Homebirth and Triplets - Page 6

[singleton+twins]

Originally Posted by 1stTimeMummytoLore

I wouldn't argue this. In fact, I would wager that just about all the multiple moms you'd find on this forum were/are dilligent about excellent nutrition and some of them unfortunately experienced PTB anyway, but one trip to my local Mothers of Multiples meeting revealed a large number of sadly uneducated mothers who were not counselled about prenatal nutrition much beyond what is normally recommeded in mainstream obstetrics for singletons and had some woefully traumatic hospital birth/NICU experiences.

What is sad about that is the women didn't take the initiative and educate themselves. WE are our babies best advocates. I read all types of books on multiples and took the info to my mw. Some books I really liked, others I took with a grain of salt and pulled the info that I wanted. Even after my girlies were born I had to educate their PED that even though they were 2 sac/2 placenta (di/di) they still could be identical...that 25% of id share this structure and most of them are misdiagnosed as frat.

[2+twins]

Originally Posted by Belle

But would the medical establishment have been able to save twins born at 26 weeks?

Very possibly. My cousin had her IVF triplets at 23 weeks & 4 days. They just turned a year old.

[nathansmom]

Did it not drive you crazy to have to walk away??

Yes both times. My heart broke on the ride out of the hospital leaving my firstborn behind in the nicu. However he is now a healthy 3 year old who I wouldn't trade for the world. He has no recollection of his time spent in the nicu and had he not spent time in the nicu I'm sure I wouldn't have been the ap mom I ended up being. One of my twins also spent 2 1/2 weeks in the nicu and he also is a healthy 17 month old who has no clue he spent time in the nicu.

[orangebird]

Originally Posted by boscopup
Quite possibly, yes. Drugs can often stop PTL until babies get to a "safer" gestation. Also, birthing those babies in a hospital with a level 3 NICU can get them immediate care for their underdeveloped lungs (they inject a synthetic surfectant), plus help breathing, etc. A 24 weeker singleton has a 50% chance of living. I imagine that 26 week twins would have at least that high a chance, possibly higher if they're a good size for their gestation. They might be micropreemies, but they could be saved by modern medicine.

Originally Posted by maxmama

In a level III NICU, the survival rate for 26-28 weekers is around 90%. Betamethasone prenatally makes a HUGE difference in survival, as does access to ECMO and cardiac surgeons (many micropreemies need cardiac repairs), but 26 weekers are absolutely viable. Twins also do better than singletons (prenatal stress). However, in order to have time for betamethasone and for any chance for viable 26 weekers, delivery must be in not only a hospital but also a level III nursery. We have a level II and transfer out all patients who are less than 32 weeks.

I was kinda gonna say the same thing. The low survival rate quoted in the first post above is probably averaging in all 24 weekers born. Many are born at a local hospital and then transported to the level 3 NICU. When the baby is born right there with the right attendants it has a much better chance at survival. We keep WAY more than 50% of our 24 weekers alive. I don't have an absolute statistic for my unit but I see that most survive. The ones that get transported in don't do as well, when they aren't treated right immediately things don't go so well but not everyone is able to make it to the level 3 in time. We transport women in preterm labor in alot too. We are starting to get away from ECMO lately, the oscillators are starting to gain popularity. Even something so simple as CPAP is being used more and more on smaller and smaller babies. Anyway, just think it's interesting.

Interesting conversation.

[orangebird]

Originally Posted by alegna

As to 26 weekers, some moms may choose to not go to extraordinary means to keep a super preemie alive and I believe that is their ethical choice to make.

-Angela

This is true. We can keep almost anything (anyone if you will) alive, but quality of life is a whole 'nother conversation.

[orangebird]

Originally Posted by maxmama

Sadly, certain people currently occupying a certain large white house don't agree, and have passed a law requiring health care workers who receive federal funds (i.e., anyone who accepts medicaid or is covered under EMTALA) to attempt resuscitation of any infant 20 weeks gestation or greater born with any vital signs, including only a heart rate. Parents' wishes don't enter into the equation and the penalty can be removal of all federal funding.

