Twin Homebirth/Approaching Peri/OB ?

[kote80]

Hello everyone, I am new around here. Im Jessica and im currently pregnancy with twins. I have some questions I hope you all might be able to help me with. Okay for starters, anyone have a twin homebirth? Do you have any information on the safety of a homebirth w/ twins vs hospital birth? I have talked to several MWs that say they feel its safe and it is really what I want at this point. My dilemma is this. I am "high risk" due to two previous very premature labors/deliveries at 23 and 25 weeks. I was Dxed with incompetent cervix and this time around I am on bedrest and I have a cerclage which I will get out at 36 or 37 wks, im not sure which yet. Anyway, when I approached my OB (high risk peri) about hospital policies regarding a twin birth and my desire for my birth to be as natural as possible he told me I would have to deliver in the OR with an epidural (dosed) and that he can't FORCE me to get the epidural he feels very very strongly about and I "should" trust him. Also he said "unfortunately there is little chance of a natural birth with twins" Basically dismissing it. He was pretty cocky, which I was suprized about because I have always trusted him thur my pregnancies, however I do realize my needs are alot different during pregnancy when I am high risk vs if I make it to term, and obviously our views are very different. When I asked about having my doula present he said he felt 9/10 are a waste of money and time and its unlikely that I would be able to have her in the OR at delivery. All of this is unacceptable to me, so we began looking at homebirth (I am 30 wks). The problem is I am still "high risk" until 36 wks for PTL etc and I need my cerclage out at this hospital by this doctor. We are military and are limited on who we can see and this is the military hospital (also apparently the most liberal hospital in the area which is awfully scary). So if we decided to do the HB w/ the MW, how the heck do I go about this? Wait until I get my cerclage out at 37 wks and then say something? The MW said she will do a Hb after 36 wks. I dont want to lie to ppl about it, but then again I dont want to be harassed over it either I KNOW that he will be very unsupportive and I dont want to be refused care which i still need until FT (I dont know if he could/would do that in this situation or now seeing that this is the only place I can really be seen and I still need care until FT and he is military) Another problem is that if I dont get my cerclage out until 37 wks and I go into labor at 36 wks Ill HAVE to go to hospital to at least get the cerclage out, then what, what if they try to admit me? You dont think they could refuse to take it out if they knew I was leaving do you? I mean a cerclage left in place too long after labor starting can do major damage to a cervix. And after its out then what, just leave? I am really confused on how to handle this, if anyone has any insight that would be great. I never thought this would be an issue because honestly I didn't think nor did anyone else that I could make it to a point where HB was even a remote option. Also I didn't realize they would treat a twin birth so drastically. Geez. Thanks! Jessica

[Ellie'sMom]

Welcome Jessica and congrats on having made it to 30 weeks! I can't answer all of your questions, but you might try posting this in the Parenting Multiples section to get more responses from twin mamas.

I am currently 37.5 weeks with twins. I was dx'd with a short cervix at 23 weeks, but since I wasn't dilating and was so late in the game they opted not to place a cerclage and just put me on modified bedrest. As it turned out my cervix just stayed short, and I was was never really put on true bedrest. I was lucky enough to find the rare peri/OB who is supportive of a woman's right to birth where/how she chooses. It doesn't mean he is truly supportive of hb, but I have been able to be honest with him. If I had not found him, I would have found another OB and just lied. Why does the doc you are seeing have to be the one to remove the cerclage? To be honest, he sounds really unsupportive and I would tend to recommend finding another doc who is less interventionist even if you can't disclose the homebirth to them. Did you have good births with him previously? Can your midwives recommend any OBs? I found mine by asking around here actually. You could try going to the tribal area for your state and posting a thread.

I don't have any studies on the safety of twin homebirth. I think the numbers are too small. The Farm in TN has some data (on 15 sets maybe?) of which I think only one mom required a hospital transfer and all babies were born vaginally. For me, my personal criteria was to find a MW with experience with twin and breech birth. Mine will be the 9th set of twins she has delivered at home. If my baby A were not head down I would also need to rethink my plan. This is not because breech/breech births are not doable (there are mamas here who have done it at home), it just would add another dimension I would have to consider. My babies are also dichorionic/diamnionic (so at low risk for TTTS) and are close in weight. These factors all give me some sense of security about my homebirth.

