3rdUP/4thUC - Wondering About Multiples - Opinions Wanted! - Page 4

[Multimomma]

Can we go back to the original discussion? Jess, I still really do not understand why you won't just go for an ultrasound? 

[bebebradford]

I agree with Adaline'sMama. I don't like any woman be forced to birth somewhere or not being in control of her body, but having multiples via UC is poor judgment. It's just all around a super risky situation considering all the things that could easily go wrong.
 

[stik]

Jess, TTTS happens during pregnancy, not birth. By the time one baby is born, nothing you can do will impact it. Clamping or not clamping the first baby's cord will not prevent it, and will not prevent it from having severe or acute effects.

With any multiple pregnancy, you run the risk of preterm delivery - it can be treated, but it can't usually be managed safely at home. Given that you've found two heartbeats, it would be a good idea to have a doctor/hospital lined up in case you go into labor dangerously early. You can revert to the home birth plan once you're far enough along. 32 week twins have a great prognosis in the hospital, but are probably not going to make it if born at home, even if you live close to the hospital.

[stik]

Originally Posted by BlessedJess 


TTTS would be rare in my case. Imagine the chances of triplets, then imagine the chances of TTTS in a triplet pregnancy on top of that. Those are two extra layers of statistics I would have to cross. That's a risk of like 0.0005% or something silly like that. Compared to the stress and the bullshit and the truly unknown risks. I don't need to go to a medical person to sell me fear on such slim chances.

I'm the only person awake in my house, and I love stats, so I'm going to attempt to show you some math here, somewhat hampered by typing on my iPod and by not having actual numbers for probability of either mono/di twins, triplets, or TTTS.

The method that most of us are taught in high school for calculating the probability of two events is to multiply the probability of one event by the probability of the other event. This method works for independent variables. You can use it to determine things like the chances that a coin toss will come up heads three times in a row (1/8), or the chances that you will win the lottery AND be struck by lightning on the same day (I don't know exactly, but vanishingly minuscule). This works with variables that don't affect each other. One flip of the coin does not influence the next. The lottery does not affect the weather.

Your situation - suspected twins or triplets and TTTS - involves dependent variables. The most common kind of pregnancy is singleton pregnancy. Because these pregnancies involve only one baby, they will not lead to TTTS. Twin pregnancies have risk of TTTS if the babies are a mono-di pair. If not, chances of TTTS are back to 0. Triplet pregnancies have three possible pairs of babies (baby a and baby b, baby a and baby c, baby b and baby c) who could be a mono/di pair. The chances of having one mono/di pair in a set of three are higher, assuming total randomness, simply because there are more possibilities. Thus, rather than it being unlikely that two rare things would happen at the same time, rare event 1 (spontaneous conception of triplets) creates a higher risk of rare event 2 (mono/di pair), which in turn creates the potential for rare event 3 (TTTS). Unfortunately, you don't get to multiply the probabilities together for a vanishingly small fraction here, because each variable increases the probability of the next variable. While I don't have exact numbers, it is clear that your chances of having TTTS in a spontaneous triplet pregnancy are much higher than the 0% probability singleton moms face. The presence of multiples puts you at higher, not lower risk.

Remember, accepting some care does not mean accepting all care. You still get to make decisions. Gathering information allows you to consider your options, identify your resources and plan. Obviously, your ideal is a UC. There are birth situations that fall short of this level of autonomy but still give you a lot of control. There are birth situations that leave you no control at all. The more you plan for alternatives, the higher the chances are that you will get to keep that control.

[graceomalley]

Quote:

Originally Posted by BlessedJess 

 What are the statistics for maternal mortality with HOM? 

Yes, perhaps Discovery channel did misinform you. The risk of maternal OR fetal mortality is the same. With HOM you are 3 times more likely to die than with a singleton pregnancy and the babies are 3 times more likely to die than with a singleton pregnancy.

Senat, M.V., Ancel, P.Y., Bouvier-Colle, M.H. and Bréart, G. (1998) How does multiple pregnancy affect maternal mortality and morbidity. Clin. Obstet. Gynecol., 41,79–83

http://www.ncbi.nlm.nih.gov/pubmed/9504226

I'm not sure how to do multiple quotes but I will make another post to address another issue in a moment.