I work at a state hospital, we accept medicaid and all that and we don't have this policy. Although after 24 weeks there usually isn't much discussion. But 23 and under it is mostly left up to the parents. 22-23 is where there is probably the most discussion. Sometimes the neonatologists/NNP/OB/RN whatever will have an opinion or try to help the parents decide, but we don't have the 20 week+ must resuss. policy. Is that new? I haven't even heard anything about it.

[minkajane]

This reminds me of the Friends episode where Phoebe had the triplets vaginally. I always thought how silly that was, because no mention of C/S was ever made. I never thought about someone having more than two babies vaginally. I've only ever heard about it once (the story of the homebirth with twins that turned into undiagnosed triplets). Guess I've been proven wrong!

[JesseMomme]

On Friends, as well, Rachel's baby was a breech and "no big deal" was a vaginal delivery. Made me really wonder if there was an informed
natural birth advocate for a writer on that show.

[minkajane]

Also, the twins were born vaginally in the last episode - no mention of C-section!

[mama_at_home]

I have to say I am kind of surprised and a little irked to see all this negativity on the HOMEBIRTHING forum on MOTHERING. Geez! I agree with all the mamas who said it is ultimately our decision as parents where we birth and we need to accept responsibility for the outcome. I chose to give birth to my twins at home because I felt in my heart it was the SAFEST place for me and my babies. I am almost positive I would have ended up with a c-section had I been in the hospital because my baby B turned transverse after baby A came out. Thankfully I had very capable midwives who calmly were able to turn him from transverse to head down and out he came. I believe 100% that my midwives were much more experienced and capable than high risk peris.

Also I have a friend who very heavily monitored during her twin pregnancy, had at least 5 ultrasounds, etc. Well when it came time for her scheduled c-section, guess what? Out came THREE babies. Even with all that monitoring and all those ultrasounds they still were not able to find the third baby. I think the homebirth triplet mama in this story did great. Had she been monitored, her babies would have come prematurely by c-section, would have had to stay in the hospital, being monitored, etc. Instead she peacefully gave birth to full term healthy babies with no problems. I still find it disturbing that we are debating the safety of homebirth on MDC. :

[DragonflyBlue]

I delivered my twins in the hospital, as I stated in a previous post.

Both babes were head down and ready. However after baby A came, Baby B decided to try and come out with both hands over his head. Not a good position for birthing.

Two things could happen. C-section, or the doctor moving his hands down and out of the way.

My peri asked what I wanted and I told him no c-section unless the baby crashed.

Little did I know what I was in for.

Up went his hand, wrist, forearm. I recall sreaming and asking for an epidural NOW. Everyone laughed with me as I told the peri that he was entering no-man's land. But it worked. He held Calebs arms down as I pushed to a point his little hands coudn't wave to the peri anymore.

He came out, no broken clavicles, no c-section.

The only thing that ticked me off was my peri would not help me with a little trick I wanted to play on dh. He refused to say there was one more in there just to freak dh out. Said he didn't want dh in the ER getting sutures from passing out when he needed to be with me and the babes.

I really had few interventions. A bit of pit to get my cranky, worn out ute to contract and dilate past 4 cm. I did have more monitoring than normal at my request. I could have had less, but *I* needed that reassurance that the babes were okay.

There are things I probably would not have done under normal circumstances. But I did what I needed to do for my well being. I'd just buried a child eight months ago and was terrified I would lose the twins.

I did deliver in the OR, which was cool with me. At that point I could have delivered anywhere and not cared. I just wanted the babies out and healthy. There was a nurse who tried to tell me I had to remove a necklace I was wearing. The necklace has my late dd's birthstone ring (16th b'day gift) on it. I'd worn it every day since I got it from the ME. I refused. She pushed. I told her I never took it off. She said it had to go. My Peri came round the corner at that point, told the nurse the necklace stayed and we were off.

I really love this guy. He was so wonderful in how he took care of my pregnancy and my mental state. Plus he was cute and had a very cute bottom! HAHAHAHA

If the babes had been a singleton, I would have delivered at home. I think. But given how I was at that point and time, I don't know.

