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Would you UC with twins? - Page 3

Poll Results: Would you UC with twins.

 
  • 36% (51)
    No, but I wouldn't UC a singleton either.
  • 21% (29)
    No, but I would consider UC if it were a singleton.
  • 18% (25)
    Maybe, if I could have prenatal monitoring and a midwife on hand just in case.
  • 3% (5)
    Maybe, if I could have prenatal monitoring (no midwife at birth).
  • 6% (9)
    Maybe UP and UC if things seemed okay.
  • 10% (14)
    Yes, definitely.
  • 3% (5)
    Other (I tried to be comprehensive! Really I did!)
138 Total Votes  
post #41 of 65
Having experienced a nightmare twin pregnancy, where my identical boys could have been lost from 19 weeks on. No, I'd never have a UC for monochorionic twins. I'd also choose a section for monochorionic twins. But this is entirely because of my personal experience with problems of shared placentas.

I honestly don't know what I'd want if I was pregnant with fraternals or identicals that each had their own placenta. I could go for a mid-wife with monitoring.
post #42 of 65
Thread Starter 
Quote:
Originally Posted by magentamomma View Post
two OT questions:

1). what does npt mean? I keep seeing it in peoples signatures

2). what does UP mean?

NPT stands for Naturally Parenting Twins. A handful of us are regular contributors to a web site we've put together to help moms who are doing natural stuff with their twins (cloth diaper, breastfeed, cosleep, babywear, lean towards natural birth when possible) know they aren't alone and to offer tips we've found work for us, bring together some of the research we've done, etc. We just put it in our sigs so we can find each other over here, since the user names we use over there don't always match the ones we use here!

UP stands for unassisted prenatal. A lot of women do their own prenatal care during their pregnancy, sometimes including things like blood pressure checks, checking fetal heart tones, urine testing, measuring fundal height, etc. Sometimes women who are planning a UC get standard prenatal care from a midwife or doctor, but sometimes they do their own care (or a lot of it, anyway).

Hope that helps!
post #43 of 65
UC wasn't in my comfort zone at all, but I was considering HB with a midwife with my second pregnancy -- I had a midwife assisted hospital birth with my first. When we found out it was 2 who shared a placenta, my low-key pregnancy turned a bit more medicalized, but I still had a great birth in a hospital with an OB and an oddly presenting Twin B (tried to emerge with two feet and a fist) with a lot of twin and breech experience. No c-section -- but he did tuck her hand back in and hold onto her feet while I pushed her out. I do think there is a lot more that is unpredictable about twin births (and about nursing twins, and raising twins, and living with twins! )
post #44 of 65
Thanks christyc and sarahloughmiller for your thoughtful replies. MDC MoMs are some of the most thoughtful, open-minded and curious mamas I've ever encountered.
post #45 of 65
It was never close to an option with my pregnancy. If it had been, I'm pretty sure I would not have chosen to homebirth, but I would have definitely done everything in my power to have a vaginal hospital birth (and I'm pretty sure I could have). My older DS was born in a birth center, and that's really my ideal birth setting, but I've never heard of a [free-standing] birth center accepting twin births.

Anyway I personally think the risk of postpartum hemorrhage with multiples is too great for a homebirth. Oh, and I wouldn't UC a singleton either, but I would consider homebirth (I was seeing a homebirth midwife with my last pregnancy before we found out we were having twins).
post #46 of 65
thanks Christyc for your answers. When I decided on a homebirth with my twins I wish there had been something like NPT. I had to really search to find the info that I needed to make my choice. What it came down to was statistics and faith. The hospitals in my area had a 30-40% C-sec rate. MW have about a 9-12% rate I think. You double your risk for maternal death with a C-sec, and most of the twin problems can be managed by a well trained MW. I am still not sure how I feel about UC, because I fell like mw need to be utilized for the benifit of the profession and women everywhere, and because I myself go too far away in birth to be responsible. I am not judging it to be wrong however. I was a fence sitter in the poll... I wanted a mw available. I actually considered UC for ds, but something nagging said no, and he turned out to be a slight shoulder dystocia guy(shoulders 2 in. bigger than head) and my mw had to pull him out. Who knows though, maybe moms who considr UC are so in tune with themselves, they know this stuff intrinsicly
post #47 of 65
I answered "no", but I would if it was a singleton.

