TWIN Homebirth and possible transfer poll

[~Adorkable~]

i know various versions of questions like this circulate frequently, this is kinda specific and I'm looking for some stats from a group of ladies closer to me than the average twin mom.

i would love to hear about these number once we take out a ton of ladies that never really made the choice for themselves or with options even in there mind, so i  come to you all

i guess what I'm looking at, is how likely with proper planning and midwifes around will a transfer be needed at the LAST MINUTE? i totally get that i can have things go in all kinds of direction, but how many things can really go.

EDIT TO CLARIFY: between the last two choices....

• **not critical** to me means that it is necessary medically but thankfully you have time to get to the hospital and are not in immediate life or limb threat (but might be if you wait too much longer)
• **critical** means that time has passed, you are hemorrhaging badly or someone is not breathing or getting oxygen and the time it takes to get to the hospital might seriously be too long.

I understand other folks have other feeling about these words, it just happened to be the ones i used, i would re-word the poll if i could but this explanation hopefully will suffice.

Edited by ~Adorkable~ - 12/6/10 at 11:01am

[mylilmonkeys]

I'm not going to vote, cause I don't fit the criteria yet, but we were originally planning another home birth.  I've decided against it only because of my location.  The distance to a qualified hospital is too far and the third midwife we would use would likely never make it.  I'm hoping that my water will break before contractions, so I can get down to my midwife's birth center.  #5 gave me an hour between ROM and the start of contractions, which would work just perfect.  I have decided, though, if I go into active labor and the weather/road conditions are terrible, I'll stay home and take my chances.  Hopefully someone would make it here in time.  I look forward to the results of your poll.  I'd really rather just stay home.  

[Hope4six]

I would like to know this, too.

[BusyMumof5]

**Removed because I'm not allowed to have an opinion**

Edited by BusyMumof5 - 12/6/10 at 5:59am

[~Adorkable~]

Busy mum, are you the onethat voted as a critical transfer? If so do you think your babies were in emendate life threat? I am in no way questioning your choice to transfer, I'm just wanting to get a feel for how far into things the choice happened.
What it a controlled, planned move to the hospital, or a panicked time? Were the babies stressed?

Thanks for sharing your experience, and I'm very happy to hear things turned out ok in the end. That's really all that matters right?

[BusyMumof5]

Originally Posted by ~Adorkable~ 

Busy mum, are you the onethat voted as a critical transfer? If so do you think your babies were in emendate life threat? I am in no way questioning your choice to transfer, I'm just wanting to get a feel for how far into things the choice happened.
What it a controlled, planned move to the hospital, or a panicked time? Were the babies stressed?

Thanks for sharing your experience, and I'm very happy to hear things turned out ok in the end. That's really all that matters right?

**Removed because I'm not allowed to have an opinion**

Edited by BusyMumof5 - 12/6/10 at 5:58am

[~Adorkable~]

ok, yeah i do not think i would have called your transfer critical, but i was not there, i was thinking that critical would have meant that you already had a cord prolapse or something equally eminently life threatening, and that you had to get to a OR as fast as you possibly could.

glad to hear that you got to transfer in a less crazy way than that, i hope.

[PlayaMama]

Originally Posted by ~Adorkable~ 

ok, yeah i do not think i would have called your transfer critical, but i was not there, i was thinking that critical would have meant that you already had a cord prolapse or something equally eminently life threatening, and that you had to get to a OR as fast as you possibly could.

glad to hear that you got to transfer in a less crazy way than that, i hope.

sorry, crashing from new posts, but ifeel like i need to clarify this... laboring for 2-3 days with a double transverse lie set of twins with no progress and determining that one of them was distressed right before the c-section is not a critical situation?

i guess i see critical as the point where the labor would have led to a mama or babies not being alive any longer, and it seems like busymomto5 was there. i would also suggest that a mama that is having a hard time processing her birth does not need to hear that maybe it wasn't as "critical" as she thinks. it makes me sad that a woman that shares her story would be questioned like that,

so, all that aside, can you offer a little clarification as to what you would determine critical? is it the point at which the outcome of living mama and babies changes, or is it a panic situation? i guess i'm not sure

[Carlyle]

I get the feeling that Adorkable is trying to answer the question "if I choose to attempt a twin home birth, how likely is it that I'll end up rushing to the hospital in an emergency vehicle, fearing for my life."  i.e. it seems like she's using the word to "critical" to mean that if mom and/or babies don't get to the hospital within minutes, they could die.  I don't think she's saying that it wasn't essential that Busymum transfer, just that it wasn't a high speed ambulance ride and lots of panic.

[~Adorkable~]

Thank you Carlyle, you explained it perfectly.
I was in no way underestimating the issue that BusyMum had, at all. If she felt that I was, I would be very bummed.

