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Midwife Meeting - Page 2

post #21 of 32
I plan on getting a doula too, as I think I really need an advocate (in addition to DH) to help the odds of me having a vaginal, non-medicated birth. What happens if you hire a doula and you end up having to have an early c-section due to some emergency or whatever?
post #22 of 32
Thread Starter 
Well I don't mind being an uncooperative patient and DH can handle things well too, but I think we both would appreciate the help of a strong doula! I'm not really disappointed, because not all of the reasons I think home birth won't work are her fault. No big deal, it isn't about me, it is about my babies and what is safest for them.

As far as a birthing center, there is one, about 1 1/2 hours from me. The only problem is after reading the web site and the blog of the midwife that owns/runs it I don't think I'd be comfortable there. She's extremely the opposite of me politically and extremely outspoken. I just got a weird vibe while reading her info. Make sense?
post #23 of 32
Also, others may know better, but all of the birthing centers in my area are singleton only for liability reasons.
post #24 of 32
Let me tell you, carrying twins will bring about more changes in your birth plan than you'll ever imagine. It became like a full-time job meeting with midwives, perinatologists, touring hospitals, getting u/s, etc. I do know that several mamas on the board did birth in the hospital, and I'm in awe of them, as they did it w/o the usual interventions. I think I had decided that if in a hospital, I would agree to a placed epi, just not dosed. I know that c-section chances are higher in a hospital, and I really didn't want to go under general and not see my babes. I know it's out there, but there have been mamas who have used "travelling" midwives, and I think there are awesome ones out there. I really wanted to be comfortable w/our mw's experience, and she had attended 14 twin births, and I thought that was ok, not great, but the average for mws in the area. I don't think birth centers can do twins, unfortunately. Also, my MW had gone through a successful twin birth w/breech/breech babies, and other challenges. Stay positive that the BEST scenario will present itself to you.
post #25 of 32
If you stay with a hospital, DEFINITELY get a doula, and definitely make it clear to your providers where you stand on certain things. As a doula, I know there's only so much I can do to help my client protect her birth plan-- hashing a lot of it out in advance with your provider is really the best way to make sure you get the birth you want (and having a supportive and strong doula can help a lot, obviously). Also, check around-- even if you choose a doctor and a hospital, there is a HUGE variety in doctors and what they're willing to flex for you.

As for homebirth, I wouldn't give up on looking for homebirth options if you feel that is going to be best for you. I'm the "fly by the seat of my pants" mama, and I spent so much time researching and planning for my birth, and ended up traveling to a nearby state to have my homebirth (rented a temporary home near a major hospital that I knew did vag twin and VBACs), had a midwife who had around 20 twin homebirths since switching to a primarily homebirth practice over a decade ago. I also know of a mom who flew a midwife in from another country. Really, there are options out there if you feel you have the fight in you to keep pursuing them, but it isn't always easy. Homebirth isn't for everyone, certainly not for every twin mom, but for those who truly know it is the best option (and for most of us, that's some combination of research, medical history on prior and present pregnancies, and prayer/intuition), there are ways to practically bend the laws of the physical universe to line up your birth if you are hardcore, committed, and creative.

What's your leaning right now, if you knew you could find the provider you wanted? If you knew you could find a competent, experienced, like-minded midwife who would attend your twin homebirth, would you choose that? What if you could find a competent, experienced, like-mided doctor who would give you a lot of freedom to birth your way in the hospital? If you had both available to you now, with which would you feel more comfortable?

Other factors... How has the pregnancy been for you so far? What is your local hospital birth climate like? Which seems more formidable-- fighting philosophical fights about birth with the hospital, or dealing with the philosophical differences with the birth center midwife? Is there anyone else in your area (hour or so radius) who has homebirthed twins? What's the legal deal with midwives and twins there-- can you just interview midwives, or are you having to go off the radar and be more secretive? Do you have a local or nearby ICAN chapter that might have some members willing to hook you up with an underground midwife to help you reduce chances of an unnecessary cesarean?

I know we have several CA moms on here who have homebirthed. Maybe one or more of them can help you with some of those connections as well.

