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Hospital birth with twins

post #1 of 11
Thread Starter 
I'm expecting my 7th & 8th live babies in October. I've been reading books about twins, and twin births, and the complications that could happen. All my other births have been vaginal. I have an OB that's supportive of a vaginal birth this time, as long as Baby A is head down. I'm worried about what my birth will be like, and how it will affect me.

How can I make this a good birth?? I'm worried that things will be out of control, and procedures done against my wishes, my babies taken away from me unneccessarily, and the impact of all this on my mental health. I'm at a great risk for PPD. I suffer from depression as it is, and I think a traumatic birth will really make things worse.

A doula would be great, if I knew there were some around here. I don't have any female friends that I'm really close to, and a few are so anti-hospital that I don't think they'd even come see me. My mom is out, I can barely stand her, and the thought of her there makes me even more tense. DH wouldn't stand up for me either, he's too medically minded being an EMT, and was freaking out at our last birth which was a homebirth.

What can I do? I'm so tired of hearing "as long as the babies are healthy, that's all that matters.". Of course I want healthy babies, but my mental & emotional health means nothing? Is there anything I can do to prepare myself for a less than ideal birth?
post #2 of 11

Find your local moms-of-multiples club and ask around to find out who liked their OB.  Yours sounds like he/she might be good, but so much will depend on having a good caregiver.  I know in my area there's really only one OB among the hundreds around I'd trust to support the vaginal twin birth I wanted. 

 

Like any birth, maybe the key to making it as smooth and happy as possible would to be to try and be sure to be in a position to "own" all of the decisions.  Know ahead of time what the hospital policies are and what you're going to do about them.  Same for many of the little things that will come up.  I like to think I would have been OK with a c/s for my twins if I had a good reason for it.  If there was IUGR, malpositioning, etc, I could have accepted surgical delivery.  And planning ahead for a c/s that I understood and supported would have been so much easier than fighting with nurses and docs during delivery.

 

Get confident in the science, and as much as possible, with your OB and your hospital.  Come up with some continegncy plans, and know there's no way to plan for them all.

 

And best wishes to you, finding peace in this challenging process.

post #3 of 11
Thread Starter 
Thank you for the reply!

How would I find out what the hospital policies are? I wouldn't trust someone just telling me, I'd want to read them for myself. Are they usually on the hospital's website?

I live in a very rural area, so there's not many choices around here. If my current OB isn't OK with some of the things I'd prefer to have/not have, there is one other hospital I could go to that I know has 2 doctors that would support a vaginal birth of twins. A very natural-minded friend knows the Dr.'s there, and has recommended a couple of Dr.'s to me if my current one doesn't work out.

I don't even know if there's a group for multiples around here, as I only know of one other person who has twins here.
post #4 of 11

I have never seen  hospital policies on a website.  The way I have found out about them is to go on the hospital tour ... usually the tour guides know nothing, but they can direct you to someone who will be able to answer your questions.  You have to be obnoxious and hang around after the tour.  Ask to speak to the charge nurse or to be able to make an appointment to speak to the most knowledgeable person. If you're willing to be the squeaky wheel, you might be able to get them to bend rules for you. 

 

Hospital policies do vary dramatically.  For example, if you are interested in not being separated from your babies, hospitals in my area vary widely on how well they would support this.  There are hospitals that have their c-section recovery areas set up to keep moms and babies together, and others that have "mandatory separations" of up to 5 hours!  So it definitely pays to know what you are getting into up front and if there is something you need to decline, to let them know ahead of time so you don't have to deal with as much attitude in the moment. 

post #5 of 11
Thread Starter 
Thank you, I have an appt. on Tuesday, and will ask to speak to someone about them.
post #6 of 11

 

Quote:
Originally Posted by Mama~Love View Post

I'm expecting my 7th & 8th live babies in October. I've been reading books about twins, and twin births, and the complications that could happen. All my other births have been vaginal. I have an OB that's supportive of a vaginal birth this time, as long as Baby A is head down. I'm worried about what my birth will be like, and how it will affect me.

How can I make this a good birth?? I'm worried that things will be out of control, and procedures done against my wishes, my babies taken away from me unneccessarily, and the impact of all this on my mental health. I'm at a great risk for PPD. I suffer from depression as it is, and I think a traumatic birth will really make things worse.

