Overwhelmed re: Birth

[JodiAriel]

Ok twin mommas I need a pep talk.  I am a labor doula and originally was planning a homebirth until we found out we were having twins and were risked out.  Now I feel like so much is out of my control.  I am being forced to deliver in an OR cause that is hospital rules.  I have to have an IV (not just a heplock), be on constant monitoring, deliver on my back in stirrups, because that is hospital regulations.  It goes against everything I have ever been taught about labor. I know these things may be necessary for the safety of myself and the babies but I hate that I have to utilize them even if they are not needed.

I have looked everywhere in my state and there is no reasonable alternative (ie birthing center, homebirth midwives, etc)  and every time we go to our centering (group centered prenatal care) group I get more and more depressed as we discuss labor, delivery, and birth since I can answer the questions yet nothing applies to me only to the other couples in the groups who are having singletons. I have come home crying from the last two visits because I am jealous that they are so "normal" and I'm not.

Please tell me that there are positive hospital birth stories and that this is not going to be the medical nightmare that I am envisioning.  Please tell me that I will get past this once the babies are in my arms and that I wont continue to mourn the birth I always dreamed of (these may be our only babies - it took a lot of fertility treatments to get here).

[queenofchaos]

I can personally tell you positive, twin, hospital births happen because I had one!  In a lot of ways, having twins can be a very lonely experience, and not just the pregnancy and birth, but parenting as well.  Unless you have a lot of friends/family members that have multiples, no one is really going to understand your experience.  I mention this only because it is a feeling you will have to come to terms with or you waste a lot of energy fighting it. 

One thing I know about birth, which you probably already know, every birth is unique, so make it your own.  Don't assume you have to do anything.  Talk to your care provider about what you want and how realistic your expectations are.  Sadly, when having multiples a lot depends on your care provider and their expertise/comfort level.  Also, how the babies are positioned makes a huge difference, too.    

As far as stories go, I had my girls at 39 wks.  I went into labor when my water broke.  I delivered in an OR.  An hour after my water broke the first babe was born, and 7 minutes later, the 2nd, and breech at that.  I was receiving an IV when the 1st was crowning.  I received no medications or interventions otherwise, unless you count the bit of help the dr gave me in getting my breech baby out (repositioning a little).  No stitches, minimal bleeding.  Babies were wonderfully healthy.  We went home 24 hrs later.  Pretty simple and straightforward.  No guarentees yours will be like that.  Put not out of the realm of possibilities.  If you start reading twin birth stories you will find all kinds, just like single births.  It's fun reading the suprise twin (as in didn't know they were expecting 2) birth stories.  Can you imagine???   LOL

[rinap]

I had a beautiful hospital birth with my husband by my side. Even though it was in the OR (which terrified me). We were able to negotiate periodic monitoring (every 20 minutes), which meant that I could walk and shower and bounce on a ball. And my husband, who is doula trained, and my doula were completely awesome in shielding me from the hospitalness of it wherever they could so that I could focus on the birth itself.

It sounds to me like your birth class is not being useful to you (and is only serving to upset you). Can you stop going and find another way to get whatever information you were hoping to get? I had a lot of panic about being out of control and having my choices for the birth stripped away one by one.

Can you talk to some local twin moms? That might help, especially if you can find some who have similar birthing beliefs to yours.
 

Also, find someone you can trust who has the right energy who you can talk to about all of your negative thoughts and fears and who will accept them (because they are reasonable), but let you release that fear and talk it through. Someone who will let you be angry and cry, but who won't make you feel even worse. Because these are legitimate feelings. I talked things through with my doula, over and over and over again.

  Remember that it isn't a defined cascade. Natural birth is awesome, but it isn't the case that the first intervention defines a path.

I wish you all the best and a good birth experience.

[mamalovex3]

I am pregnant with my second set of twins, had a hospital birth with my first set and for various reasons, have no alternative but to have a hospital birth with this set.  One thing, depending on your own comfort level, is that despite "hospital policy" you can still refuse many interventions.  You will likely have to sign something saying that you understand the risks involved and that you are going against doctor's orders, but it can be an alternative route if there are things you really just don't want to do. 