And if you end up in the hospital, remember that you still have rights, and can still say no. Sometimes, in a more progressive hospital, it's just a matter of signing refusal forms so they know they're arse is covered. Also, I know you said your local hospital is not so great; are there any in a 1-2 hour radius that are better? It might be worth traveling.
post #26 of 32
Quote:
Originally Posted by mamamolly1 View Post
I plan on getting a doula too, as I think I really need an advocate (in addition to DH) to help the odds of me having a vaginal, non-medicated birth. What happens if you hire a doula and you end up having to have an early c-section due to some emergency or whatever?
Every doula does it differently. If I support a mom during labor, and she ends up needing a cesarean in labor, there is no refund. If she schedules a cesarean, and I've been on call for her, I'll offer to go to the cesarean with her (partial refund), or if she doesn't want me to come, I'll refund everything but the retainer fee (that keeps me on call for her birth, assuming it's within a few weeks of the due date when she cancels). Most doulas have a contract that specifies what their policies on cesareans are.
post #27 of 32
Hey Christy C!! You were such an inspiration to me. Glad I know now who it was!!!!
As far as c-sections and doulas go, I have a friend who had hired a doula, and had a c-section, and the doula stayed with her in the room overnite and helped her care for her baby, as the time prior the hospital staff gave the baby a bottle, and as she was groggy w/drugs, she didn't know what was going on until after the fact. I think a doula can be wonderful, but more than that, I think it's mandatory especially for a first time birth.
I think the way to do a hospital birth would be to show up at the last minute for the birth My experience w/our doc was that he made some things sound negotiable, and as time went on, he made it clearer and clearer that basically things were NOT negotiable. Time is on your side now, and you can really start grilling everyone about what you want.
I really think that the most important thing to do is to visualize (as best as you can) the birth you want. Get ideas from reading other's stories and watching videos. I'm a big believer in putting the 'impossible" out to the universe, and letting it manifest. (I swear that's how I got twins after I wrote down that I wanted 3 kids, but DH would never go for a third pregnancy)
post #28 of 32
Yeah, my last birth turned out to be an unplanned c-section, and I stuck around even longer for her after the birth than I have with vag clients. The nurses really wanted the baby fed not too long after the birth, and she was too groggy to breastfeed, and since I knew she wanted to b-feed, I actually grabbed her boob and helped her husband to help the baby to nurse since she softly mumbled that she wanted to but couldn't hold the baby yet. Doulas do a lot more than just labor support, and having my midwife serve as my doula for my cesarean was SO invaluable for me!
post #29 of 32
Thread Starter 
Thanks Christy for your questions and comments. I appreciate your input greatly!

Quote:
Originally Posted by christyc View Post
What's your leaning right now, if you knew you could find the provider you wanted? If you knew you could find a competent, experienced, like-minded midwife who would attend your twin homebirth, would you choose that?
Based on where we live, I'm thinking it is not a good idea. Our local hospital is so terrible and the next closest (which is awesome) is nearly an hour away. Two things concern me, they are likely NOT to happen but if they did I'd be forced to go to the incompetent hospital: Babies not breathing properly or me hemorrhaging.


[QUOTE] What if you could find a competent, experienced, like-mided doctor who would give you a lot of freedom to birth your way in the hospital? If you had both available to you now, with which would you feel more comfortable? [QUOTE] Yes, except the odds of finding a doctor who is in line with what I want, is not likely!

Quote:
How has the pregnancy been for you so far?
So far awesome! And I must say, I have a fantastic OB but she's semi-retired and won't be delivering me. I've never even spoken to her about my "wants" during labor/delivery. I figure why fight the fight now. In fact, I rather not know who is delivering these babies, just take whoever is on call. It would be a lot easier for me to be a "bad patient" if I didn't establish a relationship with them in advance. Does that make sense?

Quote:
What is your local hospital birth climate like?
My local hospital is a joke, won't go there at ALL. (our son who is adopted was born there and I was there for his birth. I can't tell you what hell they put us through. As far as the big hospital, I am assuming it's pretty run of the mill in regards to procedure. I haven't taken the tour yet.

Quote:
Which seems more formidable-- fighting philosophical fights about birth with the hospital, or dealing with the philosophical differences with the birth center midwife?
I think I'd rather try the hospital. It isn't just the philosophical differences with the birth center, it's the location.


