What can I do to avoid a c-sec?

[pleiades829]

I just found out on Thursday that I will be having twins - hurray! Now, though, the possibility of a c-section seems a lot greater than it did before, partly because they're twins, and partly because I'll be seeing an OB now instead of a midwife. I trust my clinic - they actually tell everyone who's using an OB to hire a doula - but I'm still a bit nervous. I meet the OB for the first time on the 27th.

What kind of precautions can I take now, at 21 weeks, to prevent a c-sec (and for that matter, an epistiotomy and medication) later on? I know hiring a doula will help - anything else? Thanks so much!

[Greaseball]

The best way to avoid c-sec is to plan for a home birth with a midwife who is not oriented toward medicine.

If you're determined to have a hospital birth, the best way is to just say no. Make it known that you will not have a section except in cases of fetal distress, prolapsed cord or transverse presentation. Same for epidurals - just say no!! Avoiding the epidural, lying on your back, and continuous fetal monitoring are ways you can prevent fetal distress. Also avoid induction and AROM. Don't let them give you a time limit for labor or pushing. Refuse the routine IV. Insist on laboring in a regular room and not the OR.

Avoiding an episiotomy can be different, since you might not always be able to see what they are doing and it can be done instantly, unlike the epidural. You can always write "no epis" on your belly with a sharpie.

It may also be helpful to avoid routine ultrasounds, so no one can use scare tactics about the size or position of the babies. Eat lots and lots; don't let anyone tell you not to gain lots of weight.

And read lots of natural birth w/twins stories! There are plenty here.

[Electra375]

I have to agree with previous poster...
also read The Thinking Womans Guide to a Better Birth
I personally love Ina May's Guide to Natural Child birth, as well.
Sit Up and Take Notice Positioning yourself for a better birth by Pauline Scott

Just by stepping in the door of a hospital with twins ups your chance from 1 in 4 to 3 in 4 chance of a c/s. The national average of c/s is 1 in 4, around my town I counted my 10 woman friends and came up with 4 in 10, so unscientific, but put reality on it.

The more you read the better prepared you are to face either a hospital birth or a homebirth. If you do go to the hospital be sure to hire a doula who is in line with your thinking, if the hospital recommends so and so, chances are she isn't going to fight the doctor or hospital for you when they say c/s or epidural or EFM (which restricts your ability to move in labor) or IV.

Don't be surprised if they tell you you have to deliver in the OR incase you need a c/s with an IV. I've seen it done around here and they don't give the second baby time to turn, which they will do naturally, so under general aneth you go and cut your baby out. One vaginal, one c/s talk about a hard recovery!

Sorry to be so negative, but after what I've been through, I have very little left possitive to say about hospitals unless you or your baby are in distress.

I would read as much as I could find about the natural delivery of twins. The second twin can be in almost any position and turn by him/her self to the vertex position after sibling is out -- 30 minutes between births is nothing to worry about from my limited reading on the subject.

[JanetF]

I agree with the previous posters. Choosing hospital birth can have many challenges and you will have to be a highly motivated and assertive consumer in your health care to achieve a natural birth with twins. However! What a blessing that will be to your babies that you will do everything you can to make their entrance to the world peaceful, gentle and unhurried. There are lots of natural birth stories with twins, but you have to search for them. Some sites which may help you are

http://www.midwiferytoday.com

http://www.empoweredbirth.com

http://www.joyousbirth.org

http://www.radmid.demon.co.uk/

These all have immense resource lists for anything you need to know and will have links to twin-specific sites as well.

Congratulations on having a birth to look forward to! What a wonderful journey to be on

Belly rubs to all 3 of you

J

[karendrema]

..

Originally Posted by Greaseball

Avoiding the epidural, lying on your back, and continuous fetal monitoring are ways you can prevent fetal distress.

I just read this and had to do a double take, so I thought I would call it out - I assume that greaseball meant to avoid all three, do not have an epidural, do not lie on your back and do not have continous fetal monitoring. Just the wording made it sound to me like maybe you meant that you should do the last two and I'm sure that wasn't what you meant.

Good luck!

[pamamidwife]

Elizabeth Noble's Having Twins book is excellent. Contrary to popular belief, just because you're having twins doesn't mean you will deliver early - in fact, if you eat right, you will probably go past your due date a bit!

There are five homebirth mws in my state that had twins - all term babies, all at home.

I agree about looking for a homebirth mw - at least for supportive/nutritional care and advice. Your protein intake will need to be higher, and I would highly recommend a good fish oil supplement!

[Greaseball]

Originally Posted by karendrema

I just read this and had to do a double take, so I thought I would call it out - I assume that greaseball meant to avoid all three, do not have an epidural, do not lie on your back and do not have continous fetal monitoring. Just the wording made it sound to me like maybe you meant that you should do the last two and I'm sure that wasn't what you meant.

Good luck!

Yeah, that's what I meant - avoid all of those!