A doula would be great, if I knew there were some around here. I don't have any female friends that I'm really close to, and a few are so anti-hospital that I don't think they'd even come see me. My mom is out, I can barely stand her, and the thought of her there makes me even more tense. DH wouldn't stand up for me either, he's too medically minded being an EMT, and was freaking out at our last birth which was a homebirth.

What can I do? I'm so tired of hearing "as long as the babies are healthy, that's all that matters.". Of course I want healthy babies, but my mental & emotional health means nothing? Is there anything I can do to prepare myself for a less than ideal birth?

 

 

MamaLove, my sympathies.  I hope you can at least find someone good, supportive, and comforting to be with you at the birth.

 


Having actually tried to pin my doctor down about standard practices, yesterday, I am feeling a lot like this, today.  On the one hand, I have a slim hope of trying to find someone who will approach the birth differently; but it's just that, slim.  On the other, I'd be glad of feedback or good advice.

 

My babies' health matters to me more than anything else, but it is not the ONLY thing.  That's one reason I'm scheduled to deliver in a hospital with a level-3 NICU.  My own physical survival comes second - as these babies need a mother: my husband can't be left to care for them, all alone.  Yet my mental and emotional well-being matter also; my ability to be an active part of this birth, to allow my body to function properly, and not let others take control of a process my body is made for, and is doing so well, MATTERS TO ME.  I cope best with stressful or painful situations when I retain the ability and volition to respond to them.  And I am becoming angry at the suggestion that - just because it's riskier - the carrying and delivery of spontaneous twins, or that conception, are somehow wrong.  We're not talking about quadruplets, or more; or a mother with a long history of loss or difficulty sustaining a pregnancy, suddenly faced with several babies.  No doubt that needs more care, more pure carefulness, to see through.  Yes, one baby at a time is our bodies' basic pattern.  But too many twins are conceived spontaneously for me to feel it's some aberration, far outside our body's ability to do well, with minimal support.  (- As, enough food, enough rest, reasonable caution.)  Nor do I believe that all their precautions are necessarily  much safer for the babies than NOT being exposed to drugs, NOT having my low blood pressure drop, NOT adding stressors or medications that can stall the labor.  

 

As long as my first twin is head down, they'll do a vaginal birth (and, as of yesterday - at 28 weeks - both twins were head-down).  Most twins delivered in this hospital ARE vaginal births.  I do have a doula lined up.  I am fine with a c-section for genuine emergencies; and I know that the hospital tries to limit separation from the mother to a few minutes of checking, unless the babies are very unwell & need NICU care.  The minimum I would get was a moment with them, on the way out. They give twin/multiple mothers a big corner room, so all the babies can room in with you.  Once I get to the hospital, in labor, I can stay in a labor room, until delivery, when they will move me to the O.R.  (Not done for singelton mothers.)  I really don't like that move, but I can accept it.  I have tried to think about how to stay calm and relaxed, in that transition to a bright, public, very medical space. Earlier on, they'll have me on continuous monitoring, but it will be via telemetry, so I will not be confined to bed. Only - they're adamant, utterly adamant, that I must have an epidural, if I am to deliver there.  And though, at first, it may be a 'walking epidural', it's obvious the doctor wants it heavily dosed, by delivery, so they can a) stick a hand in and feel/move the second baby (which I was told is unbearable, despite people thinking they can manage it), and b) cut me open AT ONCE, if necessary.  The only comfort there at all is that this particular OB has never delivered a second twin via c-section, when the first was a vaginal delivery.  That's something.  And I've had a former student of hers tell me she's 'amazing'.  But she may not be on call at the time, so it's not all THAT comforting.  If my twins are doing well, not in desperate need of surgery, I want to be able to feel and participate in the process of birth, not as some incapacitated person, but in conscious, powerful cooperation with my body and the process at work in it.  I don't want to be unable to feel enough, don't want to be reduced to obeying directions given by someone else.  Anyway, my doctor clearly was both mildly offended (or irritated), and totally inflexible.  Bursting into tears may have conveyed my strong feelings, but it certainly did not help.

 

Also, if we get to 38 weeks without delivering, they will induce me.  I would much rather be closely monitored, but no dice.

