How do I find a doctor?!

[JoyNChrist]

I've been seeing a midwife for this pregnancy. However, Wednesday we found out that we're expecting twins. That threw a wrench in my plans, and now I have to find a doctor.

My midwife is affiliated with an OBGYN practice, but their policy is that twins have to be delivered in the OR, they will only attempt a vaginal delivery if both babies are head down, and if Baby B turns breech after Baby A is delivered they do an emergency c-section (under general anesthesia if I don't have an epidural, which I don't really want). They also won't allow twin mothers to go past 38 weeks.

This seems kind of...rigid, to me. I was hoping for a natural delivery with this pregnancy, and while I know that things may not turn out the way I want, I would like to find a doctor who is supportive. Everything I've read about twins indicates that vaginal delivery is safe as long as Baby A is head-down...if Baby B is breech, he/she can usually be turned or delivered breech because Baby A has stretched things out (for lack of a more palatable term, lol). I would also like to go into labor naturally if possible, and not be on a doctor's arbitrary deadline. I just feel like with the practice I'm currently seeing, I'm going to be pushed into a c-section or an early induction.

There are two hospitals in my area with Level III NICUs (which is important to me with twins), and I'm comfortable delivering at either. I just don't know how to go about finding a doctor...I don't know anyone who has delivered twins vaginally (I only know two twin moms personally). Do I just start calling offices and asking to speak with the doctors or set up a consult? There are like 30 OBs in my area...how do I go about choosing the right one?

Oh, and it's not legal for midwives to attend twin deliveries in Louisiana, so that's not an option for me.

[Gena 22]

Oohh, my sister has lived in NoLA for the last decade, so I have a lot of love for your state, but it is pretty tough for birthing. Last I read, I think it has the highest c/s rate in the country, higher than NJ which is notoriously bad. So, I'm sorry to say you may have a tough time finding a good OB.

The standard advice I give MoMs in your shoes is to join your local twin club and ask around. Who had natural deliveries, at what week, good experiences, etc. That's still worth a try with you, but you might need to cast a wider net. Find a doctor who's VBAC and possibly even breech friendly, and she or he might be more progressive with twin births too.

FWIW - those practices ARE rigid. There are studies showing that in the absence of complications, twin delivery is optimal up to 40 weeks. And that vertex-breech birth is safe.

Here's my new fav article:

http://www.uptodate.com/home/content...=labordel/5122

[JoyNChrist]

There's not a twin or multiples group around here, but I did call the La Leche League leader today, and while she can't give out doctor recommendations, she suggested that some moms in their group may be able to give me some advice. So I'm going to their next meeting on the 4th to see if I can turn up anything there.

Yes, Louisiana is notoriously bad for birthing. Which is a shame, as we're right next door to Texas, which has very midwife and home birth friendly policies.

[verycozy]

I would think that a local doula would have a lot of experience with which OBs are birth-friendly and which are best to avoid. Also, it might be possible for your midwife to chat with you "off the record" about different OBs. She might also be able to attend your birth as a monitrice.

Good luck! When I was pregnant with my twins I felt really pushed around by my various doctors and their policies. Be strong!

[Gena 22]

Originally Posted by verycozy

Good luck! When I was pregnant with my twins I felt really pushed around by my various doctors and their policies. Be strong!

And it may not be legal for MWs to attend twin births, but is it really IL-legal? Sometimes there's some wiggle room. Just don't know, LA is a mystery. Maybe you could talk a TX MW into crossing the border, or find a friend in TX if it's close enough. If you wanted to get really adventurous you could birth at the Farm in Tenn., but that is an awful long way.

Good luck!

[cjcolorado]

You should also post on your "tribe" area here at MDC to ask around. I was put in the same situation here in CO and ended up with a fantastic OB. Best wishes!

[klocke]

I was /am in your same situation. I was seeing a home birth midwife until I was 20 weeks and my ultrasound revealed twins. I literally had to call 20+ OBs before I found one that was acceptable. I got a list of OBs in my insurance plan and just started calling and asking who allowed vaginal delivers first and added more questions if they said yes to that. Out of all of those OBs I called I only found two yes two that would allow a vaginal delivery. The dr. I am with now will let me go vaginally as long as baby A is head down (baby b can be breech). He also said he won't induce unless the babies show some medical problem like growth restriction. I had to compromise on delivering in the OR (I can labor in a regular L&D room but will need to push in OR) but they are going to allow my DH & doula be in the OR with me. Also he highly recommend, almost requires, and epidural in case there are complications and I have to be rushed into surgery or baby b has to be turned or something. So I did have to give in to some things but it is better than a c-section at 36 weeks which is what some of the Obs required. My dr delivers 4-5 sets of twins vaginally a year so I know he is willing to do it I'm just hoping that baby A will get head down because currently he is breech.

[MamaRabbit]

Charmie981 is a midwife in LA and may know of someone in your area or have the leads to someone who may know of one.