So My Doctor was not happy to learn about the twins!

[thisisbabbleon]

We learned we were having twins at our 12 week ultrasound and had a follow up visit with my doctor the next week.  When he heard the results he was obviously not happy that it was twins.  He immediately let me know that I was a candidate for "selective reduction".  I said, "Is it that bad?"  and he said, "Well, yes."

I guess I am considered extremely high risk because 1-twins, 2-diabetic, 3-history of PROM (premature rupture of membranes).  My water broke at 26 weeks with our son and he was born at 28 weeks.  At that time I had 3 large fibroid tumors but those were removed a year ago so I was thinking that we would have a better go of it this time.  In addition, I lost 60lbs and have my blood sugar completely under control.

Now we are trying to enjoy the pregnancy but we feel like we are just waiting for something bad to happen.  After my son spent 48 days in the NICU after birth I was looking forward to a different experience this time and now I beginning to feel like this is going to be worse.  

Trying to remain positive, but it's a little sad and scary.  In two weeks we are having another ultrasound and meeting with the Maternal Fetal Medicine specialist.  

I usually just lurk on boards but this time I felt like reaching out!

[tink79]

First, congratulations on your double blessing! I think it's a shock for everyone to recieve the news that they're having twins but if you have complications, it's not only a shock but it adds a ton of worry.  I found out I was having twins after two significant pregnancy losses, had hyperemesis with each pregnancy, gestational diabetes and pre-e, among other issues.  I had the looming fear that my blessing would turn into a curse so I can definitely imagine how you are feeling.

Has your doc mentioned cerclage to prevent premature labor?  Is your doc experienced in high risk pregnancies? 

[star8kitten]

Congrats!  We found out about our twins at 18 weeks and nothing will rock your world like that kinda news!

I have read two different books on twins (Luke's, Noble's) and they all say that you need to be comfortable with your doctor and that most "normal" OB's don't know enough about twins to actually give it a try.  They mostly just tell you all the bad stuff that can happen and of course that sets up a stressed out pregnancy.  Stress is the last thing you need right now.

Personally, I am using a midwife but if we need to transfer care, I have a list of names of doctors in my area that are twin friendly.  I found most of them by going to the "my tribe" section and searching my state for "twin dcotor." 

HTH!

[lesliesara63]

Congratulations! I found that my RE was rather doom and gloom when we found that I was carrying triplets not the twins we thought. I found the MFM that I transferred to much more positive. A MFM is so much more experienced with high risk pregnancies than an OB. I was so stressed after meeting with my regular OB/RE and so not after meeting with my MFM two weeks later. And here I am at 22 weeks and everything is fine. I hope that your meeting with the MFM sheds some light on your issues. I also see a midwife - not that they take on triplet pregnancies normally. But it  helps give me a different perspective on things and to feel more "normal" My midwife will attend the birth, but the MFM will be in charge of the delivery. With twins they would still have done the delivery.

[babygrey]

Congrats,.mama. Tbh, I would RUN from an ob who suggested selective reduction for twins without you asking. that is not standard of care at all, esp if you haven't even seen mfm yet. Fwiu, SR is rarely done for twins....
Regardless, good luck and best wishes.

[thisisbabbleon]

Thanks for your replies!  I love my OB guy because he really was amazing during my emergency c-section 2 years ago.  He is the head of the department at the hospital and has always been invested in my care and well being.  But I was totally thrown by the selective reduction offer!    I feel that it was kind of extreme and out of the blue.  

We see the MFM person on April 4 and I am looking forward to that.  I am also looking into a midwife for moral support through all of this.

Right now I am looking at this as positively as possible.  Everything is going great so far and all I can do now is take great care of me and my family since that is all I can control.  Lots of water, healthy food and relaxing as much as possible.  Plus enjoying the company of my 2 year old while it's still just him!

[Llyra]

I was also told about selective reduction, because I have a congenital heart condition and pregnancy puts enormous stress on my heart. I had also had one extremely preterm birth, and a LOT of preterm labor DD1, though she went to term. What I wound up doing was searching out an OB practice that was affiliated with a fertility clinic-- the docs there had extensive experience with triplets and quads, and had even managed two quintuplet pregnancies. Twins didn't even cause a blip on their radar. They helped me manage multiple risks during the course of my pregnancy-- I also have a chronic autoimmune disease, and I developed liver disease during the pregnancy. Anyway, I'm fine, the twins are fine and went almost to term, and my OBs were awesome.

[LisaSedai]

Congrats on the double blessing! Sorry your OB is stressing you out. You didn't say if you were type 1 or type 2, I've got type 2  and my OB and a perinatologist/OB on my ICAN board say *controlled* diabetics are NOT high risk. (They wanted my fasting to be below 100) Since you lost all that weight I bet your blood sugar is awesome now, especially if you are still getting exersize and watching what you eat. My OB does twin & triplet VBACs if you are near the Atlanta area.

[Lisa1970]

All the statistics I have read have said that the risks do not go down with selective reduction. Especially not from 2 to 1. Do lots of research over diet and exercise and such. I know people here have good resources and websites to help. Congratulations on your two little ones!