I was doing my best to get some stats from BTDT moms of twins about how their home birth plans turned out. I see making a thoughtful even if last minute decision to transfer as something very different from being caught by one of the very few things that can go wrong in a way that threatens my life or that of the babies in a timeframe that a transfer might not even be an option. And knowing that those exist, I was wondering how rare they are.

I think of critical as something already going so wrong that a clock of life or limb has started to tick. I think of very urgent as what BusyMum experienced.
I do think that if you reread my post, you will see that I clearly stated that i was not questioning her at all and just said that I was using the word differently and wanted to understand more how the experience was for her.

[rhiandmoi]

I think the word you mean is emergent not critical. Double transverse lie is definitely critical it is undeliverable which makes a transfer and c section 100% critical. It wasn't a lights and sirens emergency, but could have become one shortly. A good midwife will do her best to protect you from a lights and sirens transfer though. She will use her training and experience to know when you're heading to an emergency and either make the call that allows you to transfer calmly and peacefully or she resolves the situation. Yes emergencies can and will crop up that have no warning signs but most do have them. Have you discussed what warning signs would trigger your midwife to make the call for a medical transfer?
Edited by rhiandmoi - 12/5/10 at 3:31pm

[PlayaMama]

Originally Posted by ~Adorkable~ 

Thank you Carlyle, you explained it perfectly.
I was in no way underestimating the issue that BusyMum had, at all. If she felt that I was, I would be very bummed.

I was doing my best to get some stats from BTDT moms of twins about how their home birth plans turned out. I see making a thoughtful even if last minute decision to transfer as something very different from being caught by one of the very few things that can go wrong in a way that threatens my life or that of the babies in a timeframe that a transfer might not even be an option. And knowing that those exist, I was wondering how rare they are.

I think of critical as something already going so wrong that a clock of life or limb has started to tick. I think of very urgent as what BusyMum experienced.
I do think that if you reread my post, you will see that I clearly stated that i was not questioning her at all and just said that I was using the word differently and wanted to understand more how the experience was for her.

it's always so interesting how language can mean different things to different people!

i read where busymom said "I am in no doubt that left any longer I could of lost either of the babies." and i thought that would have been close enough to the line where mom or babies could have died that it would be a critical situation.

i think if i use the word "frantic" in place of critical then it makes more sense to me.

i wish you well with your birthing journey!

[BusyMumof5]

**Removed because I'm not allowed to have an opinion**

Edited by BusyMumof5 - 12/6/10 at 5:58am

[BusyMumof5]

Originally Posted by Carlyle 

I get the feeling that Adorkable is trying to answer the question "if I choose to attempt a twin home birth, how likely is it that I'll end up rushing to the hospital in an emergency vehicle, fearing for my life."  i.e. it seems like she's using the word to "critical" to mean that if mom and/or babies don't get to the hospital within minutes, they could die.  I don't think she's saying that it wasn't essential that Busymum transfer, just that it wasn't a high speed ambulance ride and lots of panic.

**Removed because I'm not allowed to have an opinion**

Edited by BusyMumof5 - 12/6/10 at 5:58am

[stik]

I consider a single baby in a transverse lie after mom has started active labor critical.  I'm not a birth professional, but one thing I look for in a birth attendant is someone I trust to tell me when things just aren't going to work out naturally and we need intervention.  Two babies plus three days of active labor = it is pretty impressive that everyone involved is alive. 

Adorkable, please consider:

- they can't come out sideways

- at some point, an umbilical cord will descend past a baby who is not moving, and if it's pinched, that baby will die.

- at some point, the placenta will detach and if the uterus can't clamp down because it's still full of baby, mom will bleed to death AND the baby (or babies, in this case) will die

- there is no magic bus that can transport a woman from her own home straight into a hospital operating room with an OB and anesthesiologist ready to operate in the extremely short time it takes people to die after umbilical cord prolapse or placental detachment

- if a baby hasn't turned before mom's water breaks, it's not going to

BusyMumof5, your situation was clearly life-threatening, and thus, both critical and emergent. 

[BusyMumof5]

Originally Posted by stik 

I consider a single baby in a transverse lie after mom has started active labor critical.  I'm not a birth professional, but one thing I look for in a birth attendant is someone I trust to tell me when things just aren't going to work out naturally and we need intervention.  Two babies plus three days of active labor = it is pretty impressive that everyone involved is alive. 

Adorkable, please consider:

- they can't come out sideways

- at some point, an umbilical cord will descend past a baby who is not moving, and if it's pinched, that baby will die.