 

 

 

post #7 of 11

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Edited by member234098 - 6/6/12 at 5:09pm
post #8 of 11
Thread Starter 
Quote:
Originally Posted by Imprint View Post

 

 

MamaLove, my sympathies.  I hope you can at least find someone good, supportive, and comforting to be with you at the birth.

 


Having actually tried to pin my doctor down about standard practices, yesterday, I am feeling a lot like this, today.  On the one hand, I have a slim hope of trying to find someone who will approach the birth differently; but it's just that, slim.  On the other, I'd be glad of feedback or good advice.

 

My babies' health matters to me more than anything else, but it is not the ONLY thing.  That's one reason I'm scheduled to deliver in a hospital with a level-3 NICU.  My own physical survival comes second - as these babies need a mother: my husband can't be left to care for them, all alone.  Yet my mental and emotional well-being matter also; my ability to be an active part of this birth, to allow my body to function properly, and not let others take control of a process my body is made for, and is doing so well, MATTERS TO ME.  I cope best with stressful or painful situations when I retain the ability and volition to respond to them.  And I am becoming angry at the suggestion that - just because it's riskier - the carrying and delivery of spontaneous twins, or that conception, are somehow wrong.  We're not talking about quadruplets, or more; or a mother with a long history of loss or difficulty sustaining a pregnancy, suddenly faced with several babies.  No doubt that needs more care, more pure carefulness, to see through.  Yes, one baby at a time is our bodies' basic pattern.  But too many twins are conceived spontaneously for me to feel it's some aberration, far outside our body's ability to do well, with minimal support.  (- As, enough food, enough rest, reasonable caution.)  Nor do I believe that all their precautions are necessarily  much safer for the babies than NOT being exposed to drugs, NOT having my low blood pressure drop, NOT adding stressors or medications that can stall the labor.  

 

As long as my first twin is head down, they'll do a vaginal birth (and, as of yesterday - at 28 weeks - both twins were head-down).  Most twins delivered in this hospital ARE vaginal births.  I do have a doula lined up.  I am fine with a c-section for genuine emergencies; and I know that the hospital tries to limit separation from the mother to a few minutes of checking, unless the babies are very unwell & need NICU care.  The minimum I would get was a moment with them, on the way out. They give twin/multiple mothers a big corner room, so all the babies can room in with you.  Once I get to the hospital, in labor, I can stay in a labor room, until delivery, when they will move me to the O.R.  (Not done for singelton mothers.)  I really don't like that move, but I can accept it.  I have tried to think about how to stay calm and relaxed, in that transition to a bright, public, very medical space. Earlier on, they'll have me on continuous monitoring, but it will be via telemetry, so I will not be confined to bed. Only - they're adamant, utterly adamant, that I must have an epidural, if I am to deliver there.  And though, at first, it may be a 'walking epidural', it's obvious the doctor wants it heavily dosed, by delivery, so they can a) stick a hand in and feel/move the second baby (which I was told is unbearable, despite people thinking they can manage it), and b) cut me open AT ONCE, if necessary.  The only comfort there at all is that this particular OB has never delivered a second twin via c-section, when the first was a vaginal delivery.  That's something.  And I've had a former student of hers tell me she's 'amazing'.  But she may not be on call at the time, so it's not all THAT comforting.  If my twins are doing well, not in desperate need of surgery, I want to be able to feel and participate in the process of birth, not as some incapacitated person, but in conscious, powerful cooperation with my body and the process at work in it.  I don't want to be unable to feel enough, don't want to be reduced to obeying directions given by someone else.  Anyway, my doctor clearly was both mildly offended (or irritated), and totally inflexible.  Bursting into tears may have conveyed my strong feelings, but it certainly did not help.

 

Also, if we get to 38 weeks without delivering, they will induce me.  I would much rather be closely monitored, but no dice.

 

 

 


Wow, you said it better than I could. Those are my feelings exactly. At my next appointment, I'm going to talk with her more about the birth, and what would be optional. I wasn't able to talk to anyone about their policies on Tuesday, I had the kids with me & didn't have time. I hope next time I'm able to get the information I want.
Quote:
Originally Posted by miriam View Post

To the OP:

 

I would remind any doctor who is delivering twins that the Dionne Quintuplets were born at home prematurely in 1934 by a midwife and they all survived.  If you can have your twins naturally, good for you. Too bad you have to fight so hard for it.  