[Lisa1970]

I know you feel that he was amazing during your emergency csect, but you might want to consider why you had the csect. I don't know, obviously, but many of us here at Mothering have seen so many women end up in csects because of the doctors intervention, but then be grateful to their doctor for "saving" them, when in fact, the doctor is the one who put them in that situation through interventions like early inductions. I have a feeling this doctor will not be a good doctor for you. I would run far far far away from any doctor who suggested that while pregnant with twins. The doctor also sounds like he is uncomfortable handling you as a patient, which should make you want to be with a doctor with my experience and expertise so his comfort level never becomes your issue. 

Originally Posted by thisisbabbleon 

Thanks for your replies!  I love my OB guy because he really was amazing during my emergency c-section 2 years ago.  He is the head of the department at the hospital and has always been invested in my care and well being.  But I was totally thrown by the selective reduction offer!    I feel that it was kind of extreme and out of the blue.  

We see the MFM person on April 4 and I am looking forward to that.  I am also looking into a midwife for moral support through all of this.

Right now I am looking at this as positively as possible.  Everything is going great so far and all I can do now is take great care of me and my family since that is all I can control.  Lots of water, healthy food and relaxing as much as possible.  Plus enjoying the company of my 2 year old while it's still just him!

[Jane93]

Don't let internet speculators who don't know you and your medical history try and reframe your previous experience with your OB and your c-section.

All the best for a happy and healthy pregnancy -- I hope you have a positive experience with your MFM.  Mine was absolutely wonderful -- realistic and reassuring at the same time.

[Jane93]

Also, I would if I were in your shoes be very selective about my choice of midwife.  With a higher risk pregnancy, some sort of NCB ideologue who's going to apply pressure based on a particular (non-interventionist) philosophy sounds like a potential source for more stress rather than support.

[kama'aina mama]

I am kind of confused by your post.  The OP said her water broke at 26 weeks and this OB managed to keep her pregnant two weeks past that.  Pretty much the total opposite of doctor intervention leading to early delivery/ section.  I would probably have a lot of trust in a doctor who did that for me, too. 

The comment upthread about finding a doctor or practice that speciualizes in multiples is certainly worth thinking about.  Good luck, and Congratulations on your pregnancy!
 

Originally Posted by Lisa1970 

I know you feel that he was amazing during your emergency csect, but you might want to consider why you had the csect. I don't know, obviously, but many of us here at Mothering have seen so many women end up in csects because of the doctors intervention, but then be grateful to their doctor for "saving" them, when in fact, the doctor is the one who put them in that situation through interventions like early inductions. I have a feeling this doctor will not be a good doctor for you. I would run far far far away from any doctor who suggested that while pregnant with twins. The doctor also sounds like he is uncomfortable handling you as a patient, which should make you want to be with a doctor with my experience and expertise so his comfort level never becomes your issue. 

[Imprint]

Best wishes on your little ones!  It does sound like someone used to handling multiple pregnancies, including ones with extra risks, would give both peace and a better chance for both babies.... I hope your MFM specialist turns out to be perfect!

It sounds like you've done great things for your health, and your babies'.  I have no doubt you can manage whatever it takes to get them both to a safe delivery.    

Am I right, you posted elsewhere, you're at 25 weeks, now?

[thisisbabbleon]

25 weeks!  The Gestational Diabetes has kicked in so I started insulin this weekend and we are working on finding the right dosages.  I now have a disabled parking permit and a wheel chair so I can still get out of the house without pushing my activity too much.  I feel more confidant each day and have finally relaxed enough to start buying a few things for the babies!

[Imprint]

Great!  I'm so glad.  How nice to be able to get out and do some baby preparing, despite everything.  I know what you mean about finally feeling free to get things for them.  I'll be thinking of you, especially between now and 28 weeks - for me, the time (after 24) that seemed most crucial.

Best wishes on getting insulin dosages just right!

[thisisbabbleon]

Thought I would post a little update instead of just lurking around.

Tomorrow we hit 33 weeks!  The gestational diabetes is mainly under control.  I am on insulin morning and night and working hard to manage my diet so things have been going along well.  

Our one big shake up came last week when I went in for a routine ultrasound and was immediately admitted for having next to no fluid!  I thought I had been drinking more than enough water but I guess not!  There were no signs of rupture or leakage and I felt great!  So we spent two days preparing for an emergency c-section while rehydrating with IV fluids and water.  Then we retested on Wednesday and Twin A had regained nearly all fluid and Twin B had regained almost enough.  Retested on Friday and they were full up and I was sent home!  Went back yesterday for another scan and all is well and we are back on track!

It was quite the roller coaster but so far we like the happy ending.  

Moral of the story-Drink your water!

[~Adorkable~]

this is such great news, hang in there, you are getting so close!!!!!!!

[lookatreestar]

wow, great update. glad those babies are hanging in there! :)

[thisisbabbleon]

Wow how time flies!  My twins were born 4 months ago today!  In the end we made it 33.6 weeks before the team decided that my mysterious losses of fluid were too great a risk and we had an emergency-ish c-section.  Our girl, River Luna and boy Raven Jay arrived safely but had mild complications resulting in NICU stays of 30 and 35 days.  But we have made it through it all happy and healthy!  I like to look down at my healthy babes and think, "selective reduction my ass!"