- at some point, the placenta will detach and if the uterus can't clamp down because it's still full of baby, mom will bleed to death AND the baby (or babies, in this case) will die

- there is no magic bus that can transport a woman from her own home straight into a hospital operating room with an OB and anesthesiologist ready to operate in the extremely short time it takes people to die after umbilical cord prolapse or placental detachment

- if a baby hasn't turned before mom's water breaks, it's not going to

BusyMumof5, your situation was clearly life-threatening, and thus, both critical and emergent. 

**Removed because I'm not allowed to have an opinion**

Edited by BusyMumof5 - 12/6/10 at 5:57am

[~Adorkable~]

folks, deep breath here i already posted what i thought was a apology to you, BusyMum, sorry if that was not enough, i was simply using a different semantics and we got things crossed. 

again Busy mum, i in no way what so ever wish to disrespect your experience, i hope to never go thru it and I'm very sorry that you did. i am so glad that you and your babies got the care you needed, when you needed it and are safe and sound now.

i started this pole to learn and ask questions, i used a term that meant something particular to me and clearly something else to others. i was using "critical" to infer that it was something in which even a fast sirens blazing transfer might not be fast enough for. (i was thinking that would include a full abruption, existing cord prolapse, ruptured uterus and the like)  i was being hopeful in thinking that a skilled midwife or mother seeing these things coming and transferring before they actually happened was what i meant as during labor but less than critical, being as that it was hopefully a little bit more controlled and calm, if not still also urgent. it seemed like your good judgment to get yourself help fell into this later category. 

again i started this thread to learn, thank you for your feedback. i do not feel that i told you what your situation was or was not, but simply what category it seemed to fall into from the way i was using the words. i am really sorry you felt i meant something different.

can we chalk this up to the inherent limitations of the English language and the crossed wires of talking disjointedly on the Internet?

[BusyMumof5]

Originally Posted by ~Adorkable~ 

folks, deep breath here i already posted what i thought was a apology to you, BusyMum, sorry if that was not enough, i was simply using a different semantics and we got things crossed. 

again Busy mum, i in no way what so ever wish to disrespect your experience, i hope to never go thru it and I'm very sorry that you did. i am so glad that you and your babies got the care you needed, when you needed it and are safe and sound now.

i started this pole to learn and ask questions, i used a term that meant something particular to me and clearly something else to others. i was using "critical" to infer that it was something in which even a fast sirens blazing transfer might not be fast enough for. (i was thinking that would include a full abruption, existing cord prolapse, ruptured uterus and the like)  i was being hopeful in thinking that a skilled midwife or mother seeing these things coming and transferring before they actually happened was what i meant as during labor but less than critical, being as that it was hopefully a little bit more controlled and calm, if not still also urgent. it seemed like your good judgment to get yourself help fell into this later category. 

again i started this thread to learn, thank you for your feedback. i do not feel that i told you what your situation was or was not, but simply what category it seemed to fall into from the way i was using the words. i am really sorry you felt i meant something different.

can we chalk this up to the inherent limitations of the English language and the crossed wires of talking disjointedly on the Internet?

**Removed because I'm not allowed to have an opinion**

Edited by BusyMumof5 - 12/6/10 at 5:57am

[~Adorkable~]

Busymum, look i have apologized and explained myself in a number of posts now. i never told you what you had or did not have, i simply explained how i was personally using the word and how that was clearly different from the way you used the word. 

from the very beginning i said i was not there with you and never claimed to know your situation, only the thoughts in my own head.

i cannot continue to apologize for the misunderstanding, i already have explained it was not intentional or with any feeling or disrespect or judgment.

at thing point i just feel like going further would be beating me up for a unintentional semantic confusion. neither of us deserves to feel beat up

[Carlyle]

I'm really sorry if my response came across as sounding like I think your transfer wasn't critical!  I agree with you 100% that it was critical that you transfer; I was just trying to say that I think the op was using the word incorrectly.  I don't think that she meant to imply that you didn't need to transfer, she was just using the word "critical" wrong.  I have complete respect for your decisions and am really glad that both you and your babies are okay.  Again, I'm really sorry if I've hurt feelings or anything; I do think your transfer was critical and that you absolutely made a decision that saved lives!

Originally Posted by BusyMumof5 

Originally Posted by Carlyle 

I get the feeling that Adorkable is trying to answer the question "if I choose to attempt a twin home birth, how likely is it that I'll end up rushing to the hospital in an emergency vehicle, fearing for my life."  i.e. it seems like she's using the word to "critical" to mean that if mom and/or babies don't get to the hospital within minutes, they could die.  I don't think she's saying that it wasn't essential that Busymum transfer, just that it wasn't a high speed ambulance ride and lots of panic.

Because I took myself in.

Until I arrived at the Hospital no-one knew I was in labour, hence why there was no panic.

I have no doubt that if they even knew I was in labour it would of been as critical as they come.

I would of lost the babies. No doubt about that.