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#1 of 31 Old 12-11-2005, 02:54 PM - Thread Starter
 
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Our OB will only concede (thus far) to delivery in the OR, even for a vaginal, non-medicated birth. His reasoning is the need for a sterile environment and staff on standby in the event of an emergency.

I do no want to deliver in the OR! I already stated that I would agree to a heplock and the insertion of a catheter in my spinal area to deliver anesthetic in the event of an emergency. He did not agree to this.

He stated that in the event of emergency, I would need to be put under General Anesthetic and therefore the things I mentioned wouldn't be helpful.

Does anyone have any experience with policy dictating an OR delivery and can you tell me how you got around it or how you made it work for your birth. I am scared to go into the debate without some facts to back me up, and I haven't found many in my searching.

Thanks!
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#2 of 31 Old 12-11-2005, 03:04 PM
 
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In my case, it was the hospital's policy that multiple births happen in the OR.

Frankly, I think part of it was b/c there wouldn't be enough room for all of the staff in a regular labor and delivery room! (There was a team of ped's people for EACH baby, so that alone was like 4 or 6 people, plus nurses, doctors, etc.) The rest of the reason is all CYA, IMO.

I ended up having to have a scheduled c-section, so it was all moot, but I was very bummed when I was still planning a natural birth.

I suppose it's not too late to consider a second opinion from another OB, or explore the hospital's policy yourself? Hope you find a good comprimise.
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#3 of 31 Old 12-11-2005, 03:14 PM
 
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This is pretty standard with OBs and one of the main reasons I made sure to find a homebirth midwife who was comfortable with twins. I didn't end up with twins, but with family history it was a major consideration. If I do get pregnant with twins, I will have them at home. (fwiw my midwife had twins herself at home unassisted, so she knows that it can be done!)

-Angela
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#4 of 31 Old 12-11-2005, 03:27 PM
 
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I hope you can find something that is a good compromise. Can they have you in a delivery room close to OR?

There's a local mom who had an OR delivery of twins. She was just happy that she found anyone willing to delivery twins vaginally, which in our state is rare.

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#5 of 31 Old 12-11-2005, 04:12 PM
 
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I had the same problem and here it is hospital policy and one of the only things my ob would not budge on. He said that I had to have the babies in the or and that was it. I talked to the head of the maternity ward and she just made me feel worse about it all. I called hospitals within an hour or so of where we live and that is the way it was at all of them. SO, I had my babies at home After a lot of crying and talking to lots or docs & hospitals I decided I could not do what they wanted me to. I still saw my doc the whole time I was pregnant because if there was a problem or I had the babies early I wanted him. In the end I was so glad I had made the decision I did. My 1st baby was born 1 hour 20 min after I woke up in labor and that would have been a horrible car ride and he might have been born in the car by the time we got things together and our ds dropped off. I did also have my 1st son at home so I was very comfortable with home birth and I knew it was the right thing to do for me. Sorry I don't have any advice for you for dealing with this, I had no luck getting what I wanted from my doc in this area. One thing I highly suggest if you have not already is to go to your hospital and do a tour and see the or so that you are not caught off guard.
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#6 of 31 Old 12-11-2005, 04:36 PM
 
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When I delivered it was up to the DR. I had two backup doctors and one insisted on the OR and the other was agreeable to the ldr room.
The doctors almost always get final say, but they use "hospital policy" to lay the blame somewhere else.
I went to 40 weeks and got induced and that put the day I delivered in my control and I wouldnt have been induced if the knife happy misogynist was on call (my term of endearment for the doc I feared). I even tried to do the castor oil on a weekend the good doc was in charge (it didn't work)
Basically I would have done anything to keep out of the OR, if that meant delivering in my minivan in the hospital parking lot. (this was the scenario I often presented to my DH! LOL close enough to get help but out of the hospital's clutches if I didnt need it!)
Good luck, you have the right to refuse treatment you do not agree with.
Joline
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#7 of 31 Old 12-11-2005, 09:36 PM
 
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I delivered in the OR. It was the hospital's and my OB's policy to do so. It was ok with me though. I labored in my regular L&D room and even did some of the early pushing there. They just wheeled us around the corner to the OR when it was time for my OB to catch Sam, (baby A). It really wasn't bad. Plus, whoever said a standard L&D room isn't big enough is right. In the OR at my delivery was: my OB, the med. student working with him, an anesthesiologist (just in case), my L&D nurse, the student nurse working with her, the U/S tech, the neonatalogist and a team of neonatal nurses for each baby. I *think* that was everyone. Oh, yeah and DH!!

