Giving birth to twins in the hospital-advice if you've been there please!!

[mltjm]

I'm due with twins (di-di) in 9 weeks, giving birth in the hospital, and I have a bunch of questions!! Please help me out if you have any info.

#1. Induction: Did you or didn't you do it? How far along were you? Why or why not?  What method? I'm on the fence about this one, leaning towards no induction, but I don't know enough about it to make an informed decision. 

#2. Non-medicated issues: I am not planning on having an epidural but suspect they will want me to have one in case I need a C. Did you have a hep-lock? What did you do? 

#3. If the babies were preemies, were you still able to refuse the eye stuff, the vitamin K, and the HepB vax? 

#4. What's the deal with Strep B? With my first I was positive for it, I didn't really know better, so I had the IV antibiotics. Are the babies at higher risk for getting it if they are smaller/frailer (hopefully mine won't be!!)?? Can someone explain more to me about it.

Thanks a ton!

[Amanda Leigh]

I can't really answer 1,2 and 4 as I didn't have GBS and I had lots of problems with pre-term labor and already had IV's so I can't really help with 1 and 2. However, my boys were preemies and we refused the eye ointment and hep B vaccine. We chose to do the vit K as some preemies have a higher risk of intra-cranial bleed, but if we had wanted to refuse we could have. I think it was helpful to have all of this written in a birth plan so that it was very clear to the staff. Good luck!

[rinap]

#1 We induced, but that was because the twins shared a placenta.

#2 After much negotiation, I had an epidural placed at the very last minute. They put through the test dose, but no painkillers. I think I got an IV at that point, but I was half an hour into pushing, so it wasn't much in the way. It made the hospital folks feel better (in case of c-section).

#3 Ours were preemies (just barely at 36wks2days), and we refused the eye ointment, the hep b, and the vitamin K. (we did the vitamin K orally (as is in the UK protocol) on our own, and later got the hep b vaccine, but that was not in the hospital)

The big thing on all of these is to talk talk talk to your doctor and the folks at the hospital. Write these things down in a birth plan. If they say no, try to talk to them about why. Often there is some wiggle room. (my doctor was much happier to delay induction and to try for a vaginal birth when I showed that I was willing to listen to him and was willing to have a c-section if it was necessary, I just really wanted to try to make it not be necessary) But talking and negotiating help a lot.

[~Adorkable~]

I will write more about the choices I made and why, but wanted to share a book that was given to me when pregnant that really helped me understand what choices needed to be made and ways to think about each of them.  One of the most helpful things I read ever,

http://www.amazon.com/Thinking-Womans-Guide-Better-Birth/dp/0399525173/ref=sr_1_1?s=books&ie=UTF8&qid=1322449530&sr=1-1

[queenofchaos]

hmmm, my babies shared a placenta, but an induction wasn't warranted.  but then again, the shared placenta wasn't 100% confirmed until after the birth.  so I suppose that may have been why.  HOWEVER, I was not induced, planned to have an epi in place in case we needed to c-section (one of the babies was breech), but that didn't happen as the birth proceeded so quickly that they were still working on getting an IV in my arm when I was pushing the 1st baby out.  Babies were not premature, so I can't answer that one either.

ok, so that leaves the GBS concern.  there is some really good info on it here .  I could go into all the ins and outs and what the main concerns are, but I would write a lot.  1st get some info, and then you will have  to decide, do I want to know if I am GBS+?  If not, don't get the test and don't get the abx.  If so, get the test sometime in your last month and then decide if you want abx or not at that point (this is where your research will come in handy).  Wish I had a cut and dry answer for this, but here are some of the main points considering GBS and treatment:  What are the actual risks of transmission, and the actual rates of baby(ies) developing an infection IF they contract GBS (and how many that get infected actually suffer long term issues or die?)  If I am GBS+, and I want to get ABX, how effective are they?  Are there any side effects or potential problems with abx treatment?  Do they actually prevent GBS infections in babies like they are supposed to?  AND then, if you do test + and want abx, how can you mitigate any possible side effects.  You also may want to know, how can I prevent from getting a + result on a GBS test in the first place?  There is a lot to know about this topic and it is important to know.  I wish I could go into all the details, but it isn't hard to find answers to the things I listed above.

[mltjm]

Adorkable, thanks, I am looking forward to reading the book!

queenofchaos- those guiding questions were extremely helpful!! Thank you!

