okay, so I still haven't mastered mutiquote, so here goes
Nanette- I'm so glad that your peri appt went better than expected. What a relief. In my last two pgs I've seen: 2 CNMs, 1 OB, 1 peri and 1 ULMW so I've got a pretty broad sample of the feel of HCPs. I gotta tell you, tho, I'm super impressed by my peri this pregnancy. I had not intended to stay w/ him after I was viable-ish, but I've been so happy there that I'm totally going to. ymmv, of course, but here's what I like about him compared to the MWs I did most of my last two pgs with: he's completely hands-off. If this were my first pg, I'd probably be stressed out about it, but it is so nice to be able to basically take care of myself and have someone there when I need a medical license or a US, yk? He has a CNM that takes his calls and I love her, so that helps, too. He really respects me and my ability to be pg and he totally doesn't interfere unless I ask him to. (this is all said w/ the disclaimer that I know that I'm in a much greater setup for birth intervention with him). Because peris are inherently high-risk docs and twin mamas are not really that high risk in comparison to their other moms, he's just not stressed out about my pg, and, as a result, neither am I. OTOH, I love that when I am stressed, he doesn't try to talk me down and he will do whatever intervention-y thing I want to make myself feel better (an issue I butt heads w/ ULMWs about. sometimes, I don't want a hug, I want an US ). I've found that, since the peris are the top of the medical food chain and they don't have anyone to answer to (as in, a CNM has to consider her back-up doc and an OB has to consider the peri) they pretty much don't mess around w/ you for other people's sake (a personal experience of mine w/ a CNM and her backup doc....) and there's just not as much CYA going on bc they don't answer to anyone except themselves
Anyway, I'm particularly happy bc my peri is one of the few HCPs who will do a breech delivery in my state (as long as babyA is head down). All that said, I hand-picked my peri bc he is known as the most "liberal" OB in my area and he is the one the CNM that I love transfers her moms who risk out of homebirth to. That, in my mind, is a good recommend. I hope you have as good of an experience.
The one thing I'm afraid of that you might want to check into- my peri attends 70-80% of his clients' births. I'm freaking out about what will happen if I can't have him for the birth, bc he's in a big practice (18 docs; teaching hosp) and I know labor is not my preferred time to fight battles...Also, FWICT, I'm not going to be able to refuse an IV hep lock, but I'm a really hard stick, so despite my absolute hatred and sadness over about it, I don't want to be w/o one, anyway, should anything need to be done emergently for babyB (bc I'm for sure declining and epi and I don't want them to knock me out bc they can't get an IV in).
Liora- I'm declining vax and eye goop, for sure. I'm not declining Vit K. I totally respect that it is a itty bitty-to-non-existent risk esp w/ a term babe, and, it is my own baggage that keeps me from declining it (I've seen a baby die of hemorrhagic disease of the newborn). You should for sure be totally fine declining those at termish. As far as declining it if they are preemies (which they won't, won't, won't be!!) hmm; you will be fine declining vax and goop, tho I'd make sure someone at your delivery knows to make noise about it so that the NICU doesn't go on autopilot and do it in the chaos (I'm thinking about giving a note to give to DH to send w/ the babes)... IDK about the vit K, TBH. It gets sticky if they are admitted to the ICU, but you are still the parent and have a right to not have things done to the babe w/o your consent... IME, it is probably governed by hospital/NICU policy bc I know I've been places where that would have been no big deal, but others where they would have done it for sure. If you are worried, I bet you could call the NICU and ask to speak to a neonatologist about in what situations it would be possible for you to decline.
oh! I just had a thought. If you are at risk of PTL or in PTL, the NICU should come to talk to you before the babies are born. Some NICUs want a consent signed then- read it, even if you are in hard labor and just want the babies saved, bc some consents essentially consent for the NICU to do anything they want, while others are better, IMO, and consent for only what procedures they think the babes might actually need. (then you consent for things along the way) That would be the place to tell the NICU what you don't consent for. Also, you can check in w/ your ped and see who actually will be caring for your babe. As in, at the hosp I will be delivering at (ugh, I hate saying that) my pediatrician has privileges and will actually be the baby's doctor even in the NICU (and he's super non-intervention and knows me, so that is a huge help). Some peds don't do that, tho.
okay, I'm rambling. I actually came here to whine about my sob story of a night.
I'm not getting better. I'm having (SUPER TMI, sorry) watery diarrhea. I have been all week, but it was so bad last night that between that and puking more this week, I hadn't even kept fluid down for 24 hours. So I went to OB emergency (a wing of L&D here). It took them six hours and six IV sticks to get me hydrated. Blah. I'm going back tomorrow for more fluid, then Monday for fluid, then appt on Tues to talk about "options" if I'm not getting better. (I'm below pp weight again, mamas. ugh) The weird thing is I don't think I'm actually "sick" w/ something- as in, I don't think I have an infection or a virus. I don't feel bad except for the fact that everything I put in comes right back out. weird. Then, when I came home from OB at FIVE THIRTY A.M. Both of my children were awake and DH was sound asleep, so I spent the next hour settling kiddies in... ack!
oh! and I'm not having PVCs, I'm pretty anemic all the sudden so what I'm feeling is anemia turbulence. Kind freaks me out, actually, bc I wasn't anemic last week and now I am.
How did women have twins pre-medicine? this is an honest question, bc I trust my body and I trust my babies and I trust the process, but I truly feel like there are many points in this pg already where I would have wasted away and died if I didn't have Zofran, Phenergan and an IV....
blah. whine. I'm thirsty and I can't keep fluid in. Gotta run. Best to you and babes.
other twin mamas- what are you planning for births? How are you all doing? Hope, you are planning a HB, right?
Edited by babygrey - 12/3/10 at 3:54pm