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Revisiting Home birth again

5K views 80 replies 24 participants last post by  mamaeliz 
#1 ·
Well, after writing off home birth when we found out we were expecting twins, the deciding to look into - then ruling it out again based on the first midwife I interviewed and our location (our local hospital is dangerous - I would hate to have an Emergency trip there).

We are again revisiting the idea after two things: One, I spoke with a local doula who has both given birth at the hospital about 45 mins from us that we decided to go and she's also been a doula for other moms there. She said, they are not very flexible there and will fight me on their "rules". Constant monitoring, moving to OR for delivery, etc.

Second, we watched the Business of Being Born last night and it just really scared me all over again. I really don't want to go through with a hospital.

I am not afraid of pain or needing an epidural. In fact, I'm AFRAID of an epidural. My fear is that slim chance that something could go wrong. That slim chance.... it's really making this decision hard for me.

Thus far my pregnancy has been awesome! I'm 27 weeks tomorrow. My twin boys are growing on parr with singletons! My blood pressure is awesome, I've passed my glucose test twice, etc. I feel fantastic! Both boys are breech right now, but I'm not worried about that, it's stills so early.

Any words of advice or encouragement? (I've read the home birth stories here I love them). But I'm still feeling uneasy.
 
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#2 ·
Just wanted to send a hug and some encouragement. It`s a hard choice and one I think only you and your DP (after consulting care providers) can make.

For me, HB with twins was outside of my comfort level (I had been considering it when I thought they were just one). But that`s just me. And for me, the delivery in the OR was not a big deal -- I thought it would bother me beforehand (DS was born with a midwife at a hospital in a `homey`birthing room) and it didn`t one bit once I was there.

My babes were monochorionic and I was aware of the (rare) chance of late onset TTTS and I was glad for the NICU staff in the room, just in case. And DD2 had a CRAZY presentation after her water broke (two feet and a fist) and I was glad for my experienced OB (who had delivered a LOT of multiples) who was calm and helped ease her out (after tucking her arm back in).

But again, all of that is just me. I wish you and your partner the best when deciding what feels best for you. I am sure you will also hear lots of good things from mamas for whom HBing twins was in the comfort zone, too.

Good luck!
 
#3 ·
I was a planned homebirth hospital transfer. Let me tell you, I dreaded the OR. Having to birth in the OR was one of the main reasons I did not want to birth in a hospital. When it came down to it, though, it wasn't all that bad. Now, my experience wasn't bad for a few reasons: 1. my OB was very even-keeled, low-key, experienced with twin births, and an advocated for natural birth (he agreed to be a HB back up, which tells you a lot); 2. we didn't have a rescue team of 10 people for each baby waiting in the OR - my babies were term, we were at a low-key, non-teaching hospital, and my OB was very cool; we showed up at the hospital with Baby A at minus something station and ready to do more pushing.

What I do know, though, is that had I not been able to move around during early labor, the birth would not have gone the same way.

I suppose what I'm saying is that if you can find an OB that sees things as you do as far as your birthing wishes, then you likely WILL be able to have a decent or good hospital birthing experience. Your birth plan, signed by the OB, can direct things such as intermittent monitoring, epidural vs. not, etc. - those things are up to YOU and the OB, not the nurses at the hospital.

Good luck with your choice!!
 
#4 ·
Quote:

Originally Posted by kjoy2 View Post
I suppose what I'm saying is that if you can find an OB that sees things as you do as far as your birthing wishes, then you likely WILL be able to have a decent or good hospital birthing experience. Your birth plan, signed by the OB, can direct things such as intermittent monitoring, epidural vs. not, etc. - those things are up to YOU and the OB, not the nurses at the hospital.
Well the only hospital I would consider going to near us, is a major university teaching hospital. And they way they work is whichever OB is on call, is your OB. My OB is semi-retired. I really like her, but she no longer does deliveries.

I had a great conversation with a doula today (who worked at that hospital) she recommended a midwife (who is a teaching midwife) who is near me. I hope to find out more soon.