The crazy intervention-happy way twin births are treated in most hospitals is exactly why I hope to have these guys at home. I actually feel we will be MUCH safer than in the hospital. If I do transfer, my mw will go with me as my doula, and I have specified with my OB and in my birth plan that she is to stay with me wherever I deliver. Is your midwife willing to wait until 37 weeks for you to decide? I would want to know for sure that she will be available, and to have a couple of prenatals with her to get to know her.

I am really rambling...I know that some other moms with brains not scrambled by pregnancy will respond. Keep us posted!

[cathicog]

As long as you make it past 36 weeks or so(multiples' lungs usually mature a little faster than a singleton of same gestation) I would get the cerclage out, and not say a PEEP to that doc, or any doc in a military hospital, or anywhere else , for that matter....they are looking at you as a section waiting to happen, so I would keep quiet, work on plans with the midwife, and bide your time. You are much safer having the babies at home, and there are lots of sites you can find homebirth twins stories. google "homebirth twins" (Robin Elise Weiss, moderator of pregnancy/birth at About.com, had her twins at home. Her husband helped catch them, even. Her birthstories are there.) There are also the birthstories of multiples on www.freebirth.org and other similar sites. Unassisted childbirth sites have quite a few twin births on them. (one lady I know had both before the midwife got there, the mom caught the first, and then the dad, caught the second, then the midwife got there. Her labor was only 1 hr 15 min long, and the midwife lived an hour away!)Hope that helps, and keep us posted! :)

[applejuice]

Mamacita here had a twin birth at home; each has its own birthday!

Multiples have been born at home for a very long time. My grandmother was a fraternal twin born at home.

The Dionne quintuplets were born at home, and they all lived past infancy.

[ldsapmom]

(((hugs))) Mama, it sounds like you are in a tought spot.

If I were you, I think I would secure a midwife I felt good about, and plan on not going into labor until that cerclage is out! Start visualizing and thinking good thoughts about it.

I know a few moms who had sections for no other reason than their doc siad with twins it was needed (not even a trila of labor -- no talk of babies positions, even!). We do have one OB here that if Baby A is head down, he will allow vaginal delivery regardless of Baby B's position (how nice of him, huh? At least he does not opt for automatic cesarean!).

I would not say anything to my perinatologist about my poans -- I would keep going to appointments and looking like the compliant patient in case I would need him after all -- don't burn that bridge but be reserved.

Best wishes, Mama!

[courtenay_e]

If your midwife is willing to wait on you, just keep going to see that OB until you get the circlage out. Keep quiet and don't mention anything to him. They CAN NOT admit you against your wishes. You may have to sign paperwork that says you're leaving against medical advice (AMA), but they won't tie you down and keep you there! Just be strong emotionally...you KNOW that a homebirth is safer for you AND the babies. Especially since the guy is already telling you how it's going to be. He's planning a C-section. How effective a labor do you think he'll "let" you have if he's already planning a c-section? Good luck. I wouldn't say a word, I'd get the circlage removed, and then I'd go home and have those babies.

[Mary-Beth]

I would suggest that you go to regular visits with your midwife and your Dr.
This way you're not burning bridges with your Dr. and your building a relationship with your midwife. I think that relationship- that trust and bond- could help you in labor. And, midwives have a great reputation for identifying warning signs and risks...so I actually think you're in better hands with her. But like others said, I too would suggest you not tell your dr. you're having a homebirth until the last minute...

Wish you the best labor!