That said, my hospital birth was not what I imagined it to be, but I did end up getting a lot of things the way I wanted them!  I arrived at the hospital fully dilated, was brought to a L&D room, and then quickly to an OR.  There was no time for an epidural, which I didn't want anyway.  The anesthesiologist did arrive and was there, but didn't touch me!  I had an IV lock put in (no one asked me if I wanted it, and I am considering refusing this time around as it was completely unnecessary.  I was forced to deliver on the OR table with my feet in stirrups which was incredibly painful for me, and I will definitely not be doing this time around.  I also had the EFM on, but they had a hard time keeping both babies on it.  This time around I have been told that we can monitor intermittently, at least in early labour.  My first daughter was born about 40 minutes after we arrived, and her sister arrived 20 minutes later.  Both girls stayed with me and DH the whole time and we left the next day. 

Do you have any choice in hospitals?  This time we will be delivering at a different hospital (provided my babies continue to gestate at least another week!) that is not designated for high risk patients and since they are more used to normal deliveries, they are supposedly more easygoing.  One thing that helped us a lot was having our midwife there.  Even though she did not have privileges at the hospital and so the doctors were in charge, she acted as a doula more or less and was there for me the entire time. 

Also, going through this a second time has made me think a lot about what I want to be different about this birth, and there is a lot you can do to plan and prepare for the birth experience you want.  Decide which things are 'musts' for you and which are negotiable.  Don't be afraid to be vocal about what you want, as the patient, you have rights.  And ask lots of questions! 

I hope you can find some peace with your birth experience :)  In the end, it will be much more important that you are holding two precious babies :)

[Gena 22]

Hi, and congrats on your twins!

One of the PPers suggested contacting local twin moms.  ITA.  Ask around at local groups and find a doc that supports vaginal twin births.  There are a few out there, and they'll have the experience and support you need.  Could make a huge difference.

I think what's going to be really important is to set up a plan that doesn't involve conflict.  The hospital and many docs will have strict lines they don't want to cross with twin moms.  My local hospital has an 80% twin c/s rate.  As a first timer with full term (ie slow moving) babes, I knew I couldn't hope to be in that 20%.  So I stayed home with a midwife, which for me was great.  If I had decided to transfer, I would have done so expecting surgery.  Hopefully you'll be in a better place, with a supportive OB and hospital, especially one that gets you moving in labor and push upright.  But know a c/s is a real possibility.  You can stack the odds in your favor, but try to make peace with all the possibilities before you get that far.

Twin pregnancy and birth are not nearly as dangerous as a lot of the literature make it sound.  You're doing wonderfully and will continue to do so!  Ina Mae Gaskin calls twin birth just a birth, followed by another.  Now, that's making things too simple - there are complications with positioning, strain on your body, etc.  But it's not usually the high risk you sometimes hear.

Stay positive and grow those babes!  When your little ones are in your arms, they will command all your attention.  When I was getting ready for our birth, I called a twin mom who had used our midwife.  She was kind and helpful, but all she wanted to talk about was her 2 year old twins.  Which I thought was a great sign!

Birth's important, and there's every chance you'll have an easy, low-intervention birth, but it pales to what comes after.

Best wishes!

[JodiAriel]

Thank you guys for the replies... It is so nice to hear the perspective of someone who has gone through it.  Ironically I am not afraid of a c-section as I am confident that if thats what needs to be done that is what will be done.  It is all the other little pieces that scare me.  I am being monitored by MFM from a different hospital than where I am delivering but my primary care providers are a midwifery group.  So I am at the mercy of the supervising OBs on the floor, whom I will not get to meet prior to labor.  My midwife is aware of my wishes (although I am going to get to work on putting them down on paper) and is willing to work with me as much as she can within the hospital guidelines.  Right now she is finding out if the portable telemetry can handle twins which would be a much better option. I have decided to write a birth plan and really work on my husband so he can advocate for me.  I am taking a hypnobirthing course which I hope will help and just have my fingers crossed right now for a -GBS test so I can stay home as long as possible and avoid as much hospital stuff as I can. 

[Gena 22]

Those all sounds like excellent plans! 

