Birth decisions for a healthy (knock on wood) twin pregnancy

[noralou]

X-posted from "drug-free in the OR" thread:

I found out about 2 weeks ago, at an ultrasound at 25 weeks, that I am carrying fraternal twins. I had been pursuing a home birth, thinking I was carrying a singleton, and was very comfortable with my MWs and the whole situation. Now that I know it is twins, I am waffling between home birth and hospital every few hours. I'm driving myself crazy.

I had an appointment with one of the OBs from the hospital a couple of days ago, and he said they would not put me in an OR, but in a "special" room where they put moms with breech babies and twins. It is not a regular L&D room in that it is bigger, to accommodate more staff, and also there is equipment for anesthesia already in the room. Also it is next door to an OR. We'll have to go take a look to get a real idea what it is like.

I am so torn right now! The OB I met (MW's favorite of the out of the possible 4, and the only one I think I would like) sounded like he would honor my desire for natural childbirth, and sounds comfortable with flipping a breech or transverse Baby B rather than automatically doing a C/S. (as of 26 weeks, Baby A is vertex and Baby B is transverse.) I do worry that is just lip service and that I will have to constantly fend off an epidural, pitocen, etc. Also, there will be so many people in the room: two OBs (Anyone heard of this? I didn't think about asking why until later.), two pediatricians, an anesthesiologist, plus extra nurses. I would want my husband and a doula with me the whole time too. I don't know if I'd be able to tune out the "audience," and the hospital setting still strikes me as so scary. The OB said he is not willing to follow my case as "back up" if I am planning a home birth.

The home birth option still has so much appeal to me, but I am concerned about the need to transfer if something goes wrong during birth. We live 7 minutes from the hospital, and the MWs will not do a home birth if it's before 37 weeks or if Baby A is breech, or if I develop any of a myriad of health problems. In other words, they would escort me to the hospital unless everything looks as low risk as possible. Three midwives would come to my house together. I think they are wonderful, and their training sounds fantastic, but I don't think they have had much experience with twin deliveries. I'm having a hard time finding out how prevalent perinatal problems such as cord prolapse, placental abruption, hemorrhage, etc.

Besides DH, I have pretty much no family support for pursuing a home birth. My parents, in-laws, and sister all tell me they feel it is way too risky. Palpable relief in their voices when they hear I am considering a hospital delivery. I am trying to make an informed decision with just DH, but the lack of emotional support is really getting to me.

Anyway, too many topics and concerns for a single post, but this is what's on my mind today! I've been reading like crazy, trying to be as informed as possible. Thanks for reading my rambling freak-out. I hope it is coherent enough for someone to know what I mean! Anyone want to share how you made your birth decisions? Advice appreciated too. Thanks!!!

[ps4624]

I can't comment on twin birth specifically, but I can tell you I got a LOT of resistance about my home birth from everyone under the sun. My mom tried to stage a mini-intervention the week I was due! I ended up having a home birth and it was a lovely, empowering, peaceful experience. My only advice is to separate fear from what your heart is telling you and go with your heart. Your mama instinct will choose the right path for you and your babies.

Congratulations!

[Intertwined]

Huge hugs. I can't type much right now but did want to say that I, and others here, have had successful home births with our twins. I had 39 weekers at home with no majoy complications (and my Baby A was a breech, ankle first!). You'll find lots of support here, no matter what you decide. Congratulations on your twins. It's a wild and fun ride.

[Gena 22]

Wow, your OB and hospital sound unusually good!

I planned, and successful had, a homebirth specifically BECAUSE I was carrying twins. They were my first pregnancy and although I was leaning towards using midwives, when I was surprised with the twin news at 19 weeks my OB and hospital ramped up the intervention talk. I would have been induced and had to deliver in an OR, etc, etc, etc. My OBs paid lip service to respecting my wishes, but I heard from a L&D nurse that the hospital had an 80% twin c/s rate. I doubt whether some of my OBs had seen a vaginal twin birth, much less an unmedicated one.

My homebirth was WONDERFUL. But here are some things that helped me feel confident about it: like you I was very close to several hospitals. I could have been door to door in 5 minutes or less. I kept up parallel care, so if I had a non-emergency transfer I could go to my OBs, and so that if anything came up that changed my homebirth plans, I could seemlessly switch. But I didn't feel I owed my OBs any loyalty, so I had no problem just not showing up for appointments after 37 weeks. You might not feel the same way.

You have a tougher choice than most, because of multiple appealing options. Homebirth is incredible, but it sounds like you can't go wrong. If you do stay with your OBs, make sure to ask around and confirm. Join your local twin club and talk to other MoMs who delivered with them.

Good luck!