[sarahloughmiller]

I am 39 weeks pregnant with twins today and I am planning a hb. I was also really upset with the hospital policy on twins. Delivery in the OR, likely c-section (especially if 2nd baby is breech), IV, 10 people in the room (3 nurses, 2 resp therapists, 2 pediatricians, 2 docs, anesthesiologist), me only getting to have dh in the room & he would be kicked out if an emergency c-sec was needed, etc. I spent a lot of time crying and just not knowing what to do. I finally found a mw that would do it at home and I have been feeling so much better about things since. I also had a cerclage that I got taken out at 36 weeks and I have still not had these guys at 39 weeks. I had my cerclage taken out at the docs office, not the hospital. Is there a specific reason they do it at the hospital? I would talk to the mw that you choose about her possibly taking it out if you go into labor with it still in. I was very worried about that and about going in in labor to get it out and them not wanting me to leave. I didn't want to get stuck at the hospital just because of that. They can not refuse to take it out and you can sign out of the hospital against medical advice after it is taken out. In your case I think I would not tell the doc anything about planning a hb. My doc is not supportive of my decision to have these babies at home, but he said it is my choice and I can do what I want and he will continue to see me throughout the pregnancy. He basically just told me not to tell him about it because he is really not supposed to be seeing me when I am planning a hb.

I completely understand how hard this can be and I hope you can come to an arrangment that works for you. Just trust yourself and your body and know that you will make the right decision. Oh, and congrats on the twins and making this far! You can pm me also if you have any other questions I might be able to answer. If I don't get back to you right away I am probably having babies!

[amanda2b2]

As long as you make it past 36 weeks or so(multiples' lungs usually mature a little faster than a singleton of same gestation) I would get the cerclage out, and not say a PEEP to that doc, or any doc in a military hospital, or anywhere else , for that matter....

same advice here!

[kote80]

I am 39 weeks pregnant with twins today and I am planning a hb. I was also really upset with the hospital policy on twins. Delivery in the OR, likely c-section (especially if 2nd baby is breech), IV, 10 people in the room (3 nurses, 2 resp therapists, 2 pediatricians, 2 docs, anesthesiologist), me only getting to have dh in the room & he would be kicked out if an emergency c-sec was needed, etc. I spent a lot of time crying and just not knowing what to do. I finally found a mw that would do it at home and I have been feeling so much better about things since. I also had a cerclage that I got taken out at 36 weeks and I have still not had these guys at 39 weeks. I had my cerclage taken out at the docs office, not the hospital. Is there a specific reason they do it at the hospital? I would talk to the mw that you choose about her possibly taking it out if you go into labor with it still in. I was very worried about that and about going in in labor to get it out and them not wanting me to leave. I didn't want to get stuck at the hospital just because of that. They can not refuse to take it out and you can sign out of the hospital against medical advice after it is taken out. In your case I think I would not tell the doc anything about planning a hb. My doc is not supportive of my decision to have these babies at home, but he said it is my choice and I can do what I want and he will continue to see me throughout the pregnancy. He basically just told me not to tell him about it because he is really not supposed to be seeing me when I am planning a hb.

If I don't get back to you right away I am probably having babies!

First, thanks everyone so much for being so reassureing and kind, even when you know what you are doing is the right choice its hard when everyone else is so negitive about it. And thanks for the advice, I think not saying anything is what Im leaning twd. I think when I go into labor Ill just have my husband leave a msg w/ his secertary or something so he knows why I never showed up to have my babies (the clinic i go to is attached to the OB unit at the hospital) Do you think that is the best way? Or should I wait until they are born? Thats the best way I think I can handle it and I guess like you all said if I have to get the cerclage out at the hospital because I'm in labor I can always just sign out AMA. I pray I get it out first! To answer a PP question I have a shoikder (sp?) stich and Im not sure if they just take those out like the simplier McDonald stich or not (my stich is under the skin and then stiched thur), but like I said the clinic is attached to the OB unit so they would likely sent me over there to get it removed one way or the other. Also I am lucky because my doula is a midwife, she isn't CPM yet (she still does doula services too) but she is in her last phase or whatever they call that, and all her births are attended by her training midwife (Im sorry I dont know the terms here) who apparently I have heard from many is one of the best in the area and they have both done twin births. I also have spoke w/ her and she is willing to take me if i decided I didn't want my doula as primary midwife (but Im pretty sure I do) So what I was planning is working something out with her to be my midwife instead of doula since I already know her and feel comfortable with her. I AM alittle nervous the way I might get treated if a complication does arise and hospital is needed, isn't it terrible that women should be afraid of their birth for reasons like this? Its so upsetting. My husband and I have decided if we can work out arrangements with her then we are going to do the homebirth. She has been outta town (caught by the hurricane!) and is suppose to call me today. Anyways thanks again for all the reasurrance. I know in my heart hb is safer, but when you hear so much like what if something goes horribliy wrong and you need a stat section blah blah it makes me nervous, I just have to remember that most sections end up from interventions given at the hospital and the mws that will be with me are very experienced and Im in better hands at home then anywhere.