It's hard to make a decision on something so important.
 
#5 ·
Quote:

Originally Posted by DeannaK View Post
Well the only hospital I would consider going to near us, is a major university teaching hospital. And they way they work is whichever OB is on call, is your OB. My OB is semi-retired. I really like her, but she no longer does deliveries.
Ugh. I see your dilemma.

Are there any other hospitals near you that have decent maternity care in the case of full-term babies? I would have gone to our local major university teaching hospital had we needed it in case of pre-term or emergency, but b/c we had neither pre-term babies nor a transfer emergency, we traveled farther *in labor* to get to a local community hospital for birthing. Thankfully, my OB had access at both hospitals. I can see where you might not know how to go forward in your current situation as far as not knowing when the babies will be born and where you'd rather be / under care, etc. It really is so complicated
 
#6 ·
Without an understanding OB, we twin MOMs get the full force of hospital pressure for all the interventions. I chalk a lot of it up to liability fears. It really limits our choice!

Now, if you like the prenantal care you're receiving you may be able to avoid an induction. That, and like singleton mom, staying home as long as you can, essentially going to the hospital pushing can make a huge difference as far as how in control of the birth you are. If you have good prenantal care, a good doula, and have the babies before much can be done to you, you might pull off a natural birth.

I'm in awe of the MOMs who work hard and have a natural birth in a hospital. Especially the first time mothers. But doing so without an understanding OB or midwife is going to be really hard. It'll REQUIRE a really uncomfortable car ride, struggle to assert yourself during labor, and luck.

Noticed you read my birth story, so glad! Obviously I didn't want the fight. The hospitals near me asked that "I qualify to be ambulitory." My best info on how things would really go was from a L&D nurse. My OBs paid lip service to letting me "try labor." But when I talked to one of the nurses, and I heard that twins came by c/s 80% of the time, I knew better.

Go on a hospital labor tour, and talk to L&D nurses if you can. Maybe post a question in your tribe here trying to find someone who knows someone working there. You say it's a teaching hospital, maybe the school has a boad you can innocently post a question to and get a good idea of normal practices.

Like you, the epidural really scared me. I wasn't afraid of the pain, I was afraid of a catheter going into my spinal cord. Yes, they say you can refuse anything, but having a catheter in was my hospital's "mandatory policy" for twin moms, like birthingin the OR with a full team on hand. These were fights I wasn't going to win.

For healthy, full term twin pregnancy, I'm a huge supporter of twin HB. I don't imagine that it's too different than birthing a singleton. The worry is 1) positioning, and 2) the second twin. Do what you can to get those babes vertex-vertex. Spinning babes, yoga, chiropracters, etc. Or there's a good chance they'll descend on their own. The worry is that with the extra room, the second twin will get into trouble. There are thing you can do to minimize this, and I'm not sure how great the risk is anyway. Be careful about monitoring Baby B's heartrate after Baby A is born. Maybe have an assistant put external pressure to guide Baby B to the exit (not necessary in my case.)

Anyway, I think twin homebirth is very doable, and totally worth trying. What you gain is:

- avoilding induction and the "late prematurity" and possible fetal distress that follow
- easier recovery from avoiding the c/s
- and as a bonus, no PPD! A little known fact about homebirths is the really low rates of PPD. C/s carry the highest rates.

These three factors made all the difference to me and our newborn twin days / daze. If things go wrong, with an experienced MW, you will still have time to transfer. It may be worth the shot.

Feel free to PM me, and hope the pregnancy and decision making goes well, whatever you end up choosing.



PS - Glad to read you're not too worried about positioning. You babes are really moving around at 27 weeks. Mine were breech until 30 weeks, and other MOMs here, even later.
 