Quote:
Is there anyone else in your area (hour or so radius) who has homebirthed twins?
No. And I joined a twins club in the next town over and the nearly laughed out loud at my question.

Quote:
Sometimes, in a more progressive hospital, it's just a matter of signing refusal forms so they know they're arse is covered. Also, I know you said your local hospital is not so great; are there any in a 1-2 hour radius that are better? It might be worth traveling.
The university hospital is top of the line and if I were to deliver early that's where I'd want my babies to be. So I'm thinking I might just plan on delivering there, hiring a doula, laboring at home as LONG as possible and then fighting the good fight at the hospital.

They can't make me do certain things right?
They can't force me to have monitors on. If I want to walk around and change positions they can use dopplers periodically to check the babies right?

They can't force me to place the epidural catheter in right? (It's my understanding they place it right away (without meds) in the event they need to perform an emergency C-Sect).

They can't force me not to drink fluids?

I mean, in reality what can they force me to do?
post #30 of 32
Quote:
Originally Posted by DeannaK View Post
I mean, in reality what can they force me to do?
Well unfortunately in reality what they *can* do (and sometimes do do) is get a court order if they deem that your refusal of certain procedures, rules, protocols, whatever, are putting your babies at risk. Remember that the judge the call to give them an emergency order to do xyz is definitely going to believe whatever s/he's being told by the hospital about the safety of the babies. So yeah, they actually *can* sometimes force you and that's no fun.
post #31 of 32
It sounds like hospital birth is really your ideal, all things being equal. Some other thoughts that come to mind... Are there any CNMs affiliated with that hospital who might be able to attend a twin birth? Or any family practice physicians? My guess is no because of the legalities of it and the lobbying power of ACOG, but it's worth asking. But sometimes CNMs or FP Drs have a little more flexible approach. It sounds like you have a good plan (labor at home with a doula, and come to the hospital later in labor), but remember that there may be a delay between baby A and baby B. If I had gone to the hospital ready to push it would have taken me an hour to push out baby A, and then my baby B was almost 2 hours later (b/c of being posterior and asynclitic). So, I likely would have been "strongly encouraged" to have an unnecessary cesarean. Be prepared for how you might handle the intertwin interval (docs usually like to keep it under 30 minutes b/c incidence of distress is a bit higher after 30 according to the research). Also, if you are married, have your partner prepared to be your bulldog-- this will make your doula's job so much easier! As a doula, there are scope of practice issues influencing what you're supposed to do (in most cases, though not all), but as a husband, you can get away with a lot more. I know of doulas who set up a "code" with the husband in advance...

Anyway, not meaning to hijack the thread, but that was something more that came to mind.

Sorry your twins club was weird; that's really not all that unusual, but it's still frustrating. I never even made contact with my MoMs club before my birth. Still haven't actually!
post #32 of 32
Wow! PP hemorrhage and breathing issues for babies were a big concern for me, too. Looking back on the birth, I realized just how prepared and skilled my MWs were to deal with the recusitation of the babies (didn't need it, but it was a question with the cord around Sierra's neck), and my MWs had a protocol to give a shot of pit after B was born to prevent hemorrhaging, and also had the other drug (forgot the name) on hand. I truly felt so safe at home and with my midwives. But it sounds like the hospital path is the choice that best suits you at this point for many reasons, and I have to agree that establishing care with someone makes it harder to go against their wishes. At the end of my pregnancy, my peri was saying how much he would love to be able to deliver my babies, and I really felt it was heartfelt, as my DH and DD1 had formed a good relationship with him. I really liked him and yet figured that our chances of having HIM actually deliver the babies was slim to none ultimately, as that's how hospitals work. For the record, my babies were 3 hours apart (both fine and healthy as horses, but 3 hours is significant, as I don't know if a hospital protocol would give more than an hour). Typically, I do think twins come pretty close together, but like mine, it does happen like mine as well.
I'm so glad Christy C has jumped in to give you some food for thought. Her thoughtful choices and experiences were invaluable to me
Maybe start a new post calling on all moms with hospital births would be good. Like I said, I have read some stunning stories on this board of some beautiful births in the hospital.
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