UC for twins?

[aubryholman]

I'm currently 31 weeks along with fraternal twins.  No OBs in our area will consider "allowing" us to deliver without being in a OR, epidural in place, ready for C-section, which they all just "know" we'll end up needing.  It's illegal for anyone to deliver "high risk" pregnancis outside of hospitals.  We found a wonderful MW about 6 hours away, in another state, with a lot of experience delivering twins, but it's extremely costly, and my husband is not that into it.  So it looks like a UC is our only option for not having major surgery and putting our new babies through lots of unneeded  tests, intervention and risk.

Has anyone freebirthed twins?  If so, do you have advice, recommendations or stories.  Thanks!

[rnra]

Have you called all the OBs/Hospitals to see what their specific polices are--or are you just going on heresay?  In the hospital where I work, all twins must be born in the OR.  However, we have done many, many, many completely natural unmedicated vaginal twin deliveries in the OR.  There is nothing that says the mothers must have epidurals if they are having twins.  The mother labors in a private birthing suite, and then when birth is imminent, she is moved to the OR.  After delivery, she returns to her private suite.  While the OR is not the most soothing environment, we do our best to dim the lights, have the mother's choice of music playing, keep things quiet, etc.  

Edited by rnra - 2/22/12 at 3:43pm

[DaviAfua]

Are the babies in 1 sac or 2? If they are in 1, the risk of cord entanglement is really high. 

Do you know the positions of babes? There is often 1 breech babe with twins, and breeches tend to need more 'work' after the birth.

Have you considered the Farm? Or asking the midwife who is far away if she can barter any of her price?

You could also walk into the hospital when you are just about ready to push...

[aubryholman]

We did look into the farm, they're about 10 hours from us. They have wonderful statistics for twin birth, but it's even further than the MW we're hoping to use.  The main reason it's become so expensive with her is because we're having to pay another MW to be there, the expense of renting a place to stay while we're there waiting and after the birth and we're also having to pay for our regular prenatal care out of pocket.  Our insurance company does a global pay out, so no one wants to see us because they won't be the ones catching the babies and they won't get paid for the regular prenatal care, which I totally understand.  Our care has gone from $40 per prenatal visit and $250 for a MW to deliver to $125 per prenatal visit, plus any labs and $6,000 for delivery including our rent for what we estimate to be about 3 weeks, both MWs and PKU tests and some other miscellaneous stuff.

Not interested in going to a hospital, period.  We planned to use a MW and birth clinic before we found out there were 2 babies. If there is an actual emergency that needs assistance, that's something completely different.  I don't need a doctor to create an emergency for me though.  Nor do I need a staff of super nice, but over trained, paranoid, know-it-all nurses monitoring us for 72 hours afterwards. In our last hospital birth, the nurses completely ignored our wishes not to give our baby a pacifier, which she did every time she had him out of the room being weighed and evaluated, put triple dye on his cord although it was plainly written on his chart that we did not want it.  The staff pushed formula hard with both of our other babies, some of them were hostile because we refused vit. k, hep. b, and antibiotics, and frankly, we just don't that kind of crap.  No one wants to be that parent that leaves the hospital with newborns "against medical advice".

2 sacs, positions undetermined, they're both currently head down, but baby B flips about every 3 days, so we'll see.

[Everlong753]

For a bit I thought we were having twins and did consider doing UC.  I am a big UC advocate, and natural twin birth advocate, but I can't really give my opinion on "do it" or "don't" because each person's comfort levels, health, and circumstances are so different.  I'd just do all the research you can and become as informed as possible about the different types of scenarios that you might experience with birthing twins.   Prepare for opting in on extra tests you might not otherwise get- just to confirm things for yourself so you can be best prepared  (2 sacs is great news btw!).  The unassisted birth forums by Laura Shanley have excellent resources and knowledgeable, supportive members.  Definitely check around there too for first hand experiences.  I don't blame you at all for not wanting to do a hospital for them, but I hope you can find someone that can be a good support to you in even a small way.   