#7 ·
Quote:

Originally Posted by Gena 22 View Post

Now, if you like the prenantal care you're receiving you may be able to avoid an induction.
I will not have an induction unless I am having series issues. The good thing about a big hospital is they are always staffed sufficiently so my babies can pick their birthday! If I should need a section due to babies being breech or what have you, I can still go into labor first. (I'm sure it's much easier to say this now at 27 weeks than it is at 37 weeks when I may be miserable and ready for them to exit


Quote:
That, and like singleton mom, staying home as long as you can, essentially going to the hospital pushing can make a huge difference as far as how in control of the birth you are. If you have good prenantal care, a good doula, and have the babies before much can be done to you, you might pull off a natural birth.
This is something else we considered, hiring a midwife to check my progress so that we could be very far along in dilation before we left for the hospital. A couple of things that would bother me about this. One, I'd still have to move from my comfort zone to a the hospital - which may slow down and/or reverse my progress. We would have a 45 min drive to the hospital. (which despite my hypnobabies ) may still be an uncomfortable ride. And I'd still have to give birth on the OR table.

Quote:
Go on a hospital labor tour, and talk to L&D nurses if you can. Maybe post a question in your tribe here trying to find someone who knows someone working there.

Yes, they say you can refuse anything, but having a catheter in was my hospital's "mandatory policy" for twin moms, like birthingin the OR with a full team on hand. These were fights I wasn't going to win.
We did the hospital tour last month. It is a big, wonderful hospital. That could care less about a natural birth. No tubs, no showering once you are admitted, continual fetal monitoring, twins delivered in the OR. Of course I can refuse anything. But who wants to fight their entire labor? A hep lock is required but not an epidural catheter.

Quote:
If things go wrong, with an experienced MW, you will still have time to transfer. It may be worth the shot.
After I posted on here last night the midwife I left a message for called me back. We are meeting with her on Sunday!
She is very experienced. Both the doulas I have spoken with recommend her. The second doula I spoke with is a midwife in training with her. I'm feeling more and more confident in being able to do this at home.

I can't tell you how much I appreciate the advice and support here. It is really making me feel like this is not only possible, but probably the best decision I could make for my babies.


That and having the most amazing supportive husband who was very scared of home birth 5 years ago and now is completely understanding and encouraging me, well, it makes all the difference in the world!
 
#8 ·
If you want to click on the link in my sig, my twin double breech birth story is there. I would not change how they were born, even though Claire's footling breech presentation made for a very difficult two hours of NOT pushing when I really, REALLY needed to push. In the position they were in I would have had an unnecessary c-section. Unneccesary because I pushed both babies out no problem. Ben flipped vertex as Claire was coming out, but he flipped from breech anterior to vertex posterior so that was no picnic, either.


I had more monitoring than I would have had for a singleton home birth. My midwife saw me weekly from 30 weeks on and I had, I think, 6 ultrasounds to check on them. We had NO problems other than crazy positioning. I gained 40 pounds, ate well, took a freaking TON of supplements, BP and blood were always really good, etc. Carried them to 39 weeks and labored 8 hours before Claire was born. Ben followed 35 minutes later. I trusted my team of midwives (primary, two assistants, two students) and when Claire was born really wet from her rapid birth, they took great care of her right there on the bed next to me.
 
#9 ·
Quote:
If things go wrong, with an experienced MW, you will still have time to transfer. It may be worth the shot.
When something goes wrong time is of the essence and that time taken to transfer may mean the difference in a good outcome and a bad outcome. It doesn't matter how "experienced" a midwife is.

Good luck momma!!
 
#10 ·
Quote:

Originally Posted by mommato5 View Post
When something goes wrong time is of the essence and that time taken to transfer may mean the difference in a good outcome and a bad outcome. It doesn't matter how "experienced" a midwife is.

Good luck momma!!
I couldn't agree more. Do you want to risk losing a baby with a homebirth...that's really the question here. The "risk" might be low, or seem low...but how about when it's your baby? Just bring a doula or midwife to the hospital with you if you so desire for advocacy. Best wishes,
.
 
#11 ·
Actually the reason I want a home birth is because I feel it is safer for my babies at home if it is a normal labor/birth. This isn't about ME, it's about the babies.