Hey I can't wait to hear you had your twins, I would love to know how it all went! :)

[Rockies5]

:twothumbs Wishing ll the twin mama's well! :clap

to the OP (kote) I would like to pursuade you not to call your dr when you go into labor if planning a HB with twins. OB seems to already have shown you how he feels about the safety of twin birthing, and since he's already surprized you once (by being flip and unsupportive) he may surprize you again by calling an ambulance to your front door, or delcaring that you're putting your babies as risk, and notifying CPS. It would likley cause no more then stress and paperwork confusion but still...not a happy thought. It has happened before.

I, personally, would just keep quiet until a little while after the birth. Your loyalty to this guy (no matter that he helped you with your previous pre-term births and doubless was someone you counted on or you wouldn't speak now as if you felt you were betraying him) is displaced.

[kote80]

:twothumbs Wishing ll the twin mama's well! :clap



I, personally, would just keep quiet until a little while after the birth. Your loyalty to this guy (no matter that he helped you with your previous pre-term births and doubless was someone you counted on or you wouldn't speak now as if you felt you were betraying him) is displaced.

Hmm, If i seemed like I am being "loyal" to him I may have come across wrong. Its more like I have a hard time with "lies", i dont feel like Im betraying him, I just prefer to be up front and out in the open with things and Im frustrated that I dont feel comfortable doing that because of the situation and the doctor. You are right he has helped me alot with my other pregnancies but like I said before my needs are rapidly changing. I just thought letting him know right off the bat would avoid confusion or other issues, but you brought up a good point, I really dont want an ambulance at the door or ppl in my face questioning me, Unfortunatly keeping quiet might be the only option that is best for my family. The more posts i read from you all the more i am convinced to stay quiet about it, I know he'll have to know eventually because he'll wonder where Ive gone to, but waiting might be best after all. Thanks for the insight.

[Cyneburh]

I second the opinion about calling after the babies are born... maybe even the next day or two! Don't rush to call the OB... if you even wait at week, it's just fine.

But as for needing an emergency C-section, after transfering to the hospital with my 1st, I now firmly believe that if you want to get into the operating room stat, you're better off calling them from home and telling them you are on your way in and will probably need a section. They'll panic and get you in so fast you won't believe it. It's amazing. You'll probably get into the operating room faster coming in from home then you would if you were already at the hospital! (Depending on how long a drive you'd have to get to the hospital of course.)

Don't go unless you need it but know that if you need it, you'll be able to get help super fast by coming in from home!

[applejuice]

:truedat:
ITA

[kote80]

I second the opinion about calling after the babies are born... maybe even the next day or two! Don't rush to call the OB... if you even wait at week, it's just fine.

But as for needing an emergency C-section, after transfering to the hospital with my 1st, I now firmly believe that if you want to get into the operating room stat, you're better off calling them from home and telling them you are on your way in and will probably need a section. They'll panic and get you in so fast you won't believe it. It's amazing. You'll probably get into the operating room faster coming in from home then you would if you were already at the hospital! (Depending on how long a drive you'd have to get to the hospital of course.)

Don't go unless you need it but know that if you need it, you'll be able to get help super fast by coming in from home!

Yah we would call ahead if there was a big issue. See the reason my doc wants an epi and in the OR so there is little waiting if we do need a section, but how often is a section needed with in 3 mins? I mean even w/ twins that has to be really rare, most have time to get spinals at least. I think I would risk the low chance of having to go under for a section in the rare case i might need one THAT fast then, putting myself and my babies in hostile birthing environment where i have little choice and control over what happens to me or my babies.

thanks for all the information all. Ill let you know what the outcome is!