[TinyLittleFeet]

You sound like you have some good plans!  I was planning a homebirth too until we found out we were having twins (it's illegal in my state for midwives to knowingly attend a twin birth).  You're so right -- there is something very isolating and lonely about a twin pregnancy.  I switched providers, cried a fair amount of tears, and spent most of my pregnancy fighting to try and achieve the best outcome possible.  It seemed like I was hitting one road block after the next and having to fight over the littlest things.  I made a birth plan, but didn't feel confident that it would be followed.

I ended up going into labor just shy of 38 weeks.  The OB on call was one I had never even met, and he ended up being a lot more willing to work with me.  Yes, I had an OR birth, but he allowed me to deliver on a delivery table (the other OB told me I would be *required* to birth on the operating table, strapped down, to make sure I didn't fall off).  He was obnoxious about insisting on stirrups, but I sat as far up as I possibly could, and the position was surprisingly comfortable, all things considered.  The team in the OR was actually pretty good about leaving me to do my own thing -- I sat in there for almost three hours at 8 cm until I was ready to push, and no one even mentioned a c-section or pit!  I had a natural birth with my babies born six minutes apart -- I actually was nursing baby A while I pushed out baby B!

Obviously, with a multiple hospital birth, you're not going to get quite the hands off birth you would like, but looking back on mine, I think my experience was about the best multiple birth in that environment that I could possibly have hoped for.  Yeah, it's not a warm, fuzzy water birth story or anything I would have ever dreamed of, but truthfully...no regrets.  I went to the hospital after laboring at home for a while, and even there, we ended up sitting in a little garden area just outside the hospital for several hours so I was nearby if things went quickly but not stuck being monitored the whole time.  It made a huge difference intervention-wise, I think.  Best of luck to you!

[13pumpkins]

Congrats on your twins and hugs of support.  I cannot offer much insight as I have not had twins but I had a wonderful hospital birth with my second daughter.  Really, my first daughter's birth was smooth but it was more intervention than I had wanted and took awhile to come to terms with.  I think the best thing that helped for making things go the way I wanted was finding my "voice" and standing up for what I wanted with the nurses.  That, and my dear friend who helped us through the birth.

I am still coming to terms with my upcoming birth plans.  With the trips it has to be a c-section and every bit of my body feels it is wrong.  My mind says that it is what is necessary to ensure their safety but my body/heart breaks over it.  So while I cannot give any proper help on delivering twins and I can at least give empathy and understanding when birth plans are not what you wanted going in.  It is hard because so many people act as if I am being selfish or silly when I just want to be listened to.  Of course I want and will do what is best for the babies, it just does not mean it is emotionally easy.

[QMtwins]

JodiAriel,

I too am working through the birthing twins thing...again.  Ended up with a c-section the first time around for a failed induction and pre-eclampsia.  So, this time looking at a trial of labor with twins after c-section with twins.  Some providers I know think I am just silly and others are supportive.  The hospital nearby (4 min away) is one I don't think of as VBAC friendly and, in my opinion, doesn't have supportive nursing staff.  So, as I was hopnig to deliver with midwives an hour and a half away, now I am consulting with them regarding a VBAC in a week or two.  We shall see how this goes. 
My biggest thing about a second pregnacy was that I hoped it would be, "normal."  Low risk, just a VBAC, no biggie.  Now, I'm adjusting my thoughts and hoping for a, "normal twin birth!" 

Good luck with your birthing prep and experience! 

[RadTwins]

I had my twins just over two years ago. And I too struggled a lot to find a doctor that would let me deliver naturally. These were my first (and last due to age and 3 rounds of IVF to get there) and I really wanted to have a natural birth. I had read two of Ina May Gaskin's books about natural childbirth and I really wanted to have that experience. I was so frustrated that doctor after doctor kept telling me that I'd have to give birth in the OR along with everything else you've been hearing. Finally I found a practice with some older doctors and they agreed to try natural birth if I wanted to when the time came. My son however was breech and refused to turn, so that made things more complicated. More than one doctor told me they might have to put their entire arm up inside me to turn the baby. (Someone told me that any doctor below the age of 40 these days just isn't taught how to deal with twins or breech births, so they all want to do c-sections, and that if I wanted a natural birth I'd have to find an older doctor.)

