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need to labor in the OR for twin birth??

post #1 of 30
Thread Starter 
I'm in Florida where it's (apparently) against the law for a midwife to attend an out-of-hospital twin birth. The hospitals around here will require me to birth both babies in the OR. I believe that I am "allowed" to labor in a normal room, however.

My question is this: what do you think will happen if I refuse to move to the OR?

I already plan to refuse the epidural catheter and an IV. My goal is to make it as hard as possible for them to bully me into a c-section.
post #2 of 30
Aaaahhhh, the challenges of just trying to deliver your twins! I hope all goes as well as can be. I was told that I'd have to labor in the OR, as well as birth there, but they changed their story the week before the birth. I seriously couldn't imagine doing it "naturally" if I had to labor in the OR. We were lucky enough to be in the right state (Oregon) and to have AWESOME midwives attend us. I asked all that I could about refusing things to our perinatologist, but it's pretty exhausting to always have to refute things. I know some mamas on the board here have made the best of their hospital births, so I hope they will help out.
Hugs, mama!
post #3 of 30
Nada, just I was so thankful to be in Texas when I had my twins. Birth should not have to be a battleground.
post #4 of 30
... see next post below
post #5 of 30
Originally Posted by Night_Nurse View Post
Can you hire a doula to help your wishes be known on the big day? My advice is to labor at home for as long as possible so your battles are kept to a minimum. As a patient, you always have to right to refuse something but I'm guessing you will have to preregister at the hospital and they'll know you are coming in with twins. So they may refuse to put you in any available room other than the L&D OR when you arrive. Also, hospital staff are more willing to skip protocol (if possible) if your OB is on board with the plan. Ask your doctor about birthing in a regular room and for him/her to write it as an order for L&D. That will make it a much smoother process. Good luck!
Sheesh! Nevermind...it's really late and I misread your post. I thought you meant you'd be required to labor and birth (not just birth) in the OR. So none of my suggestions really make sense (except maybe for the doula but I'm not sure if they'd allow her in the OR). I'm sorry. I have no idea except maybe convince your doctor to let you birth in the L&D room and just have the OR set up on stand-by for an emergency. I'm pretty sure they'd be more open to this suggestion though if you allowed the IV.
post #6 of 30
I delivered my twins vaginally in an OR -- however, I was young and not well informed and didn't know much about birth. If I could go back, I would have done things differently. If I were pregnant with dichorionic, diamniotic twins, I'd have a homebirth. Even if midwives can't legally attend you, you can find one.

If you "refuse" things, the worst case scenario -- which has been known to happen! -- would be a court order against you, CPS, all kinds of drama.
post #7 of 30
I plan on refusing the OR birth. I will inform my OB of this tomorrow. I discussed everything with him early on in the pregnancy and just kind of held in what I was really thinking ... knowing that making a battle out of it early on wasn't going to get me anywhere. So, I plan on telling him that I'm not birthing in the OR, doing the GBS, or being induced at 38 weeks. From the birth stories that I have read, MOMS who birth in the OR are surrounded by 20 different ppl who are all ready to whisk the babies away, or they are experiencing extra pressure to take interventions. No thank you! I'm healthy, the babies are healthy, we always have been healthy ... no need for all this extra attention.

I like what a previous poster said .... birth shouldn't be a battleground... and it does get exhausting have to fight all these battles.
post #8 of 30
I haven't any great advice, but I have a similar situation, and here are my thoughts.

The first OB I saw (who discovered the twins) insisted that c-section was really the way she handled twins. She would allow me to try for vaginally if I was set on that, but she has never had a mother successfully deliver twins vaginally. She absolutely does not let twin mothers go beyond 38 weeks. She offered that we could schedule that very day (this was at 10 weeks ... I suppose that with week 38 being Christmas week, she was being nice in offering me a chance to plan my holidays!). And by the way, I was gaining too much weight, therefore she recommended a low-carb diet.

I began looking elsewhere. I discovered that here in Maryland, CNMs can't do out-of-hospital homebirths. In fact, the high risk cases are cared for by the OBs. The CNMs participate, but they are not in charge. And with twins, I found that I am always considered "high-risk" and treated a bit like a walking time-bomb! The first CNM I talked to quietly gave me the name of a CPM (not recognized here, legally) who has lots of experience with twins.