At any rate, all those people wouldn't have fit in a regular room.

ETA: I delivered at 34 weeks.
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#8 of 31 Old 12-11-2005, 09:41 PM
 
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My mother had a VBAC in '85, and she still delivered in a regular room. Tell your OB that if he's really worried he can have the OR set up down the hall (they did for my mom), but you think it's dangerous to risk not having an OR open for someone who really needs it just because he's afraid of normal birth. (Um... maybe find a nicer way to phrase that.)
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#9 of 31 Old 12-11-2005, 09:50 PM
 
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Speaking quickly as an L&D nurse, then I will bow out.

1. It has nothing to do with room size, it really and truly is about the medical equipment available. What's available in the OR isn't available in the LDR rooms.

2. Lots of younger docs are afraid to deliver twins outside of the OR, they have been taught that twins are "double set-up" deliveries, meaning you are ready for a crash c-section at all times. They honestly don't know any better.

3. It is indeed your right to refuse treatment/procedures of any kind you do not want.

Delivering in the OR is not as horrible as it sounds. It really really isn't. Inconvenient? You betcha. Annoying? Yep. Believe me, the nurses hate moving you to the OR to deliver as much as you hate being moved there.

If your doc is really stuck on this and won't budge, and neither will you, I honestly suggest you try to find an alternate care provider. Someone who has enough experience delivering twins that they don't view it as "abnormal." Which is how lots of OB's I know think of twin deliveries. It doesn't make it right, but as the song says, that's just the way it is. Most midwives will deliver twins....well....like you expect a midwife to deliver. They usually don't do the move to the OR crap unless they have a really control-freak spaz OB on call as their backup.

Bowing out now. I hope you have a wonderful birth.

ETA: I think the idea the poster above me came up with, the having the OR set up "just in case" is a good compromise. The OB should be willing to do that. That's very reasonable.
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#10 of 31 Old 12-11-2005, 11:09 PM
 
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I just had my twins September 28th. I had my first twin (DD) in the labor room, not OR, with no medication or intervention of any kind. This was not what I wanted by the way. I wanted an epidural but had precipitous labor and barely made it to the hospital.

But there was no policy of the hospital or my OB that I had to give birth to my twins in the OR. My second twin (DS) was an emergency C-section and I was literally thrown on a gurney and into the OR for a C-section in a matter of minutes due to a prolapsed cord. This was a deadly serious, potentially fatal complication for my DS. For my multiple delivery, there is no way I would have an unassisted delivery or delivery anywhere but in a hospital. My son would have died without the C-section taking place as fast as possible. As it was he spent 12 days in the NICU. As I understand it, a prolapsed cord is when the cord emerges from the birth canal before the baby and is more common in multiple deliveries.

I think as long as you are close to the OR and you and your doctor understand the potential risks, you are fine in a regular L&D room. Even with my serious complication, we were only steps away from the OR. Maybe it depends on whether or not the OR is on the same floor as L&D in your particular hospital? Maybe the nurses and/or doctors here would know this?
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#11 of 31 Old 12-12-2005, 12:33 AM
 
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I wanted to really echo what the PP said about a midwife.
I had a midwife attend my twin birth, she was the same who had attended my previous out of hospital birth. Her backup doc had to be on the premises but he did not have to be in the room. In fact he made an appearance once only and that was between babies A and B to make sure baby B didnt change position.
The majority of the team in my LDR room were my people (not the hospital staff) I had my dh, dd, Doula, doula's daughter, MIL, Mom. And the two midwives and two baby nurses.
It was the best possible hospital birth and everybody was incredibly respectful.
Joline
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#12 of 31 Old 12-12-2005, 12:55 AM
 
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Can you find another doc?

Ultimately, the birth you have is the birth you have. You can plan and want and wish for an 'experience', but your end goal is to have healthy babies, no?

That said, I had complete faith and trust in my OB. he was comfortable delivering a breech baby vaginally (which we needed to do) but prepared me for the possibility that I might need a c-section. He would avoid it if he could, but if DD showed ANY distress, he wouldn't hesitate to do one. I labored until the very very very end in a LDR room (was moved to the OR 5 minutes before DS was born) with my doc the whole time (the nurse was there, but not nearly as long or as consistenty as the doc). When we got to the or, there were about 87,000 people there but you know what? I didn't care. I was completely focused on my body and my babies. It wasn't the experience I WANTED, but it was the experience I HAD.