If the twins shared a placenta I would schedule a cs. If the twins had their own placentas I would be having a vaginal delivery. With the risks and lack of research of ttts I dont think laboring is worth the risk, but that is just my opinion...
post #48 of 65
Thread Starter 
Quote:
Originally Posted by mama_tigress View Post
Anyway I personally think the risk of postpartum hemorrhage with multiples is too great for a homebirth.
The PPH factor is a big part of why I wouldn't want to UC twins. I had a PPH with my twins, which was handled beautifully by my midwife.
post #49 of 65
PPH was a big concern so A) did what I could prenatally to try to prevent B) had herbs on hand C) had a good transfer plan in place

No PPH, in fact less blood loss with the twins than with my two singletons! Why? I think my nutrition was way better with my twin pregnancy, and I had a true unmanaged 3rd stage.
post #50 of 65
I didn't lose much blood either, actually. My MW asked me to do a precautionary pit injection upon delivery of the placentas and I declined. I told her she could have it drawn up and ready but after three big gushes (that felt like a RIVER of blood!) my uterus clamped down and that was it. One of the other midwives attending who had seen 18 twin home births had never seen a MoM not hemorrhage.I was thrilled to show her it could be done!
post #51 of 65
Quote:
Originally Posted by christyc View Post
The PPH factor is a big part of why I wouldn't want to UC twins. I had a PPH with my twins, which was handled beautifully by my midwife.
This is me too. I did have pph but it was handled beautifully by my mw. I asked about the possibility of xfer, wanting to know if it was going to come to that, but it never was necessary. I think it's really important that people realize that pph doesn't mean immediate death w/o transfusion. There is time to get it under control and/or xfer if needed. B/c of this, I would never opt for a hospital birth just in case of pph. That's major overkill to me.
post #52 of 65
I also want to point out that pph and other complications of pregnancy and birth aren't just things that can be avoided by doing the right things. My nutrition was wonderful during my pregnancy, and that probably contributed to the fact that my boys were born at about 4 lbs (3 lbs 12 oz. and 4 lbs 4 oz.) at 30 weeks 6 days. But the complications I did have, placenta previa with extensive bleeding and placental abruption, were not really avoidable, no matter what I did. It sometimes makes me feel uncomfortable when I read suggestions that women had perfect pregnancies and births because they did things right, and fail to recognize the element of blessing or luck or whatever you want to call it that is definitely involved. Because that suggests the contrary, that if things aren't perfect you somehow could have avoided it (and the emergency c-section under general anesthesia that saved all 3 of our lives)...

I know that my experience has colored my current opinion of birth. But I'm definitely not as laid back about it as I was when my older DS was born .
post #53 of 65
Quote:
Originally Posted by 2+twins View Post
This is me too. I did have pph but it was handled beautifully by my mw. I asked about the possibility of xfer, wanting to know if it was going to come to that, but it never was necessary. I think it's really important that people realize that pph doesn't mean immediate death w/o transfusion. There is time to get it under control and/or xfer if needed. B/c of this, I would never opt for a hospital birth just in case of pph. That's major overkill to me.
Yeah, there are few things that would be emergencies of a magnitude that couldn't be managed with transfer to the hospital, IF you live close enough to a hospital. Some people don't. I do think there are more of these possible situations with a twin birth.