[graceomalley]

Originally Posted by BlessedJess 

I was interested in preventing acute TTTS during birth by cord clamping.

There is nothing you can do to prevent TTTS at birth, acute or chronic, outside a hospital. Depending on the type of TTTS, if it's left untreated it has an average mortality rate of 80%. 

Copied from the following link:

Acute TTTS can occur in any case of monochorionic twins, who may not have shown any of the clinical symptoms of Chronic TTTS through the pregnancy. The pressures invoked by normal delivery can cause a mass transfusion of blood from one twin to another. Experienced hospitals can combat this by monitoring fetal heart rates during delivery for signs of Acute TTTS. If it is detected, an emergency C-Section will usually be offered.

http://www.twin2twin.org/What_is_TTTS.htm

[momtoafireteam]

I hope no one minds me barging in here, but I have been reading and thought I might have a unique perspective for you, Jess. Let me first say that I am a HUGE HUGE HUGE proponent of UP/UC and the whole concept in general and this definitely is not a "You're crazy to UP/UC" post. At all. I just wanted to give my own POV on this. 

I also have lots of children, and am currently pregnant with my 7th, 8th and 9th. I have four singletons and a set of twins and am now 32 weeks with triplets. Overall, all have been pretty easy smooth pregnancies and uncomplicated deliveries. All did "what they were supposed to" (as in, my body and my babies etc). My body has beautifully given me and grown 6 (well, 9) gorgeous children and I have been extremely blessed. 

Nothing could have prepared me for a triplet pregnancy. Nothing could have prepared my body. For the first time in all my years of child bearing, I feel like my body is struggling. This is the first time ever that things are not neat and tidy. I have always had a strong sense of being in tune with my body and now I can definitely tell that it is having a hard time coping. I wish I could just invite you to an u/s to see how things look in there now. This is not a normal pregnancy, there is nothing average or routine or "how its meant to be" about a HOM pregnancy. There are a million variables and they all intertwine to just make a huge mess. I have always admired the amazing ability of women, and in particular UP/UCers, to rely on their senses and read their bodies and babies to gauge the pregnancy and the birth. Imagine three people screaming three different books in your ear at the same time. Oh, and one is in italian, and one is about a subject you don't know anything about. Thats a triplet pregnancy. 

And honestly, I felt pretty fantastic until about 22 weeks. And then I felt kind of fantastic til about 26 weeks. At 32 weeks I can feel that my body is coming to the end. Trust me, no amount of taurine will help this. Like I said, its completely impossible for you to comprehend it. I couldn't have comprehended it. I am not telling you not to UP or to UC. Its your decision and your babies and your body. Would I have done it in any pregnancy before now? Absolutely. Would I do it this time? Not in a million years. 

I am doing such a bad job at conveying my thoughts on this and I have a strong feeling I am just going to make you angry and respond with "Well, I'll do a better job than you". Which is fine. I just wanted to give you my thoughts as someone who isn't part of the statistics- who is actually carrying three babies and wanted to give you that perspective. I wish you the absolute best of luck and blessings for your body, your baby and your birth. 

[suchende]

I was thinking about you and your dreams of 3 after your thread was locked and I was wondering if it could possibly be a symbol of twins with one placenta. Lots of people think the placenta has its own spirit, and I could well imagine it being represented as a baby (or a teacup) in a dream. 

