact, it might turn out to be quite necessary in the OP's case.

[wombatclay]

Ok... I did read the whole thread. And I do hope that everyone stays gentle and on topic... there is a whole (very passionate) debate just waiting to pop out here and I don't think that's what the OP needs or wants!

~~~~~~~~~

OP- I would second the suggestion that you explore care provider options. Perhaps attend a local ICAN meeting (the mothers there tend to know which care providers/hospitals are all talk, and which ones will actually listen to you). The multiples, vbac, and birth trauma forums here at MDC might be good places to visit as well. However, I totally understand having been told something over and over and over and accepting that 9 months just isn't enough time to change. It's worth trying out different scenarios in your mind, just to see how they feel... be open to the options, but go with what you are truly at peace with! (and again, the forums I mentioned above might help in giving you the details to "flesh out" those different scenarios)

And for a slightly different perspective. I've had both a c/s (with my first babe) and a 4th degree tear (with my vbac babe). Both were unpleasant and painful, but the recovery time from the 4th degree was a lot shorter and I felt less "disabled" during the recovery process. So barring medical need I'd personally avoid a certain c/s when the option is a possible tear. And yes, I realize that tearing is a fear and not a deal breaker! But it's something I have experience with so I thought I'd chime in.

Also, research is just showing up to suggest that c/s doesn't actually protect the pelvic floor and might even increase your risk for pelvic organ prolapse. It's all in the "early days" of the research process, but prolapse rates in young women are soaring and the ever increasing c/s rate seems to be one of the few factors that could account for the increase. (which makes a certain sense if you consider the fact that in a c/s the bladder is moved, pretty forcefully, out of the way and as a result it may be more prone to "falling" in the future). In my case, I do have pelvic organ prolapse, and it's been attributed to the c/s, not to the vaginal birth (even with the tearing). So while many OBs suggest automatic c/s for women with prolapse, I'm opting out of the surgery since that's what started the whole circus to beghin with!

Anyway, I just wanted to chime in with that tidbit... a c/s does mean you wont have a baby passing through the vagina, but it doesn't mean you wont have a significant "change" to the pelvic geography. If anything, a c/s is a bigger shift for your body to adapt to.

[Talula Fairie]

Originally Posted by L.A.Mamma

Talula: "If it were me, I'd do everything in my power to get those babies out of my vaj, even going so far as traveling to a midwife who will do it naturally." I respect that. Unfortunately, I don't feel comfortable with having a midwife delivery vs. an OBGYN. I have too many doctors in the family that have shaped my way of thinking. Not to disrespect midwives -- it's a wonderful service they provide, unfortunately not for me.

I would research this yourself if I were you.

Here's some bullet points you might find interesting:

The US has the second worst infant mortality rate in the developed world. If you look only at the countries that had at least 400,000 births, it's ranked last.
http://www.cnn.com/2006/HEALTH/paren...mothers.index/
https://www.cia.gov/library/publicat.../2091rank.html

The US has one of the worst maternal mortality rates in the developed world.

In every other developed country (except Brazil, and they are the ones with the worst infant mortality rate in the developed world) including Great Britain, France, Germany, Spain, Holland, The Netherlands, Japan, ect...midwives attend 70 to 80 percent of all births, and the OB/GYN doctors are there to attend the smaller percentage that develop complications. This is the proven system, and the US stands alone.

Birth with a midwife (at a birth center or at home) is proven to be as safe if not safer than hospital birth. Midwives come to your house with pitocin, items for infant resuscitation, dopplers, other drugs for postpartum hemorrhage, oxygyn, ect. The myth is that everything has to go perfectly well and that a midwife isn't trained for complications, but actually, they are just as trained in birth if not more so than OB/GYNs (the exception to this would be surgical procedures of course, which is what OBs are specialized in. In fact, that's what they're best for). Most OB doctors have no idea what the Gaskin maneuver is, for example.

Midwives know all kinds of tricks like that for getting a baby out. Most OBs also have little training if any at all in vaginal breech birth, whereas midwives do. And if there is a point where a midwife realizes the woman needs intervention, they are trained to make the judgment call in time and transfer to a hospital.