It's probably partially just defensive, protecting myself, but after my experience with my twin pregnancy and delivery (I have trouble calling it a birth, honestly) I feel more along the lines that a healthy mother and baby are what really matters, and in most situations I would feel most comfortable in a birth center (for an uncomplicated pregnancy) or a GOOD hospital with a provider I trusted (for any complications or a multiple pregnancy). That's where I am now, and I personally don't think it's overkill, but that's just my opinion
post #54 of 65
Quote:
Originally Posted by Intertwined View Post
One of the other midwives attending who had seen 18 twin home births had never seen a MoM not hemorrhage.I was thrilled to show her it could be done!
Did you discuss why this might have been?

So far I have read that less intervention; including waiting to cut cords and a lower iron level can contribute to less likelihood of pph.
post #55 of 65
Quote:
Originally Posted by mama_tigress View Post
I also want to point out that pph and other complications of pregnancy and birth aren't just things that can be avoided by doing the right things. My nutrition was wonderful during my pregnancy, and that probably contributed to the fact that my boys were born at about 4 lbs (3 lbs 12 oz. and 4 lbs 4 oz.) at 30 weeks 6 days. But the complications I did have, placenta previa with extensive bleeding and placental abruption, were not really avoidable, no matter what I did. It sometimes makes me feel uncomfortable when I read suggestions that women had perfect pregnancies and births because they did things right, and fail to recognize the element of blessing or luck or whatever you want to call it that is definitely involved. Because that suggests the contrary, that if things aren't perfect you somehow could have avoided it (and the emergency c-section under general anesthesia that saved all 3 of our lives)...

I know that my experience has colored my current opinion of birth. But I'm definitely not as laid back about it as I was when my older DS was born .

I am sorry if you feel like any of say that if you do everything *right* you are guaranteed no complications. I think everyone on here is realistic in the fact that all birth carries risk and that twin birth does carry a little more risk. Any time anyone gets pregnant there is a chance they or their baby will die, that is just life. We all want to do what we can to lower that risk and obviously we all have our own opinions of how to do that. There are certainly things that can not be avoided and sometimes you can do everything right and still have complications. There are also a lot of ways you can greatly improve your chances of things going well. Good nutrition greatly reduces the chances of early labor, PROM, Pre-e, etc. and increases your chances of making it full term with big healthy babies. I think that is the point most of try to get across, especially to those pregnant with twins. We all stress those things so much so that hopefully the pregnant women that come here will take them very seriously and have better outcomes. Some women may not be close enough to a hospital to get there in time for certain emergencies and that distance is certainly something they need to take into account when deciding where to birth. I am twenty minutes from a hospital and I was comfortable with that, if I was much further away I may not have been ok with it with having twins. As far as pph goes, there are a lot of us hb'ers here who dealt with pph and I don't know of anyone that transfered for it. Most of the time it can easily be dealt with at home with a mw.


shukr-I have never heard of a lower iron level leading to less hemoraging. I was pretty low I think when I gave birth and I had a pph and the already low iron levels made it that much harder to recover from. Waiting to cut the cords is supposed to help and I think the main reason is that if you want until all that blood is transfered to your baby that is just that much less blood to come out of you!
post #56 of 65
Quote:
Originally Posted by 2+twins View Post
I voted 'Maybe, if I could have prenatal monitoring and a midwife on hand just in case.' I don't consider it a true UC but my ideal is to have a birth with a mw who is willing to wait in the wings, only stepping in if I need her. That's the way my twin birth was, actually, and it's my preference. In absence of finding the right mw I would consider a true UC, although prenatal monitoring would still be important to me.
:
Oops, I have a bad habit of voting in a poll then read the OP.
But I would still want minimal prenatal observation and a hands-off midwife.
I have not had to decide, but right now, I do not trust doctors/hospitals.
post #57 of 65
Quote:
Originally Posted by sarahloughmiller View Post
shukr-I have never heard of a lower iron level leading to less hemoraging. I was pretty low I think when I gave birth and I had a pph and the already low iron levels made it that much harder to recover from. Waiting to cut the cords is supposed to help and I think the main reason is that if you want until all that blood is transfered to your baby that is just that much less blood to come out of you!
LOL. So long as it does benefit them, they can have it!