Anyway, by about 34 weeks I was so ready to just have them out that I didn't even care anymore how it happened. In the end, I gave up and scheduled a c-section for 38 weeks and when my labor hadn't started by then, we headed to the hospial on the appointed day. It was wierd to walk in and say, "It's 10:30am, and I'm here for my scheduled baby delivery." It seemed sort of surreal to have my birth experience be so different than I had wanted, but it was calm and no one was hurried. I even chatted with the doctors as they sewed me up.

I found out later that day that a woman I'd met in my multiples class, had gone into labor (at 36 weeks) earlier that morning. She had her first baby naturally and then the second one got stuck and they had to do an emergency c-section. She said it was scary, and that the doctor had the scapel in her hand before she was barely on the table. (I don't mention this to scare anyone, but to let you know that this kind of thing can happen, which must make it harder to recover physically and then begin to mother twins.) On the flip side of this, I know another twin mom who went into labor around 38 weeks, and within 3 hours of her water breaking she delivered both babies naturally with no trouble. She also breastfed her twins for a whole year with no trouble. We're all quite jealous (and proud) of her experiences. 

One positive thing about a scheduled c-section is that I got to choose my doctors (helpful if you go to a large practice) or if your doctor happens to be on vacation. In retrospect, I truly thought I would feel that I had missed out on something if I didn't do a natural birth, but I honestly didn't feel that way afterwards and I still don't. You go through so much with twins, that it's enough just to have two healthy babies. Twins are really hard from about halfway through the pregnancy until at least the end of the first year. With all of it, I just don't feel like I missed out on anything. The whole experience is so overwhelming at times and the birth is only one piece of a bigger puzzle. So don't worry too much about how it will happen. Find good doctors, and do your best to get things to happen in the way that you want, but don't worry if it doesn't go the way you hoped. You'll be too busy to worry about it later anyway.    : )  

[mauri456]

I remember that same exact feeling that you are describing and feeling almost upset that there were two babies.  Now I look at my two almost 2 year old sweet little girls and am so happy we were blessed with them.

Their birth was in a hospital and it was everything I could have hoped for!  They were an unmedicated VBAC at 39.6 weeks.   I delivered them in the room with no crowd - just my husband, midwife, OB, and two nurses.   I did have monitoring but it was intermittent until I was in transition.   I did need some pit, AROM but I was completely okay with it.   

My providers were completely supportive and amazing.   It was a very peaceful, perfect birth.  They nursed after delivery and are still nursing now!  

[QMtwins]

Originally Posted by mauri456 

I remember that same exact feeling that you are describing and feeling almost upset that there were two babies.  Now I look at my two almost 2 year old sweet little girls and am so happy we were blessed with them.

Their birth was in a hospital and it was everything I could have hoped for!  They were an unmedicated VBAC at 39.6 weeks.   I delivered them in the room with no crowd - just my husband, midwife, OB, and two nurses.   I did have monitoring but it was intermittent until I was in transition.   I did need some pit, AROM but I was completely okay with it.   

My providers were completely supportive and amazing.   It was a very peaceful, perfect birth.  They nursed after delivery and are still nursing now!  

Mauri, are your girls di-di or mono-di?  I'm so glad you had a VBAC of twins...I'm working towards this myself and its not an easy haul.  Thanks for sharing this...I'm feeling a bit down about where I am in the process right now. 

[kchara]

I think the key in a situation like yours is to labor at home as long as possible.  I did that with my twins, (36 weekers, but the doctor was fine with that), and in the end, they didn't have time to get me to the OR, didn't have time to get the IV in, and the on call doc didn't even get there in time to deliver Baby A!!  (Hubby caught her, nurse freaked out, it was epically cool.)  It went as best as I could have hoped for for a hospital birth, and was my first completely natural (no epi or any drugs) birth at all. 

Now, just a disclaimer, in my situation, it was a weekend in a small town hospital.  I didn't know that L&D closed on the weekends. My bad.  They got over it.  I also had a really good OB, who was a midwife's husband.  He was even willing to deliver breech, so I went in there with tons of confidence.