This is YOUR baby. Not your family's baby. Most doctors don't have a high opinion of midwifery in general...but you know what? Most doctors are wrong. If they weren't? The US would have the #1 infant and maternal mortality rate in the world, since only 8% of US women deliver with a midwife (and of those, only .05% deliver at home). And we don't.

But don't take my word for it. Read some books on it! The Thinking Woman's Guide to A Better Birth is a good place to start, as well as any article about birth in Mothering or any of the Mothering books, and Ina May's Guide To Childbirth. You may also want to watch The Business Of Being Born and Pregnant in America. Check out some informative websites too, this forum is great as well as gentlebirth.org which lists many of the studies in relation to the safety of midwifery.

I would just like to add that whatever you want to do is your choice, and I totally respect either decision especially considering your situation. I just want you to make that choice based on accurate information, not what people are telling you. And like I was saying, don't just listen to me. Do some research yourself on it. And do look into different care providers, especially if you don't feel comfortable with your current one.

[NaturalMindedMomma]

Originally Posted by snowmom5

I think it's going a little too far to say that birthing twins in a hospital is totally unnecessary. Without getting into a large debate (not my intention), at least consider the fact that half of all twins are born pre-term and thus it's possible that, in fact, it might turn out to be quite necessary in the OP's case.

Twins are notoriously preterm because moms are almost always induced. Your lucky to get to 36 weeks without some "problem" some are real, some are not.

A normal healthy twin birth in the hospital IS unnecessary. Most Homebirth midwives will not attend before 37-38 weeks at home.



To the OP- A brilliant Dr (no offense) would not blindly recommend a c section at this point in pregnancy. You have no current factors that would decide a C section is better. Birth was always attended by midwives until Dr's realized they were missing the monopoly on that part of the market (they claim they wanted to improve outcome which is funny because we have a high maternal/infant mortality rate, I think we are second?). You will most likely have a C section if you are attended in the hospital and will almost certainly have one if attended by your current OB. She is blatantly telling you a malpractice suit is more important than what research says is better . She cares more about her bottom line than your gynecological and obstetrical health at the end of the day.

Midwives are amazing and if I were you I would take into consideration that someone who has something to lose and may have a huge bias may not be the best person to ask for advice, KWIM?

[holyhelianthus]

Originally Posted by L.A.Mamma

Thanks ladies! Lots of invaluable information.

My instinct is that vaginal is better. But the first issue I have is that my OBGYN will not do a vaginal delivery if one baby is in breech (for reasons discussed above, i.e. malpractice). So the question is do I continue with this OBGYN? My gut is saying yes. Also, I only want to deliver at a specific hospital at LA, my thoughts are that it will be very difficult finding a OBGYN that would deliver a breeched baby. The idea of changing up my OBGYN/MFM team is daunting. I'll have to reflect on this.

Now I agree with everyone, 2 babies head down, w/o any other medical complications seems like a no brainer. I'm not denying being scared sh*tless, but my decision can't ever be motivated by fear. I agree, what's difficult at this point is trusting my body. After infertility, it's been tough having faith in my body. But I'm joining a women's circle here in LA and I think it will help.

I've got to do tons of research. My brother-in-law is a brilliant doctor and he really is advising for a C-section as well. It's hard to not put a lot of weight on his advice b/c I trust him. Still, it's my decision to make. I know my husband is on board with whatever I choose.

I'll do my research. And be prepared for whatever happens in this pregnancy.

This is my situation. I have had one epidural vag in the hospital, 1 "natural" hospital birth, and one homebirth turned hospital transfer that was still as natural as it can be in a hospital setting.

That all said I am OB/hospital birth all the way with these twins. I know that the doc will not deliver a breech baby even if A is head down. It'd be great if he would but honestly sometimes OBs with a higher risk of a section are better than the alternative. Disagree all you want mamas, frankly you aren't in my shoes. I am coming from a traumatic birth stemming from a very abusive midwife. She is the only one within 2 hours in my area. Even if I did go nuts and decide to use her again she does not deliver twins (that one was a red flag when she told me during baby #3's pregnancy). I do not have the money, the emotional strength, or the want to go to another midwife 2 hours + away. Twins sealed the deal for me as my grandmother had 3 sets and out of all 3 only 1 baby made it. I am scared to death of giving birth again and even more so to TWINS!!!