Does that help?
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#13 of 31 Old 12-12-2005, 01:03 AM
 
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You have plenty of time to find the doctor or midwife who can give you what you want.

Good luck. My grandmother was the first of a fraternal twin set of girls born at home. Both lived to a ripe old age.

My Aunt, her DD, had fraternal twin boys in an OR in a huge medical center and teaching hospital; and one twin boy was stillborn and the other boy, my cousin now 30, lived.

No one can guarantee you anything, no matter how much technology is around. It is the hospital policy and the doctor's malpractice insurance dictate the OR policy.

Good luck with your decision.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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#14 of 31 Old 12-12-2005, 10:16 AM
 
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I had to have my deliveries in the OR because it was connected to the NICU. I did delivery early (35 weeks), but would have delivered there at any time. Also, my first was an unmedicated vag birth and the second was a c-sec under general anathesia.
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#15 of 31 Old 12-12-2005, 10:30 AM - Thread Starter
 
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My previous birthing center does not do VBACS, and the second that is semi-close won't deliver VBAC Multiples. I'm not comfortable being 2+ hours away from where we would deliver, or I would consider The Farm in a heartbeat.

I am not personally 100% comfortable with a homebirth. We have considered finding a homebirth midwife and laboring at home as long as possible, and then going to the hospital (it's less than 2 minutes away). I wasn't sure how protocol of care would work in that situation. I imagine we would simply keep our OB appointments and hire the midwife. That starts getting really pricey though - especially since having twins alone is almost double the cost.

Thanks for all of the information! I think my best bet is to request the OR be set-up and be very agreeable to moving at any sign of distress, but otherwise staying in my room. Have an appointment in a few minutes...
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#16 of 31 Old 12-12-2005, 04:44 PM
 
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I totally understand why you are not comfortable with having twins at home. There are more variables and everything and if you are not comfortable with it of course you should not do it. When we were g to figure out what to do we talked about staying at home with our midwife as long as possible also and even parking my moms trailer in the parking lot at the hospital and going in right at the end I hope you can find a solution or doc that will work for you and that you are comfortable with. Good Luck!
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#17 of 31 Old 12-12-2005, 09:15 PM
 
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My doctor also gave me the reasoning that there is more room in the OR and they need more staff on hand. But then again this is in a NYC hospital and the labor rooms are very small!
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#18 of 31 Old 12-14-2005, 12:22 PM
 
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I don't have any answers for you, but I can sympathize! I am feeling so frustrated! I have changed docs once, but this one is not much better. They won't consider vaginal delivery unless both are head down...and they don't sound very happy about THAT. Just about all the twins around here are delivered by caesarean, and that just makes me mad, b/c I do not need to have a caesarean recovery when I have 5 children under age five to take care of!!! I SO miss my midwives where I used to live. There are none around here! Anyway, my kids are calling! gtg for now...I'm gonna keep reading these posts and keep trying to find a better doc! :-)
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#19 of 31 Old 12-14-2005, 04:32 PM
 
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Quote:
Originally Posted by 3+2=5:-)
I don't have any answers for you, but I can sympathize! I am feeling so frustrated! I have changed docs once, but this one is not much better. They won't consider vaginal delivery unless both are head down...and they don't sound very happy about THAT. Just about all the twins around here are delivered by caesarean, and that just makes me mad, b/c I do not need to have a caesarean recovery when I have 5 children under age five to take care of!!! I SO miss my midwives where I used to live. There are none around here! Anyway, my kids are calling! gtg for now...I'm gonna keep reading these posts and keep trying to find a better doc! :-)


The research literature indicates that in otherwise uncomplicated twin pregnancies, the outcomes for babies' conditions are about the same for vag vs. surgical delivery IF baby A is vertex/head down. In other words, unless some issue/complication arises during labor or delivery, it doesn't seem to matter if baby B is vertex, breech, transverse lie, etc. (Some Euro studies are even questioning "auto" c-section if baby A is non-vertex, esp. for a mother who has had a previous pregnancy and birthed vaginally.) Sure, issues can come up after the birth of baby A -- issues more likely with twins than singles -- and one can end up with surgical birth for the 2nd. I'm just sharing what's in the research lit -- unless there's some new lit out there, which is certainly possible.

