hypothetical twin homebirth question

[1stTimeMummytoLore]

in comparison to the feedback i recieved from my midwife during my twin pregnancy and feedback recieved by various doula clients, i was curious how other midwives here would respond to a hypothetical situation like this.

1)what would your advice be to a mom who was measuring 8-10 weeks ahead at around 20 weeks if you had not been able to identify multiples via fetascope or palpation yet?

2)would you be willing to attend a homebirth for twins without an u/s?

3)if it was your first twin birth and first breech birth, what sort of support, if any, would you feel you would need at the birth?

thanks in advance for any feedback anyone is willing to share.

[christyc]

:

Figured I'd edit and add:

1) N/A since we already had u/s confirmation of twins before meeting my midwife.

2) My midwife (a CNM) was VERY wary of ultrasound, talked a lot about its risks, and attends LOTS of births of women who do not consent to ultrasound (including a few surprise twins whose mama's didn't measure large), but requested I get at least one u/s to know # of placentas.

3) N/A because I was my midwife's 20th set of twins in her homebirth practice (and I know she had a lot of breech experience as well). She brought an assistant, and I had a doula there as well, so there were lots of hands to help when needed.

[mwherbs]

[QUOTE=1stTimeMummytoLore;10199893]in comparison to the feedback i recieved from my midwife during my twin pregnancy and feedback recieved by various doula clients, i was curious how other midwives here would respond to a hypothetical situation like this.

1)what would your advice be to a mom who was measuring 8-10 weeks ahead at around 20 weeks if you had not been able to identify multiples via fetascope or palpation yet?
you are measuring large for the dates we have- large enough that I wonder if you have a multiple pregnancy, are we off on dates? or have something else going on?

2)would you be willing to attend a homebirth for twins without an u/s?

I have some concerns-- why no ultrasound? I don't have to know very early but- humm if I have a large uterus and not able to hear baby/ babies and not able to feel/define baby/babies with my hands-- this doesn't seem normal to me-- and if I am only hearing one- and feeling one that is smaller than the uterine growth- what else is going on- fibroids or partial molar pregnancy...

3)if it was your first twin birth and first breech birth, what sort of support, if any, would you feel you would need at the birth?


someone who has lots of experience at attending twins or breeches would be my primary wish- and from there on out I would want to ask that mw the rest of the questions and follow her lead--- as for numbers of assistants needed the extreme- 2 resuscitations and hemorrhaging mom that would be 5 people minimum-- but I don't know midwives who do it that way they would probably trim down to 3 or 4 and the babies would get mouth to mouth-- if need be... I know a few retired mws and would probably draw upon their knowledge base and possibly pull them out of retirement for such a birth...

[MsBlack]

For anyone measuring that far ahead, I'd start w/careful review of LMP/conception, to be sure she was *really* that far ahead in cms compared to weeks. Then I"d want her to get an u/s to see about multiples or other possible issues. I, too, am wary of u/s for a number of reasons, and seldom recommend them--but I tell all clients that I might rec. one under certain circumstances and that is one.

If I knew it was multiples via other means, I would definitely want an u/s to see placenta situation and whether we'd need to be wary of twin-to-twin transfusion.

If I had advance knowledge of twins and/or breech, I'd definitely want to have another mw onhand who'd already assisted at such births if it were my first. I would want another mw on hand anyway, for twins, even if I'd done several sets. I know mws who don't include another mw for twins, but it just seems sensible to do so, to me. You have, with twins, 3 people needing attention--and in some cases, 1 or more of those people could need 'special attention'. One mw doesn't have enough hands!

[1stTimeMummytoLore]

thanks very much to the women who have offered their feedback so far. other mw please feel free to add your own perspectives. i find this topic facinating.

[FairFlowers]

I would simply ditto everything that MsBlack and mwherbs said.

BTW, I'm a mom of twins, too!