I am totally fascinated with the Dionnes! Thank you, I will remember that.
post #9 of 11

You could always compromise with your docs on an epidural port, and only get the drugs if and when you need them.  Not comfortable, but a compromise.

 

Or better yet, show up pushing.  Might work for the OP, but harder for first time mommas.

 

Hope you can avoid an induction, Imprint.  Doesn't sound like a good discussion with your doc.  Might try again next time.  hug2.gif

 

Best wishes to you both!

post #10 of 11

MamaLove, best wishes on your next appointment!  - And on the attitude of your doctor.  It's not a wonderful situation to be in (aside from the lovely, growing children  2ndtri.gif2ndtri.gif 3rdtri.gif3rdtri.gif we're blessed with, and versus not having access to necessary care) but I am glad not to be the only one who feels this way about it.

 

Actually, having the epidural set, but not dosed, was something I offered as a compromise, which I thought my o.b.'d accept.  It was feeling that was so reasonable, so likely to be okay, and having it flatly rejected that started the tears.  She all but said: don't do this, and we won't deliver your babies.  But thank you, Gena!  It really is a good middle position to try.  I hope any discussion will go better, next time.  As I said, I hoped they might be willing to monitor me more closely, and wait till 39 weeks, but now am thinking that if I don't find someone else, and I hit 36 or 37 weeks without going into labor, I'll up my activity level a bit (which so far has caused more contractions than are desirable, this early) and hope that will aid in getting things going.  I don't want the babies born too early, but if it's that or an induction, would prefer to try various things that might start labor naturally.  (Also, having been born at 32-33 weeks, myself, I appreciate how much another 4-6 weeks in the womb could help them, even more than I mind that they might lose time they could have had.  The supposedly better lung development, etc., for gestational age is also some comfort, if this can't be avoided.)

 

Miriam, I am considering going in somewhat later than advised, but, with the lack of experience of previous labors, not so late as that. It definitely doesn't seem wise for me or other first-time mothers to wait till the pushing stage... though others might manage it and be alright.  And I do want someone who's qualified able to check the babies' well-being, or assess things, before we get quite so far along.  Though I think the greater risks to twins often inspire too intense and worried a response, they do exist, and I do - truly - put their safety before anything else.  The fact that the monitoring would be via telemetry at this hospital is one of the few things I can say I'm sincerely happy about.  smile.gif  I've been in the related cardiac center and found the ability to move freely while being monitored very welcome, compared to being confined.

 

I wish there were more home-birth midwives, here, but they're almost all working in hospitals, and though that means more resources are available in an emergency, it probably also means more rules and less personal discretion.  I doubt they're allowed to take someone like me, even if they're willing.  (First-time mother of twins with a pacemaker.... though no heart weakness or heart disease.  It's only the regulation/initiation of my heartbeats that fails to work on its own.  The pacemaker does a beautiful job of supplying this, and is 'exercise-responsive', so my heart's reaction to exertion is quite normal. I'm not at an elevated risk of dying in a normal labor.  My cardiologist said they should shield the pacemaker, if a c-section is done, though, as a cauterizing agent often used might stop it functioning.  Though I'm willing if the twins' safety truly requires it, that's one more reason I want to avoid a surgical birth, or anything that makes it more likely - in case I'm not alert enough and someone screws up....)

 

post #11 of 11

I had my twins in a military hospital.  I was 37 weeks and my water broke at home.  I went up to the hospital where I was given an epidural because I was already 4cm dilated.  I chose to get the epidural because of personal reasons and previous experience with natural childbirth.  I literally fell asleep throughout all of my labor and woke up ready to push.  I was wheeled into the OR which was a little intimidating with all of the tools and contraptions in there.  However it was the best experience of my life.  I had my twins within the next 7 minutes, both of them.  They placed each baby on my chest right after they came out before taking her over to the midwife.  The only other thing that was intimidating was that I had so many people in my room.  I had my OB, a midwife for myself, my husband and my anesthesiologist.  Each baby had two nurses, and each had a neonatologist.  It was a little squishy but again it was great.  Chosing to go with the epidural I think in my situation was best for us considering past experience.  I really had the best twin birth possible and I don't regret any part of it.  I was able to nurse both my twins right away.  We were released from the hospital the next day :) 

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