[BlessedJess]

Originally Posted by Adaline'sMama 


I'd like to take a moment to point out that not everyone here believes that God is smarter than doctors. In fact, not everyone who advocates or participates in UC is a believer in god at all. And as far as you getting upset that people are trying to advocate you stepping away from UP/UC being against the board rules- The board protects people seeking answers/ support about unassisted childbirth. This is not a support only forum. No one here is proselytizing against UC, people are merely telling you that UPing (something that the forum guidelines do not protect) with triplets (or even twins) is a bad idea. As with any thread, if you think someone is breaking the user agreement by posting, you can report their post by clicking the little red flag at the bottom left of the post.
You asked for advice, but you have yet to take any of it seriously. It is looking more and more like you came here to argue and start a thread where you are the focus of attention and are getting a rise out of people. I suggest you start a poll to ask people what they think you what people think you should do. By far,Ill bet most people think you need to see prenatal care so that you know that it is safe for you to birth at home with no assistance. (Which, if you have no problems then I see no reason for you not to do.) You have made many obnoxious statements about how everything that goes wrong is because of a cause ( my son's death is absolute proof that not everything that happens has a cause.) , that women who are healthy have no birth problems (tell that to all the women in the PAL or TTC after loss forum. Id bet they would disagree with you.) The idea that you can rely only on intuition is just not smart. As PP said upthread, I've bought many a lottery ticket on intuition. Intuition is not always right. Its not always perfect. I have believed things and known things within my soul and been wrong about them.
I want to ask you if you are planning to change your mind, or take anyone's advice at all? If a new poll continues to say that you should only UC if you get an ultrasound, will you do that? Or are you just planning to follow your gut and not do anything that would make you feel morally obligated to change your plans? And do you believe there are triplets or twins?

I'd like to take a moment to point out that not everyone here believes that God is smarter than doctors.

I'd like to point out that you can call it nature if you prefer. What's the #1 cause of death in America? How about iatragenic causes? (see the dreaded google for more information, add Dr Mercola into the search terms if you like to get your opinions from doctors.) There are many, many casualties in my personal circle of family and friends and I've only scratched the surface. I didn't even start with the literal assault and medical abuse of my friends and relatives. Maybe my circle is just unlucky, maybe I'm unusual, but I think the numbers speak for themselves.

No one here is proselytizing against UC, people are merely telling you that UPing (something that the forum guidelines do not protect) with triplets (or even twins) is a bad idea.

Too bad you don't see pregnancy and birth as a continuum. I do. You can't separate birth outcomes from pregnancy.

It is looking more and more like you came here to argue and start a thread where you are the focus of attention and are getting a rise out of people.

I see people are happy to give you a thumbs up for saying that. (2 thumbs down)

You asked for advice, but you have yet to take any of it seriously.

I only had 2 questions. One, if you-all with experience knew if my pregnancy signs pointed towards multiples, and two - if clamping was a good idea between birth intervals, to avoid blood loss in a possible ID twin set within a possible triplet pregnancy. My mistake was to use the words "acute TTTS"... which got everyone telling me to seek medical care. Good grief. If I had signs of polyhydramnios or oligohydramnios after viability was reached, that might be the only thing to do.

But you all need to understand something. Because I don't think you will understand me otherwise. My husband is 100% disabled, nerves poisoned by sarin gas while cleaning up after "Team America" in the first Gulf war. Some days his guts are so torn up he can't make it to the toilet a few feet from his chair, and some days his vertigo is so bad he has to crawl. Without me here, watching the 5 kids I already gave birth to and taking care of him with his critically low intracellular magnesium and potassium levels, he'd probably be dead. I couldn't do it alone, but my uber helpful eldest teen daughter needs me to be here, watching his water and nutrient intakes, making sure his food is edible to him, etc. I can't be stuck in a hospital many hours from home for months on months at a time. Not unless it was life and death, because me being here at home is a matter of life and death for him. So unless I know I need to go, I'm not going anywhere, get it? The outcomes of my babies in utero depends on me feeling that my husband, the love of my life, my one and only, is safe and taken care of.

my son's death is absolute proof that not everything that happens has a cause

I never said you were at fault but how do you know he just died with no cause? How do you know it wasn't something beyond your awareness or control that is happening to people all around you in this artificial commercial environment swimming with toxins and EMF pollution?

If a new poll continues to say that you should only UC if you get an ultrasound, will you do that?

No. You-all think ultrasound is safe. Well, guess what? We once thought yearly dental xrays were okay for kids, now we find out this year that we are increasing their risk of certain brain tumors by 5X just by doing what the dentist recommends. We also used to xray babies in the womb. How many dumb ideas will people run through before they start getting smart about this kind of thing? You-all be the guinea pigs if you want. I'll wait for the evidence that I'm not doing my children or grandchildren harm with the new fangled technology folks love so much.