I got on MDC and sought advice from other people in my area. I managed to find a hospital with a group of CNMs and OBs that are not quite so c-section happy, but they still like OR for delivery. And the same CPM's name kept coming up.

In the end, I have decided that when in labor, I will hardly be up for fighting hard for what I want (natural, vaginal, no OR). This pushed me to settle on home-birth with the CPM. But I am doing parallel care with the CNMs/OBs that I liked pretty well. This way, I stay on good terms with the hospital folks. My CPM and I have talked about the situations where she or I would not be comfortable with HB.

For now, I am just doing my best to myself and these babies healthy, and for as long as everything looks and feels right, I will be planning HB.
post #9 of 30
Just chiming in to say birthing in the OR ended up being no big deal for me. I thought it would be. I thought the NICU team and all the people being there would bother me. None of it mattered by the time it was time to deliver. But I had a wonderful quiet labor in the room next door, with one amazing nurse and my DP, and I told them when it was time to push, and in I went to the OR, still in that labor zone, and 30 minutes later, there they came. And I didn't really notice the "crowd" in there.

My Twin B needed a little help at first, too (just some O2... she presented with two feet and a fist and ended up being a double footling breech extraction), so having the NICU people there was better than having her whisked away.

So I am just saying if you *have* to deliver in an OR, it can still be a great delivery.
post #10 of 30
I delivered my twins in the OR. But it all went fine and really was no big deal. I had delivered naturally with my older dd (at the same hospital and with the same ob/gyn) and both twins were head down, so my docs saw no reason I couldn't deliver vaginally with the twins and told me to "go for it". So I actually had quite as natural a birth as possible, just in the OR. My docs were just erring on the side of caution.

NICU was standing by, but really were not needed. My twins were monitored in the NICU for less than a day and then came back to my room to stay with me. I was very fortunate and am grateful.
post #11 of 30
I gave birth in an OR and it was less than ideal... but there were MANY people there since it was a premature birth and the lights were very bright... they tried to get me to get off of the hospital bed and onto the metal operating table with no sides and I flat out refused. (I mean, are you kidding? Who can give birth on a cold table with no sides with bright lights and all of these weirdos staring at her?!?) I can laugh only b.c I am happy I had a vaginal delivery and despite all of these factors it was still the best day of my life. But all of these factors made it ideal conditions for this mama who dreamed of no drugs to cave and have an epi when she was 10 cm dilated and ready to push.... I was like a deer in headlights!

I would refuse to go to the OR if I were term... the scare tactics got me. Blindsided is a good way of putting it!
post #12 of 30
Well...my certified nurse midwife informed me quite some time ago that they require her to delivery all of her multiples in the OR. I will be able to labor in a regular room, but once I get close they will haul me off the the OR for any "just in case" situations. She said it won't really be a big deal and they can still keep the lights down and I have play my music and whatever. It must be a pretty serious law/rule cause I know like with the erythromycin in the eyes thing, I am able to just sign an AMA form so they don't do that. But, pretty sure they will not change their minds about the OR thing. Oh well, it doesn't seem like a big enough battle for me to fight, since my midwife made it sound like it wasn't really a big deal.
post #13 of 30
Thread Starter 
Those of you who have already given birth in the OR--was everybody suited up in caps & masks? That would freak me out.

My only other child was a homebirth, so I'm really kind of a novice about how hospital births work. I'm really comfortable signing any AMA forms; so is my husband.

I have an appointment today with the OB, and I'll try to ask her some questions in a calm and non-confrontational way (and then I'll come home and cry and slam doors or whatever).
post #14 of 30
Originally Posted by verycozy View Post
Those of you who have already given birth in the OR--was everybody suited up in caps & masks? That would freak me out.
You know, I don't even remember... clearly I was focusing inward and not on "them"... I can't even picture it in my head (although I can remember still, four years later, the amazing feeling of Twin B moving around after Twin A was born! And the thrill and "are you nuts" feeling when I heard "She looks beautiful (Twin A)... now let's do it again!"