Now my gma's situation was something totally not likely nowadays (this was in the late 50's early 60's afterall) I realize. I also realize a c-section is no walk in the park. I also love midwives (just not the one I had :Puke) and under different circumstances would jump at the chance to use one. When we thought this pregnancy was a singleton we were planning a UC.

My point is that you have to find your own ideal. People (especially mothers) are full of opinions but they don't mean much when it is happening to you personally. I would most certainly do research on every option. Even if you don't want to UC it could be something that just happens for you so look into it! Be prepared! Even mamas going in for the natural experience may end up with intervention so prepare for that too. Cover your bases. And then really look inward and you will know.


Besides all that c-sections are going to cause more physical damage and I and several people I know personally (not all female) like vaginas after birth more so then before

ETA- don't force yourself into any birth environment! Midwives are great but only if you are comfortable and calm with them. If a homebirth is a source of stress for you it's not a good idea.

[holyhelianthus]

Originally Posted by snowmom5

I think it's going a little too far to say that birthing twins in a hospital is totally unnecessary. Without getting into a large debate (not my intention), at least consider the fact that half of all twins are born pre-term and thus it's possible that, in fact, it might turn out to be quite necessary in the OP's case.

That is true. I know in my case I have small babies so there is some concern over getting these 2 to grow grow grow. I also have only carried 1 of my 3 babies to 40 weeks.

[Talula Fairie]

I don't think anyone here is faulting or would fault you for your choices, magstphil.

All we were saying is that the "midwives are not as good as doctors period" message is inaccurate.

Also, who said birthing twins in the hospital is "totally unnecessary" ? I don't think that's true. That's an awfully sweeping generalization, too.

[holyhelianthus]

Originally Posted by Talula Fairie

I don't think anyone here is faulting or would fault you for your choices, magstphil.

All we were saying is that the "midwives are not as good as doctors period" message is inaccurate.

Also, who said birthing twins in the hospital is "totally unnecessary" ? I don't think that's true. That's an awfully sweeping generalization, too.

I'm not disagreeing.

But there are plenty here and in the Natural Birth community as a whole who would and have faulted me. That's just it, for some people even a NATURAL birth in a hospital setting isn't good enough and for others it's the only thing they are comfortable wit h (and that's just to name 2 options). All I'm saying is to each their own and look into every option just in case.

[FernG]

OBs in L.A.

I would consider interviewing some other OBs. I don't know which hospital you are wanting to deliver at, but I know that some OBs at Good Sam will deliver vaginally when Baby B is breach.

[Talula Fairie]

I'd be pretty surprised to see that on MDC specifically, and if you did, the mods are pretty good at taking care of stuff like that.

I don't think it's the natural birth community that's like that, I think it's the INTERNET that is like that. People are mean on the internetz!

I agree, look into every option. That's what I was suggesting. I only wish I had looked into -and could have afforded- other options when pregnant with my first and second baby.

[ChichosMama]

Originally Posted by snowmom5

I think it's going a little too far to say that birthing twins in a hospital is totally unnecessary. Without getting into a large debate (not my intention), at least consider the fact that half of all twins are born pre-term and thus it's possible that, in fact, it might turn out to be quite necessary in the OP's case.

I didn't say twins. Must I really point out that this is for the majority women? Really? Okay.

Unless you/baby has a serious medical condition(you and/or baby will CERTAINLY die if you don't have c/s), birthing in a hospital is totally unnecessary.

[holyhelianthus]

Originally Posted by ChichosMama

I didn't say twins. Must I really point out that this is for the majority women? Really? Okay.

Unless you/baby has a serious medical condition(you and/or baby will CERTAINLY die if you don't have c/s), birthing in a hospital is totally unnecessary.

Well in that case birthing with a midwife is also totally unnecessary.

Unless of course mama is more comfortable with either option which is helpful in creating a safe birth as much as anything.