Or are you just planning to follow your gut and not do anything that would make you feel morally obligated to change your plans?

Sorry, that's just a rude question. I'm "morally obligated" to do what my heart tells me and look after this family God gave me. And I couldn't do anything else.

And do you believe there are triplets or twins?

Depends on whether or not you put stock in intuition. If my intuition is correct, like it was about that damn tincture before I found out what was in it and lost my baby, then I'd say healthy multiples with now 2 dreams about there being triplets, plus having my ribs kicked when that shouldn't happen until the baby(s) are big enough to reach, like 30 weeks. And if I'm just plain wrong, then guess what, who cares about my intuition, there's probably one baby and no need for an U/S.

[BlessedJess]

Originally Posted by suchende 

I was thinking about you and your dreams of 3 after your thread was locked and I was wondering if it could possibly be a symbol of twins with one placenta. Lots of people think the placenta has its own spirit, and I could well imagine it being represented as a baby (or a teacup) in a dream. 

Interesting theory! :-) I thought at first it was a symbol of God's protective spirit over the pregnancy, like with the 3 worthies in the fiery furnace. But frankly, I know I double ovulated. The chances are one in millions that it is ID twins.

[BlessedJess]

Originally Posted by momtoafireteam 

I hope no one minds me barging in here, but I have been reading and thought I might have a unique perspective for you, Jess. Let me first say that I am a HUGE HUGE HUGE proponent of UP/UC and the whole concept in general and this definitely is not a "You're crazy to UP/UC" post. At all. I just wanted to give my own POV on this. 

I also have lots of children, and am currently pregnant with my 7th, 8th and 9th. I have four singletons and a set of twins and am now 32 weeks with triplets. Overall, all have been pretty easy smooth pregnancies and uncomplicated deliveries. All did "what they were supposed to" (as in, my body and my babies etc). My body has beautifully given me and grown 6 (well, 9) gorgeous children and I have been extremely blessed. 

Nothing could have prepared me for a triplet pregnancy. Nothing could have prepared my body. For the first time in all my years of child bearing, I feel like my body is struggling. This is the first time ever that things are not neat and tidy. I have always had a strong sense of being in tune with my body and now I can definitely tell that it is having a hard time coping. I wish I could just invite you to an u/s to see how things look in there now. This is not a normal pregnancy, there is nothing average or routine or "how its meant to be" about a HOM pregnancy. There are a million variables and they all intertwine to just make a huge mess. I have always admired the amazing ability of women, and in particular UP/UCers, to rely on their senses and read their bodies and babies to gauge the pregnancy and the birth. Imagine three people screaming three different books in your ear at the same time. Oh, and one is in italian, and one is about a subject you don't know anything about. Thats a triplet pregnancy. 

And honestly, I felt pretty fantastic until about 22 weeks. And then I felt kind of fantastic til about 26 weeks. At 32 weeks I can feel that my body is coming to the end. Trust me, no amount of taurine will help this. Like I said, its completely impossible for you to comprehend it. I couldn't have comprehended it. I am not telling you not to UP or to UC. Its your decision and your babies and your body. Would I have done it in any pregnancy before now? Absolutely. Would I do it this time? Not in a million years. 

I am doing such a bad job at conveying my thoughts on this and I have a strong feeling I am just going to make you angry and respond with "Well, I'll do a better job than you". Which is fine. I just wanted to give you my thoughts as someone who isn't part of the statistics- who is actually carrying three babies and wanted to give you that perspective. I wish you the absolute best of luck and blessings for your body, your baby and your birth. 

Hey look, I can't take anything for granted, and I'm in NO WAY offended by your post. I'm delighted and honored that you took the time to write this up. God only knows how you are fighting to keep going. I pray you make it full term, but if you don't CONGRATULATIONS on making it this far!!! :-D

If I end up in your shoes and need help, I'm sure it will be a harsh reality check. I'm only 21 weeks today so I'm just taking it one day at a time. I know it will be a miracle to do this UP/UC but I believe in miracles. I've seen them so many times I could write a book (and chances are folks wouldn't believe me, LOL).