The only question that nags me is if what if something does happen. Something is MORE LIKELY to happen in the hospital due to their interventions and protocols. But, it also easier "fixed" at a hospital.
 
#13 ·
Actually low risk women in labor (in the hospital and at home) present with a 10% complication risk (this includes all complications, to both mother and baby). Whereas in the hospital many life threatening complications are quickly "treated", the same cannot be said for being at home.
And actually since you're carrying twins, you're not considered low risk.
 
#15 ·
Deanna: It would make me too nervous! I totally believe that an uncomplicated (or only mildly complicated) birth, including twin birth, would go much more smoothly and naturally at home with a midwife, rather than at a hospital, especially if forced to deliver in the OR. But it's those complicated twin births-- especially ones where baby B suddenly goes into distress, that would make me too scared of a homebirth with twins. So, in most cases the homebirth would be better, but to me those much smaller number of cases win out-- since the chance of complications always rises with twins.

Anyway, I'll be following your case closely since you're further along than me, though, and will be curious and eager to see how it all goes, whichever route you choose-- and of course totally support you in either choice!
 
#16 ·
Quote:

Originally Posted by starlein26 View Post
Actually low risk women in labor (in the hospital and at home) present with a 10% complication risk (this includes all complications, to both mother and baby). Whereas in the hospital many life threatening complications are quickly "treated", the same cannot be said for being at home.
And actually since you're carrying twins, you're not considered low risk.
Where did you get your 10% complication risk? I've heard closer to 2%.
 
#17 ·
Deanna, BIG HUG!!! I think that you are in a position that only another mother of multiples can truly appreciate (no offense to singleton mamas), but really, it is SUCH an interesting birth scenario you are led into with multiples. Like you, it was all about the babies, and I trusted my animal instincts on the day of the birth, and knew that the SAFEST place to birth MY PARTICULAR TWIN BABIES, was at home. In my bathtub, actually. I had done copious amounts of research, been monitored by a perinatologist who engaged in many great discussions with me, and I was also cared for by an amazing TEAM of midwives. I am a strong believer in intuition. When I was 25 I asked a doctor for a blood test, as I knew something was wrong with me. She wrote me off as a "cuckoo", because I also mentioned a dream I had about being ill. A year later, we learned I had stage 3 cancer that had spread from throat nodes, to chest nodes to abdominal nodes. I knew something was wrong with my body, as I trusted myself to know if home was not the right place for the birth. The "expert" oncologist I later saw (Lance Armstrong's oncologist
), told me the same about intuition. He told me that we could run all the tests we wanted to, but I would know if my cancer returned. I agreed.
My perinatologist and I discussed the use of fetal heart monitoring and how it has escalated c-section rates with inaccurate info. The fear of cerebral palsy was part of the reason for the protocol of monitoring in the hospital. We now have learned that cerebral palsy in an in-utero brain accident that occurs during the pregnancy. He agreed that it is too bad that it has become protocol.
I know I'm all over the place here, but I guess that only you can know where the right place to birth your babies is. Trust your intuition. Tap into it, and celebrate the fact that you are having such a wonderful, healthy pregnancy. It was important to me to have no need for intervention in order to feel comfortable with the homebirth idea. My experience was that it was THE SAFEST, BEST CHOICE for MY family. Only you will know, and I send blessings your way for whatever your path will be.
 
#18 ·
Thanks for the support.

I must admit, I don't trust my instinct. I suppose if something is going wrong, I would trust it. But I don't trust my instinct to know everything is going right. That's why I'm happily taking advantage of the best medical care I can find.

I just wish that medical care included the ability to labor naturally. Since it doesn't I'm going to rely on the best midwife I can find and do what I feel is safest for these babies.

But I know that if ANYTHING comes up prior to their birth that sends a red flag to my OB, the Midwife or myself, than we will happily head to the hospital for birth.