[A_Random_Phrase]

I would recommend that you search the old posts on this forum. There are mothers who were on here who uc'd twins. Also, you could do a search on youtube (you might have to join if the content is considered "mature"). Also, Laura Shanley's site might have a story or two.

[DoubleDouble]

Look in the Multiples forum for homebirth and UC threads. This one is the most recent.

[heatherfd]

Are you aware of why trained Obstetricians like to deliver in OR with all facilities on hand for urgent surgery if required ?

The reasons are locked twins, cord entaglement , cord prolapse , and for the reason that once you deliver the first twin the placenta may well shear off for your second twin who if undelivered risks imminent anoxia & death.

For you, there's the risk of PPH due to an overextended uterus .

I find it amazing that you describe these potential outcomes as something the Doctors create .

Good luck beacuse if you deliver safely you'll have dodged any number of bullets .

PS I've been delivering babies since 1983

[Novella]

Would you care to cite the rate of locked twins? I've read it in the past, but don't have the number handy. It's so low that I find it slightly offensive that you are citing it as a meaningful consideration and implying that her consideration of UC is fool-hardy.

There is no doubt that all these things you mention are possibilities. However, in my personal research during my own twin pregnancy, it seemed clear that there was a much greater likelihood that unwanted medical interventions would cause complications. It is a difficult position for parents to be in to feel like they have a "rock versus hard place" choice between preparing for the worst possibilities, or preparing for the most likely possibilities.

From what I've seen, the medical "steam-rolling" that naturally-minded parents get forces decisions to extremes because the medical staff are often so unwilling to bring their expertise in on a reactive basis (rather than proactive). Several of the studies that I investigated during my own pregnancy would have, for example, a summary that c-section birth was safest. But when you actually read the details, natural birth wasn't even one of the options they considered. How ridiculous! C-section versus total breech extraction (as an example). It's very misleading that only some of the options were being considered.

In the end, we decided to work with a medical facility when our twins were born. We felt absolutely embattled that we had to fight so hard for a natural birth of vertex Twin A and double footling breech Twin B. There were several moments when we were very close to opting for birthing in the back of a vehicle, near the hospital. If we had found any one person (not necessarily with medical training) who was willing to be extra hands at home, we would have UC'd. I completely understand the frustrating situation the OP is in.
 

Originally Posted by heatherfd 

Are you aware of why trained Obstetricians like to deliver in OR with all facilities on hand for urgent surgery if required ?

The reasons are locked twins, cord entaglement , cord prolapse , and for the reason that once you deliver the first twin the placenta may well shear off for your second twin who if undelivered risks imminent anoxia & death.

For you, there's the risk of PPH due to an overextended uterus .

I find it amazing that you describe these potential outcomes as something the Doctors create .

Good luck beacuse if you deliver safely you'll have dodged any number of bullets .

PS I've been delivering babies since 1983

[Novella]

OP said she is having fraternal twins. Should be 2 amniotic sacs, then.
 

Originally Posted by DaviAfua 

Are the babies in 1 sac or 2? If they are in 1, the risk of cord entanglement is really high. 

[Novella]

How can this be? Is this bona-fide or just what you've been told? UC discussions aside, there are legitimate precipitous births so I just don't see how a physical act like birth could be made illegal.
 

Originally Posted by aubryholman 

 It's illegal for anyone to deliver "high risk" pregnancis outside of hospitals.  

[erigeron]

Attending such a birth is illegal, not having one yourself.