I know, that's just one person's experience (one who had a low key OB who had TONS of multiples experience) and others have had MUCH more invasive experiences... but I definitely thought delivering in the OR would bother me and when the time came, I clearly didn't notice much about it at all! Good luck, mama...
post #15 of 30
I was a planned HB turned hospital transfer w/my twins. We had a very supportive OB w/lots of twin experience at a fairly laid back hospital. I was full term.

Here are some answers to your questions:
I don't remember masks... no, no masks. The MW and my DH had to put on those cheap scrubs, but I wasn't focused on the fact that they looked like smurfs.

Moving from the hospital bed to the operating table was stupid. I remember thinking, 'You've got to be f*cking kidding me.' So, yeah, if you can avoid shuffling on your back from a bed to a cold, hard table while contracting and pushing, I highly recommend it.

I remember thinking that there were not that many people in the OR. I suppose it was b/c I was full term and the OB was rather relaxed.

I had feared and dreaded an OR birth, but it really was not bad. As w/Louis Lane, I was too 'in the zone' and was able to labor mostly at home and then in an L&D room until it was time to push. The worst part of it, to me, was the fact that the hospital staff whisked the babies away to the other side of the room as soon as they were born, to weigh, measure, & suction. I didn't see the babies until after they were already wrapped up in blankets. Bleh. I don't like to look at the OR photos b/c there is one of twin B laying in a pool of blood between my legs, on the metal table, immediately after the breech extraction. She should have been handed to me. So if I had to do it again*, I would make sure that the babies were handed to DH or I immediately after birth and insist that the weighing and measuring wait for at least 20 minutes or until we were ready for it. I would have more talks w/my OB in case of hospital transfer to assure that a hospital birth would be as "nice" as possible.

*If I had to birth twins again and they were di/di, I would find a competent provider & plan a HB or travel to the farm. If they were mono/di, as mine were, I'm not sure if I'd plan another HB.
post #16 of 30
Thanks for all the responses and experiences, as I'm facing the same situation.

My mw will be with me in a labor room until I start to push. Then I'll be transfered to the OR where my OB will meet me. I'm ok with that, since they are so laid back. My impression is the midwife can even deliver, so long as there are no complications. I will check on staying on a l&d bed vs. the table and about holding the babies immediately.
post #17 of 30
Originally Posted by verycozy View Post
Those of you who have already given birth in the OR--was everybody suited up in caps & masks? That would freak me out.

My only other child was a homebirth, so I'm really kind of a novice about how hospital births work. I'm really comfortable signing any AMA forms; so is my husband.

I have an appointment today with the OB, and I'll try to ask her some questions in a calm and non-confrontational way (and then I'll come home and cry and slam doors or whatever).

I remember DH being in scrubs. You know those green pants and tops and a cap, but I don't remember a mask.

Honestly I don't remember much about anyone else.

I DO remember singing along with the a Journey song that was playing in the room, which made one of my nurses laugh and say I must be relaxed. And I DO remember chatting with my OB about buying a house, because his wife was a real estate agent.

So really all in all, it was quite a comfortable situation. No trauma, just a great birth. My babes were 8 minutes apart though, because I was TIRED after pushing out DS and I needed to rest a bit before pushing DD.
post #18 of 30
I birthed in the OR as well with no big deal. Lots of people who were really bored- the OB, the anesthesiologist, the surgical team, the NICU team...all standing around with nothing to do. I was lucky that they had just installed new padded operating tables, so no cold metal for me!

That is one thing I would add, be ready for a super cold room. My MW had them bringing warmed blankets to me every 5 minutes.
post #19 of 30
I gave birth naturally to my mono/ di twins in an OR after laboring across the hall in a normal room. There were a ton of people in the room and only my husband for comfort. My twins were small so had to go to the NICU and out of the whole experience I'm still haunted by the fact that I didn't get to hold my first or really see him and that we weren't allowed to take any photos of their amazing birth. Other than that, I feel like where you labor is more important for healthy unmedicated birth than where you deliver- and having your HCP/ doula advocate for you.
post #20 of 30
I delivered my twins vaginally, in the OR, with one being a breech extraction. No worries on laboring in the OR, since I did all of that at home. (showed up crowning Baby A)

You know my answer to everything .... if you stay at home as long as you can, you get to eat, walk, and labor as you wish.
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