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#31 of 31 Old 01-02-2006, 12:37 AM
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Originally Posted by Karen Gromada
I debated whether to respond. My heart goes out to your friend who second twin died because of a prolapsed cord -- a scenario that is more of a risk with the secondborn of twins, since the second cannot descend into the birth canal until the first twin is born, as I hope her midwife informed her prior to the homebirth. Because you are correct, and it is quite likely that had she given birth in a hospital her secondborn twin would probably be alive and healthy because a crash/emergency c-section would have been done immediately. A prolapsed cord is one of those situations with only minutes for intervention if a safe outcome is to occur.

I apologize but I don't understand the logic about maternal comfort or confiidence for birth situations that pose more risk for the infants involved. I believe the infants have rights about outcome as well. When discussing full-term, unmedicated, vertex birth following an uncomplicated pregnancy and facilitated by an experienced and well-skilled midwife or physician, risks for home vs. hospital are comparable or better. The same cannot be said for twins. Less than 15% of twins are full-term; less than 45% are vertex-vertex. Not to mention that the risk for postpartum hemorrhage is significantly higher with twin births.

Just because "there are risks no matter...," it does not follow that all risk is equal and that place of birth of is of no consequence in some situations. There are levels of risk. And it is important to be aware of relative risk and level of risk when making decisions about place of birth for infants who cannot make this decision for themselves.

I'm not against home birth when risks favor or are comparable; my fifth child, a singleton, was born at home. However, the level of risk is higher for any twin birth -- even when full term, even if both are vertex. I understand that each couple must decide the level of risk they are willing to accept, and what consequences they are willing to live with. But for babies' sakes/health as well as a woman's own, I hope any expectant couple obtains the information they should have to make well-informed decisions.

I agree with this completely. My son would have died of a prolapsed cord had I not had an emergency C-section. I would never put my desire for a birth experience over the safety of my children. He's alive today because of that.
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