[~Adorkable~]

please remember that just being in a hospital does not mean you will have to have a c section. i went in to a hospital at 7cm with my twins (that i had been planning a home birth for) because something told me that at my point 35w5d and feeling something intangible i still can't explain that i should go in. I discovered that needed to get treated for sudden very high BP( would have been sent in my my MW the moment she arrived). and although the magnesium sulfate that they truly needed to give me to protect me from seizures was a drag and it did stall my labor, they respected me when i stood my ground and took my time.

i labored there for another 20+ hours before finally pushing out two amazing babies vaginally in 16 minutes. It worked in part because I was calm and clear with them and had a great doula by my side.  i actually stayed in a regular L&D room because i told them that was what i wanted and put it on them to explain a situation where they would need me in the OR that was right down the hall and would not be able to roll the bed there fast enough, they could not, so they backed down and i stayed in my room. it was all surprisingly civil.

one of the few other issues i had was very heavy bleeding and clotting after i deliver two huge placentas, the OB was very rental and skilled and sweeping out huge blood clots that were holding my uterus open and massaging my uterus and getting the blood flow to rapidly slow, we needed no other intervention at that point but had she not done that i would have possibly kept bleeding and needed help for that, she was good to me and i did feel she worked at being as hands off as i wanted her to be for the most part.

i share this to point out that just as we are smart to understand that interventions can't be the start of a cascade effect leading to a less that optimal birth, we also have the ejection to stop that cascade a lot of the time. Knowing what can happen puts you in a great place to stop things before they start even after you take a few steps down the slope.

[eknuckles]

I just have to say women all over the world give birth to twins vaginally and med-free. I am sure you could tell up above there are some definete TROLLS trying to scare you. Do NOT let fear be your deciding factor, rather think as rationally as possible. I hope everything works out, no matter what you choose!!

[heatherfd]

 I find it extremely offensive to be called a troll just because I  offered an opinion that doesnt agree with yours.

Women do give birth med free all over the world wihtour intervention, which is why, in those countries the death rate of mothers & babies is much higher .

[Novella]

LOL (at myself). I always just automatically think of it being the birthing women who are "delivering" the babies.  Hahaha - silly of me to not catch the intended other meaning.
 

Originally Posted by erigeron 

Attending such a birth is illegal, not having one yourself.

[A_Random_Phrase]

Unassisted birth forum?

The discussion I read on twins in the uc forum four or so years ago read way differently than this thread.

This seems more like a "reasons to go to a hospital" forum - or a "let's scare anyone who wants to do things differently than mainstream" forum.

Weird.

Way weird.

[heatherfd]

Sorry, I thought this was about sharing information & advice, not just the party line of " Hospital is a bad scary place " and only " natural " birth is valid .

Seems the whole ethos here is that birth is performance art & the safety of your babies is a secondary / irrelevant outcome. Til of course something goes wrong . Then it's mainstream medicines fault for " scaring us away" 

Gee, damned if you do, damned if you don't 

[~Adorkable~]

heather, welcome to mothering.com, really.

do should understand that they question was aced in a area that is generally talking and supportive of women exploring there options for UC or unassisted childbirth. so coming in with strong wording to the contrary without history around here is likely to be not taken very well. 

We work really hard to give information in a friendly and supportive way. we can think a broad spectrum of things and still choose to talk in a really productive way.

(this reminder is for everyone!)

I'm sure the original poster knows that there are risks and benefits to all choices. She asked for stories and info about UC or birthing her twins by herself, not for us to tel her what she should do.  I gave her some encouragement to feel like she could be more empowered to get the birth she wants in a hospital if she ends up there, since that was the personal experience i struggled with and ended up pretty successful at.

i understand that you have been attending births for a long time, so you better than most should understand why it is not helpful to spread fear to pregnant ladies. And many of the scary things you mentioned were not even apicable to her because she is having Di/Di twins and she stated in her second post.

you are always welcome to chime in anywhere here, i just suggest you think about the questions being asked and the context and figure out a way to be hear a bit more constructively.  I'm sorry folks got called trolls (heck they may have been referring to me as well) i do not believe you came across this way on purpose. 

[heatherfd]

Thank you for that comment .

Saying that, I have noticed on the net stories of homebirth gone wrong ( NOT trying to scare anyone here, just commenting on what's out there already ) and the 2 themes that commonly run through them are :

- " Nobody told me "

- " I thought it was safe "

I actually thought I was being helpful , but clearly not .