[holyhelianthus]

Originally Posted by Talula Fairie

I'd be pretty surprised to see that on MDC specifically, and if you did, the mods are pretty good at taking care of stuff like that.

I don't think it's the natural birth community that's like that, I think it's the INTERNET that is like that. People are mean on the internetz!

I agree, look into every option. That's what I was suggesting. I only wish I had looked into -and could have afforded- other options when pregnant with my first and second baby.

I agree about the internet but no I have NB friends IRL who aren't too happy that I am not fighting tooth and nail/driving the hours to another MW to escape a c-section. I understand that they are looking out for my well being so it doesn't really bother me. I just wish people would understand things are not usually black and white.

[rhiandmoi]

My SIL delivered her twins vaginally, but they had to use vacuum extraction for TwinB, because he did not engage well and SIL was fairly exhausted at that point. TwinA is usually not the problem, unless that one is breech, it's TwinB that has a lot of the risk.

[ChichosMama]

Originally Posted by magstphil

Well in that case birthing with a midwife is also totally unnecessary.

Unless of course mama is more comfortable with either option which is helpful in creating a safe birth as much as anything.

What? My pregnant brain is not letting me understand what you are saying.

People do what they want, this doesn't mean it's necessary. Like, "I'm going to call a cab to drive me around, even though I have a car, bc I dont know this area very well." It's not necessary, but this is what the person wants to do.

[holyhelianthus]

Originally Posted by ChichosMama

What? My pregnant brain is not letting me understand what you are saying.

People do what they want, this doesn't mean it's necessary. Like, "I'm going to call a cab to drive me around, even though I have a car, bc I dont know this area very well." It's not necessary, but this is what the person wants to do.

In birth mama needs to be as comfortable as possible. A frazzled mama can equal a difficult birth and turn it dangerous. If mama is scared out of her mind to be out of a hospital then it's not a good idea to be out of one. If she walks into a homebirth scared and unprepared and freaking out it won't be beneficial to the process.

So in that case a hospital setting is necessary to that mama beyond the situations you named. Mama's well-being/peace of mind should be a necessity.

Hope that made more sense.

[snowmom5]

Originally Posted by NaturalMindedMomma

Twins are notoriously preterm because moms are almost always induced. Your lucky to get to 36 weeks without some "problem" some are real, some are not.

I don't know of any twin moms who were induced, so if you have a statistic on that I'd be interested to see it. Multiples tend to be born preterm because of preterm labor, which is by far the most prevalent complication of multiple pregnancy. See e.g. Barbara Luke, "When You're Expecting Twins, Triplets or Quads" (1999), (ch. 5).

For every twin mom who had a blessedly uneventful pregnancy to term, there is another one who did not. I did not. I did vbac them, at the hospital, after going into spontaneous labor due to a gross rupture of membranes (as in, they could see hair) at 33w. Oddly enough, of the twin moms I know, they seem to be about evenly split between those who delivered at 37 weeks and those who delivered prior to 34 weeks like me (some well prior).

Some docs do tend to be a bit quicker to section twins, that much is true - about half are delivered by section, I think. But I don't know of any docs who would deliver early over problems that were not real. The nicu experience isn't remotely worth it.

[Talula Fairie]

Originally Posted by magstphil

Well in that case birthing with a midwife is also totally unnecessary.

Unless of course mama is more comfortable with either option which is helpful in creating a safe birth as much as anything.

I think what she meant is that the hospital has all kinds of monitors, machines, nurses, ect...and you don't need all that for a normal, singleton, low risk birth. I do think you need a midwife there, however, because birth doesn't always go perfectly and you do need someone there just in case. I don't think saying a hospital is overkill means all birth professionals are always overkill. I know some women choose to UC, and to each their own. I think if you're well researched and prepared, that's fine. I personally wouldn't feel comfortable with it, but more power to women that do. And I can't speak for anyone else, but I've yet to see even a UCer say midwifes are totally unnecessary.

I agree that it's important for a woman to feel safe. Being afraid increases pain, not to mention decreases enjoyment.