And I don't just want a miracle, I need one. I can't leave my family, I don't live a short drive from a fancy NICU. Somebody has to keep my disabled husband alive. That's me. Nobody else can do what I can. God will provide and help us, I'm sure. I'm hoping for the provision of a healthy pregnancy and birth at home. His will be done.

So we will just have to see how this goes.

Thank you for your concerns.

[stik]

Given your dh's serious illness, it is likely you will need significant help with this pregnancy.  There is a chance that it will, at some point, be be necessary for you to spend time in the hospital or on bed rest.  It could be a matter of life or death.  What resources are available in your community?  What (if anything) can the VA offer you?  Could you find a home health nurse if you needed one? 

[Kaydove]

Originally Posted by BlessedJess 

my son's death is absolute proof that not everything that happens has a cause

I never said you were at fault but how do you know he just died with no cause? How do you know it wasn't something beyond your awareness or control that is happening to people all around you in this artificial commercial environment swimming with toxins and EMF pollution?

Careful, this is not what a grieving mother needs to hear. I personally was offended by your post up thread about how a miscarriage is caused by poor nutrition. SIDS and miscarriage happen at no fault to the mother, no matter what her nutrition was. Please watch what you say and realize that "theories" like this are best left unsaid on a forum such as this.

[suchende]

If a new poll continues to say that you should only UC if you get an ultrasound, will you do that?

No. You-all think ultrasound is safe. Well, guess what? We once thought yearly dental xrays were okay for kids, now we find out this year that we are increasing their risk of certain brain tumors by 5X just by doing what the dentist recommends. We also used to xray babies in the womb. How many dumb ideas will people run through before they start getting smart about this kind of thing? You-all be the guinea pigs if you want. I'll wait for the evidence that I'm not doing my children or grandchildren harm with the new fangled technology folks love so much.

The fetal doppler you've been using has the exact same technology as an ultrasound. That's why I was so perplexed you were willing to use one but not the other. 

[BlessedJess]

Originally Posted by stik 

Jess, TTTS happens during pregnancy, not birth. By the time one baby is born, nothing you can do will impact it. Clamping or not clamping the first baby's cord will not prevent it, and will not prevent it from having severe or acute effects.
With any multiple pregnancy, you run the risk of preterm delivery - it can be treated, but it can't usually be managed safely at home. Given that you've found two heartbeats, it would be a good idea to have a doctor/hospital lined up in case you go into labor dangerously early. You can revert to the home birth plan once you're far enough along. 32 week twins have a great prognosis in the hospital, but are probably not going to make it if born at home, even if you live close to the hospital.

I'm not in a good position to even be pregnant with twins/triplets if I needed intervention. Think of this, a half hour away from an inadequate hospital that couldn't even be trusted to section me. 3.5 hours just to get to the capitol limits where I could be treated, and that's not including getting through tangles of traffic to make it to the heart of the city. I'd need to call for an airlift. And I've only been giving birth faster and faster each time.

Never mind the fact that I'm sorely needed at home.

Thanks for the advice about cord clamping. I'm actually leaning towards not clamping at this point, but am still keeping an open mind. I don't need placental complications after the birth, if you know what I mean.

[BlessedJess]

Originally Posted by Kaydove 

Careful, this is not what a grieving mother needs to hear. I personally was offended by your post up thread about how a miscarriage is caused by poor nutrition. SIDS and miscarriage happen at no fault to the mother, no matter what her nutrition was. Please watch what you say and realize that "theories" like this are best left unsaid on a forum such as this.

I fail to see the offense. That's like saying you were raped because an evil guy was stalking you. The because does not turn it into your fault!

Like I mentioned, I was partly the cause of my first miscarriage. I know how that complicates things emotionally. I learned then and there that even the coolest, most unusual, most natural birth friendly-seeming OB can be a total ... you know. I take charge of my health care from now on. They just consult and help, if I let them.