The low iron perspective came from the point of view that the body knows it needs to bleed less with lower iron levels and kicks in from itself to prevent pph, but I hear you on the recovery.

I know Chantel had a lowish level so was wondering if she could verify anything along those lines from the practical experience of her midwives?

As I understand it, an artificially induced higher iron level, (I would define this as using non food sources to push levels up significantly where no health issues are behind the drop in levels) *isn't* healthy, so was wondering if that was a point of consideration too iyswim.

What is a normal/low/high haemoglobin dilution with *multiple* pregnancies? Kwim? I have asked about this elsewhere and got no reply....now that I know you ladies are Da Researchers Extraordinaire I'm gonna be asking away even more
post #58 of 65
Thread Starter 
Quote:
Originally Posted by shukr View Post
a lower iron level can contribute to less likelihood of pph.
I heard that low iron can contribute to it. ???

ETA: For a while, I was afraid that low iron was going to risk me out of a homebirth. I had anemia during my 2nd and beginning of 3rd trimesters. By the end of my pregnancy, I was eating iron-rich foods all the time, taking floradix, beet powder, alfalfa, liquid chlorophyll, and slow fe. These were added in one at a time, and as each failed to raise it high enough, I'd add in something else on top of it. By 36 weeks, I was out of the anemic range. My PPH wasn't SUPER severe, but I did get two IM and one IV shots of pitocin, 3 days of methergine, and a big jug of liquid chlorophyll right after the birth.
post #59 of 65
Quote:
Originally Posted by sarahloughmiller View Post
I am sorry if you feel like any of say that if you do everything *right* you are guaranteed no complications. I think everyone on here is realistic in the fact that all birth carries risk and that twin birth does carry a little more risk. Any time anyone gets pregnant there is a chance they or their baby will die, that is just life. We all want to do what we can to lower that risk and obviously we all have our own opinions of how to do that. There are certainly things that can not be avoided and sometimes you can do everything right and still have complications. There are also a lot of ways you can greatly improve your chances of things going well. Good nutrition greatly reduces the chances of early labor, PROM, Pre-e, etc. and increases your chances of making it full term with big healthy babies. I think that is the point most of try to get across, especially to those pregnant with twins. We all stress those things so much so that hopefully the pregnant women that come here will take them very seriously and have better outcomes.
Yeah. I've only seen one instance where it was clear that somebody was saying that she had a perfect pregnancy and birth because of what she did, and not due to any luck at all. I'm just still incredibly sensitive about this, which is probably pretty understandable. I did everything I possibly could, and I still ended up with the pregnancy from hell and preemies. I still feel like it wasn't fair, and it upsets me and to a certain degree I feel guilty about it, even though I could have done nothing different. This is all really personal stuff, but you know how emotional we can get over pregnancy and birth. Thank goodness my boys are incredibly healthy and happy (I've never known happier babies). But anyway, to the topic of the this thread, I'm sure our personal experiences play a huge role in our opinions on birth in general.

Oh and I wanted to add: I think the hemoglobin level at which they will transfuse you varies from hospital to hospital and doctor to doctor. I know mine got below 7.5, and they didn't transfuse me. I guess my point is that probably even when we read about women getting transfused, some of those women may have been fine without a transfusion, but they were "playing it safe".
post #60 of 65
Thread Starter 
Quote:
Originally Posted by mama_tigress View Post
I did everything I possibly could, and I still ended up with the pregnancy from hell and preemies. I still feel like it wasn't fair, and it upsets me and to a certain degree I feel guilty about it, even though I could have done nothing different.


I'm sorry you went through that. All we can all do is the best we can, and beyond that are many things that are just simply out of our control. You can't blame yourself for that. I know I did everything possible for a good outcome in my twin pregnancy, but that was no guarantee that things would go well. It can improve your odds, but there are just no guarantees.

You did everything you could, but as a fellow mom who guilts myself over every little perceived shortcoming or failure, I can completely relate to how it must frustrate you.

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