[hotmamacita]

Twin homebirther here. Applejuice was referring to me--she made a typo. I don't think MAMACITA has twins.

:wave

Anyway, come on over to the parenting multiples forum for lots more stories.

In the meantime, where do you live and WHAT do you want to do?

I wouldn't go to any appointment or care provider unless you wanted to.

I don't believe in jumping though hoops to make someone else happy at the expense of what your own gut, heart, and mind are telling you.

All that said, I also do not feel the same hostility towards OBs that I used to and do believe that there are good ones with good experience and knowledge that can help you understand the very real concerns he/she may have about your body and birth.

Only you can decide what to do but I would have a heart to heart with him. But that's me. If would help me understand more.

[kote80]

Twin homebirther here. Applejuice was referring to me--she made a typo. I don't think MAMACITA has twins.

:wave

Anyway, come on over to the parenting multiples forum for lots more stories.

In the meantime, where do you live and WHAT do you want to do?

I wouldn't go to any appointment or care provider unless you wanted to.

I don't believe in jumping though hoops to make someone else happy at the expense of what your own gut, heart, and mind are telling you.

All that said, I also do not feel the same hostility towards OBs that I used to and do believe that there are good ones with good experience and knowledge that can help you understand the very real concerns he/she may have about your body and birth.

Only you can decide what to do but I would have a heart to heart with him. But that's me. If would help me understand more.


OKAY! this is the 3rd try in posting this, it keeps freezing on me. Anways I live in texas and I want to labor/birth in a safe environment where I feel my wishes are respected and that my babies are respected. I feel like I am not going to get that in my hospital or I am going to have to fight the whole time for it, which I dont want to have to do while Im in labor, I deserve to deliver in peace. Anyway I do plan to talk to him in depth on my next appt ( I may or may not mention HB, I dont think at this point I will though) That is if they can manage to fit me in, they always seems so concerned w/ my cervix they forget that this cervix is part of a person :-/. I also plan on meeting with my possible MW tomarrow. Depending on how the meeting w/ her goes tomarrow I think there is a good chance we will end up doing the HB unless something comes up. I am still unsure of how to handle letting my doctor know, I have mixed feelings about it. I just know the more I think about it the more HB feels like the right thing to do for us despite the lack of support.

[cathicog]

I, personally, would just keep quiet until a little while after the birth. Your loyalty to this guy (no matter that he helped you with your previous pre-term births and doubless was someone you counted on or you wouldn't speak now as if you felt you were betraying him) is displaced.
:yeah:

Calling after the babies are born might be a good idea with the relatives, as well!!! :LOL

[Jlcampbellkidz]

Just checking to see how you are doing with everything. What area of Texas do you live. I'm in the Dallas/ Ft. Worth area. I know hosp. and docs here can be so pushy. i am praying for you and hope that you get the birth you desire.

[hotmamacita]

I know excellent MW in the central Texas area experienced with twins.

:1praying: for you regardless.

[kote80]

Just checking to see how you are doing with everything. What area of Texas do you live. I'm in the Dallas/ Ft. Worth area. I know hosp. and docs here can be so pushy. i am praying for you and hope that you get the birth you desire.

Thanks :) Actually we offically are planning a homebirth now. As long I make 36 wks (and of course have the cerclage out) we are doing this at home :) My doula who is about to test for CPM and the midwife who trained her (not sure on technical terms sorry) Will be my midwives :) I am very excited!! They are both experiences in twin and breech I feel good about it :)

[kote80]

I know excellent MW in the central Texas area experienced with twins.

:1praying: for you regardless.

thanks for the prayers :) We have found a good midwife, well two :) Yay. Thanks again for everyone's encouragment and support

[Ellie'sMom]

Yeah!! Keep us posted!

[Jlcampbellkidz]

i am so excited for you. congratulations!

[applejuice]

Good Luck. :thumbs