Edited by BlessedJess - 7/15/12 at 9:54am

[BlessedJess]

Originally Posted by suchende 

The fetal doppler you've been using has the exact same technology as an ultrasound. That's why I was so perplexed you were willing to use one but not the other. 

Not according to what I've read. The technology is all over the place. A 30 minute high powered ultrasound capable of heating tissues to the point of creating DNA bubbles is not the same as a 5 minute battery operated doppler.

[BlessedJess]

Originally Posted by stik 

Given your dh's serious illness, it is likely you will need significant help with this pregnancy.  There is a chance that it will, at some point, be be necessary for you to spend time in the hospital or on bed rest.  It could be a matter of life or death.  What resources are available in your community?  What (if anything) can the VA offer you?  Could you find a home health nurse if you needed one? 

I've got really helpful kids. My teen is already cooking for me, with supervision, of course. She gets better every day. And thankfully my husband, while fragile, is able to get around and do stuff when he's not having attacks. So he's been there for me, too. We also have a two-man couple here, best friends with us since we married, right next door, who look after us and help with groceries when needed. They can even help with child care sometimes. Nice as they are, I don't think they are prepared to babysit constantly, though.

I already spend a lot of time resting, I just have to keep an eye out for everybody from my chair/bed, when I'm not up and about, to keep the chaos from breaking out.

My husband is not really up to having strangers in the home, if you know what I mean. Low magnesium levels leave him very vulnerable to stress.

[BlessedJess]

Originally Posted by stik 

Your situation - suspected twins or triplets and TTTS - involves dependent variables. The most common kind of pregnancy is singleton pregnancy. Because these pregnancies involve only one baby, they will not lead to TTTS. Twin pregnancies have risk of TTTS if the babies are a mono-di pair. If not, chances of TTTS are back to 0. Triplet pregnancies have three possible pairs of babies (baby a and baby b, baby a and baby c, baby b and baby c) who could be a mono/di pair. The chances of having one mono/di pair in a set of three are higher, assuming total randomness, simply because there are more possibilities. Thus, rather than it being unlikely that two rare things would happen at the same time, rare event 1 (spontaneous conception of triplets) creates a higher risk of rare event 2 (mono/di pair), which in turn creates the potential for rare event 3 (TTTS). Unfortunately, you don't get to multiply the probabilities together for a vanishingly small fraction here, because each variable increases the probability of the next variable. While I don't have exact numbers, it is clear that your chances of having TTTS in a spontaneous triplet pregnancy are much higher than the 0% probability singleton moms face. The presence of multiples puts you at higher, not lower risk.
Remember, accepting some care does not mean accepting all care. You still get to make decisions. Gathering information allows you to consider your options, identify your resources and plan. Obviously, your ideal is a UC. There are birth situations that fall short of this level of autonomy but still give you a lot of control. There are birth situations that leave you no control at all. The more you plan for alternatives, the higher the chances are that you will get to keep that control.

Not bad points. But I would have to use factors that include the chances of suspicions being more than just suspicions before I could start my math. So first multiply my chances of suspicions being correct. So if it's twins it's nearly 0% because of the double ovulation. And since I only suspect triplets are possible, you have to say how many women suspect triplets but go on to have only one or two. I don't know what the odds of that are, but a lot of people suspect multiples and only have one. Problem is, nobody here, even me, can answer if my suspicions are more concrete other mothers' suspicions.

[MeepyCat]

BlessedJess, I don't know what search terms you're using. Per the CDC, the leading killer of people in the US is heart disease, followed by cancer. I haven't looked at the more detailed tables today. Dr. Mercola is the subject of complaints from the FDA and the Better Business Bureau because of unsubtantiated claims he has made about the nutritional supplements he sells.

And honey, you may NEED a miracle, but God doesn't hand out miracles just because we need them, they are not ordered for us, to meet OUR needs, but by God, to suit His. I'm a practical person, and I don't expect God to always feel that my needs and His are related. By contrast, social service organizations (like the VA) can be moved by human need and human persistence, and have legally enforceable human obligations. I would tell ANY pregnant woman with a disabled husband to make some phone calls.