I'm just glad that right now Home Birth is the plan and hospital is the back up. It is such a relief to type that!
 
#20 ·
Quote:

Originally Posted by Intertwined View Post
I'm sorry you feel that popping into the twins board with absolutely no links to any scientific data is "information".

And sorry you view anecdotes as information.
 
#21 ·
Quote:

Originally Posted by starlein26 View Post
And sorry you view anecdotes as information.

As a midwifery apprentice, I'd be more than happy to review any links posted. Feel free to share where you gathered your "information". I'm sure that all the expectant twin mothers here on MDC who are trying to make informed decisions not swayed by the medical model of birth would be more than happy as well.
 
#22 ·
Here is a great link: http://www.suite101.com/blog/brendap...ech_first_twin

and it is too bad that hospitals have to practice medicine that is based on being able to cover their you know whats instead of it being based on what is safest for mothers and babies.

I knew-- and it got much stronger towards the end of my pregnancy-- that the safest place for my babies was to be born at home with 3 midwives who were highly trained in breech and twin/triplet births. Unfortunately, a hospital cannot offer me the same skilled training.

I think you have made the right decision for yourself and your babies
 
#23 ·
I must admit, I don't trust my instinct. I suppose if something is going wrong, I would trust it. But I don't trust my instinct to know everything is going right. That's why I'm happily taking advantage of the best medical care I can find.
Deanna, don't get me wrong on the instinct thing
, it's not that I knew "for sure" the whole pregnancy that I would have a home birth. I knew that my pregnancy was going great, and yet I loved it when a medical test only confirmed it, and the doctors had to admit it as well. I was always jealous of women for whom homebirth was just so natural. I was scared. I was scared of what people would say if I did have to transfer, which I have to tell you, after my first was born so peacefully, and I waited 3 HOURS for Sierra, I was feeling completely ok with a hospital transfer if need be, b/c I had been able to labor and birth so peacefully.
Some people gather information and inspiration to help guide them in their choice. Some gather their greatest fears. I opt for information and inspiration, and, of course, intuition. I don't know if you always know that you are tapped into it. Just start talking to your babies. I told mine to give me a sign if I needed to go to the hospital. Never got one, and I can't tell you just how firmly planted my feet felt on the ground the morning of the birth. You will get signs. Keep seeking information, it will help quell the fear mongering
 
#24 ·
Quote:

Originally Posted by mamaeliz View Post
Just start talking to your babies. I told mine to give me a sign if I needed to go to the hospital. Never got one, and I can't tell you just how firmly planted my feet felt on the ground the morning of the birth. You will get signs. Keep seeking information, it will help quell the fear mongering



Thank you! I will. I'm not going to hold hard and fast to any particular birth plan. But at this point, Home birth is at the top of the list. I hope it gets to stay there, but I will gladly head to the excellent hospital we have chosen as a back up!
No pride involved here. Just trying to do what is best for my babies. And a home birth is best if all is well and healthy with them.

Thanks Again!
 
#25 ·
There are so many factors to consider but it all boils down to your comfort level. The biggest concern with a twin homebirth is what happens after the first baby is out. That's when things can get complicated. For me, I'm way more terrified of a hospital birth (especially with twins) than a homebirth. It is so hard to have a natural hospital birth with twins. I was completely comfortable planning a homebirth for both sets of my (MC) twins. And the first set was a successful HBAC and the second was an emergency cesarean. I still wouldn't change a thing about my plans for any of my births though. You need to decide what you feel best choosing and go with it. When choosing a homebirth a lot more responsibility is on you so you have to be ok with that too.

Choosing a hospital birth does not guarantee a good outcome, just as choosing a homebirth does not either.
 
#26 ·
Quote:

Originally Posted by carycaj View Post
Here is a great link: http://www.suite101.com/blog/brendap...ech_first_twin

That is an interesting article! Thanks for sharing. I also heard on the radio this morning something about a higher rate of asthma for children who were born via c-section. I'm going to surf the internet to find the study.
 
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