I found out a week and a half ago that I am expecting twins. I had a home birth with my first and am seeing a MW and wanting a home birth with twins as well. They are di/di twins and while I do have a while to go I feel very good about my decision to continue with a home birth. Here is my problem. My MW told me that home birth twins are illegal in WA state for her to deliver, she is a CPM and LM. I have been scouring the internet and have found nothing to support this claim. I also haven't been able to get more than a minute or so with her on the phone to discuss it. I am wondering if she just isn't comfortable doing so and doesn't want to tell me. She has been delivering babies for the last 25 years and has had breech before. The next closest midwife is 2 hours away. The closest hospital to me is 30 minutes and in 2010 had a 38% c-sect rate and have a no VBAC policy so I can only imagine what policies they will have for twins. Is home birth with twins legal in WA? Please throw some ideas my way. This is the biggest stress for me with having twins.
You might have success getting an answer to this on the Washington Tribal Board:
I know a couple doulas/ childbirth class instructors I'll ask and get back to you.
The WA midwifery law does not technically prohibit any particular clinical activities. So it is not actually "illegal". However, when there are bad outcomes involving WA LM care, the State looks to our professional association guidelines and other community standard experts to determine whether a MW is working within the scope of practice of her/his license. The law does specify that with anything outside the range of normal (which twin gestation is), an LM must consult or transfer as appropriate. And our professional association guidelines explicitly list multiple gestation as a risk factor necessitating transfer of care in the antepartum and intrapartum periods. (http://washingtonmidwives.org/for-consumers/indications-consultation3.html)
The majority of LMs also carry malpractice insurance--which we need if we want to have insurance contracts, aside from other obvious reasons, and we sign a statement that we will not engage in certain "high-risk" activities, including twin deliveries.
That said, there are a handful of LMs who will take a risk and work outside of these parameters. That is true nationwide--not only in WA. It's possible for a twin delivery to be straightforward and uneventful, but there are also a lot of possible risks that are not part of a singleton delivery. Some midwives are willing to take that on and others are not.
There are also some LMs who have an arrangement with an OB where they will do all the prenatal care and "co-manage" with an OB and go into the hospital with their client in an advocate/doula role.
What part of the state are you in?
Thank you for your reply. I live in South Central Washington. I am along the border between Oregon and Washington about 2 hours from Portland. We have discussed finding someone nearby in Oregon whose home I could deliver at, but I'm not sure I really know anyone who would be open to that. I would obviously only be delivering at home if baby A was head down, I was full term, and had no complications.
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