[SunshineH]

1. Induction - I went in at 38 weeks for one.  Turns out I was already dialated to a 7, so they broke baby A's water and that was it - away we went.  In retrospect, I wonder how fast everything would have gone, and when.  That day?  2 days later?  My previous 2 singletons were fast, unmedicated labors, and part of me felt out of control during them despite my awesome midwives in the hospital.  I've since read a lot more, and now I look back and wonder.

2.  I did choose to have an epi, partially because of my nervousness.  Baby B was transverse but did turn head down - but posterior and kind of kept getting her chin stuck.  She was vacuum assisted 40 minutes after Baby A.

No help with 3 and 4, but I see some other good advice above.

[Strong Mama]

I hope you get good advice! I went into labor on my own at 37 weeks and had to have a C so i had the epidural. I have had two natural births before the twins birth and OMG epidurals ROCK.LOL I was 4 when I got the epi and they did the section so I was just starting to feel a LITTLE bit of crampy labor pain so lucky for me, didnt have to deal with the pain this time. Had to have the csection because B was breech and 8 pounds, 4 oz and they couldnt turn her., Loved my birth, and you will too, regardless of how it goes.

[speedfunk]

#1.  Baby A's water broke at 7:30 am and they gave me until around noon for contractions to come on their own.  Then they started pitocin.

#2.  Fortunately I found an OB at our hospital that was comfortable delivering a breech baby B (which is how she was delivered), but strongly suggested an epidural in case I couldn't tolerate the breech delivery or needed a quick c-section.  I had the epidural line put in place early on but didn't have a dose until right before I went into the delivery (operating) room.

I had mono/di twins born at 35w6d.  I was bummed about the likely epidural and how it was really pushed at the hospital.  I was hoping to sneak by without it.  I was happy to have it in place early on because it would have really sucked if they did it when I was 9+cm. 

I had a hard time being "high risk" because of the twins.  It wasn't the pregnancy I'd imagined, especially compared to my first, but in the end everyone was very healthy and it went as well as it could have.  Good luck!

[nd_deadhead]

At 39 weeks I hadn't started to dilate yet, but there was no talk of induction. My bood pressure went through the roof all of a sudden (DH took my BP every day, and it was fine in the morning; sky-high at an 11 am appointment). I had HELLP syndrome, and a C-section under general anesthesia that afternoon.

I delivered two wonderful, healthy baby boys - one weighed 7-16, the other 8-0.

I can't help you with your other questions, but I can tell you that it is possible to go to term with twins. I was really uncomfortable for the last few weeks, but it was well worth it!

Oh, and my "babies" are 17 years old now!

[newmommy7-08]

I delivered didi twins via c-section at 39w3d. We had a breech baby A, so the c-section was warranted. But if she'd been positioned properly they would have allowed me to go as late as 42 weeks before any kind of induction as long as babies were in good shape.

My hospital did require an epidural but would wait if you were in labor as long as possible, but did prefer to get it done by 6cm... mostly because they didn't want to be trying to place it during transition. Having had a natural birth I wouldn't have wanted them messing w/ me during transition either! :) and yes, they would have allowed a heplock. my midwives did tell me however that they would be fine w/ me calling for the epidural just before pushing, but once again cautioned me about having to deal w/ an epidural placing at that time. 

We were allowed to refuse anything we wanted to. as far as question 3. Just like we were w/ our singleton. I don't know if that's because my girls were fullterm or not though.

I can't say anything about Strep B since I've always been -.

The bottom line with getting the experience you want is you need a provider that stands by you and agrees with you. You need a provider that will be there with you.

When I was in labor w/ my son the overseeing OB wanted me to have an epi placed because I'm overweight and he didn't think I could labor naturally. (Mind you this was a man who'd never met or examined me... he only looked at my chart.) My midwife literally went toe to toe with him at the nurses station (my doula witnessed this) and told him absolutely not. that she wasn't going into my room to tell me that my body couldn't do what she knew it could do. BTW I did have my perfectly natural no pit or anything else needed birth. She was right and I will be forever grateful that she was the one with me that day.

[deborahbgkelly]

Newmommy- That is ridiculous that the OB said just because you were overweight he didn't think you could do it naturally. I'm so lucky my OB is all for vaginal birth whenever possible. This is why I will insist on meeting his backup prior to birth.