I do know that I chose my peri carefully, trusted him and felt he understood my desires for the kind of birth I wanted. And despite being high risk, I got it.

I don't believe hospital births are all bad. Nor do I believe all homebirths are good. I know some wacky midwives who should not be in practice. Some women should not give birth at home. But it is, afterall, their choice.

Janis

[MyCalling]

I've had all 4 of my children at home, including my twins. All perfect births, all with wonderful midwives attending. My husband even delivered all of them, including both twins. It can be done. I would also chose to knowingly birth triplets at home, though obviously I have had some practice.

It is different to have twins or more at home. There is the whole "second birth" (or more) to worry about cords and unusual birth positions. Both of my twins were posterior and I hear that's supposed to be tough. It's not like two singleton births though, there is not much stress on the second baby after the first one's out. The most stress is on Mama worrying about this time before it happens.

[Satori]

Originally Posted by mara

I work at a state hospital, we accept medicaid and all that and we don't have this policy. Although after 24 weeks there usually isn't much discussion. But 23 and under it is mostly left up to the parents. 22-23 is where there is probably the most discussion. Sometimes the neonatologists/NNP/OB/RN whatever will have an opinion or try to help the parents decide, but we don't have the 20 week+ must resuss. policy. Is that new? I haven't even heard anything about it.

Thats what i'm wondering, around here they will not attempt to save a baby under 24w0d unless that baby comes out kicking and screaming and showing its ready to fight.

[sarahloughmiller]

Originally Posted by MyCalling

It is different to have twins or more at home. There is the whole "second birth" (or more) to worry about cords and unusual birth positions. Both of my twins were posterior and I hear that's supposed to be tough. It's not like two singleton births though, there is not much stress on the second baby after the first one's out. The most stress is on Mama worrying about this time before it happens.

both of my twins were posterior too (at home too) and I pushed them out like nothin. actually i didn't even push the 1st babies head out, after i got the urge to push but didn't push with it and i felt down and it was out! my 1st baby had been over 10lb so pushing out 2 8lbers was sooo easy.


there are so many variables and everyone has a different comfort level and none of us can say what is right for someone else. we all have to make the decision that is right for us and that we will feel good about. me and my dh made the decision to have all of our kids at home and to take full responsibility for anything that might happen. this was our decision and it was right for us and for other people it would not have been right and that is ok. it is wonderful that as women we do have the choice, like others have pointed out. i think it is our responsibility to make an informed choice and i think many people do not, but that is a whole other thread

on another side note, not all complications have to be dealt with at the hospital. for example, i hemoraged and never went in. for a mother of multiples this is the most comon complication and really is pretty comon (although a lot of docs automatically give pit to prevent it) and most of the time it can be dealt with at home as can some other problems. i was thankful to have my mw there with pit when i hemoraged 6 hours after the birth and passed out and i was borderline needing a transfusion but i made the decision to stay home and was glad i did. not all complications (or should i say variances?) in birth have to be dealt with at the hospital. oh, and on the monitoring thing, my twins were checked a few times (very fast labor and i did not want to be touched) and everyone that i know that had twins at home had their babies monitored.

[twins10705]

hmm..I wish I had seen this thread earlier. Any future pregnancies I have, whether twins or not, will be homebirths unless there is an emergency. I had PROM at 29 weeks as well, but I never really went into labor. Although baby A was deep vertex and could have come out easily were he ready to be born, I was grilled for two hours by 4 different OBs in L/D until my husband(and only "support") was just begging me to let them section me. : I wish I had known that there were techniques to reseal the bags(and preventative supplements that could have delayed or avoided the PROM). I had tons of u/s and doppler heart checks too, so I am thinking that could have really messed up a good thing. Yes, I am happy my babies are ok now -- but I still mourn what happened to us and I hate hospitals and allopathic medicine with a vengeance now(though if I had another micropreemie I would definately hand them over to the NICU, no other option for me after what I have seen). Pregnant women are treated like freshening cows on a farm, at least in Phoenix, AZ. If I am still in AZ for my next baby(or babies) it will have to be U/C unless the law changes allowing midwives to attend VBACs.