Another concern is "pushing" docs who are apparently uncomfortable into something they may not be good at. I'm not sure I'd want to depend on an unpracticed person in charge if my baby was footling breech, transverse lie, etc. I'd want someone who'd done a bunch and was comfortable (but not overconfident) skill-wise. Personally, I'd be interviewing to locate that doc.

BTW, if of interest, I have a "fill in the blanks" birth plan for twin and some triplet pregnancies under "articles" at my web site: www.karengromada.com/

One thing you might do for now is ask your current docs to support their position about surgical delivery if any twin is non-vertex with research re: outcome studies. May be interesting.

Good luck.

Karen (who had an unmedicated birth with her vertex A and surprise vertex B -- surprise as he'd been obviously breech up to within hours of birth and we have no clue as to when or how he turned; can't believe he found room!)
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#20 of 31 Old 12-16-2005, 05:03 AM
 
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[QUOTE=Karen Gromada]
Another concern is "pushing" docs who are apparently uncomfortable into something they may not be good at. I'm not sure I'd want to depend on an unpracticed person in charge if my baby was footling breech, transverse lie, etc. I'd want someone who'd done a bunch and was comfortable (but not overconfident) skill-wise. Personally, I'd be interviewing to locate that doc.
QUOTE]

Absolutely. you do not want any practitioner, OB or midwife, doing something they are not comfortable with. You don't want someone cocky, but not unsure either. I would interview some other OB's and ask around.

I had a solo practitioner OB who also said he was do a vaginal birth if both babies were vertex, and probably if just Baby A was vertex. I had a failed induction, though, and ended up with an urgent C-section. The hospital's policy was to deliver in the OR and I was OK with that, the goal like the PP said is healthy babies, not an "experience." You will still labor in the labor room, and by the time you are pushing you will be focused on your body and your babies, not the room you are in.

Christine, mama to Daniel & Abby, 9 and Patrick, 4. Wife to a rockin' train engineer. Gluten and nightshade-free. Multiple kiddie food sensitivities.

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#21 of 31 Old 12-18-2005, 09:23 PM
 
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We also had to have our twins in the OR due to hospital policy. While this wasn't what I wanted, it wasn't that big of a deal to me. We had a dr who totally believed that twin pregnancies were normal unless proven otherwise, who was completely on board for a spontaneous drug-free birth, who was pleased that I had a doula and that I would be breastfeeding and who didn't work on rotation so we knew that he would actually be the one at our birth baring a personal emergancy...the location just didn't matter that much to me.

Our hospital's reasoning was the same as some have mentioned that twin deliveries are double set ups and they want to be ready to do an emergency c-section. During my delivery, there was me, dh, our doula, my dr and two nurses in the room. There was quite the contingent on standby outside the room (anesethologist, pediatrician, more nurses, etc) but my delivery was lovely and very personal despite the slightly sterile environment - not that the l& d rooms were much better!

Something that made it less of an issue for me, too was that when I arrived at the hospital I was 8cm so we moved to the OR rather quickly, rather than me having been there for hours and comfortably spread out in an l&d room. They did move me on a gurney, though, which was quite entertaining as I wouldn't lie down and went on my hands and knees
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#22 of 31 Old 12-21-2005, 12:19 AM
 
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Hello, I just had my twins on Thanksgiving. It was also policy at the hospital where I delivered to deliver twins in the OR. I was scared to death of the cold, sterile OR, but it actually worked out well. By the time I was ready to push, I didn't really care if I was in the L&D room or the OR.
It was more important to me that my babies were delivered vaginally and they were.
Ask if the doctor will place an epidural catheter w/out medication. In this case, he/she will be able to administer meds quickly if an emergency arises and not have to give you general anestesia. General anestesia is often used as a very last resort, so it is important to discuss with your Dr. all the steps he will take before resorting to that.
My doctor and I agreed on having the catheter placed without meds. It worked out great! My baby A got a little stuck and was started to get distressed, so the doc used forceps. The doc had enough time to give me little bit of an epidural so that I didn't feel it too much when he used the forceps or pulled baby B out by his feet.
I guess what I'm getting at is that he should be able to place the catheter w/out meds if he's super worried about have quick access in case of an emergency. Also, I was able to get the experience I wanted (laboring in the L&D room, unmedicated labor, vaginal birth) despite the birth took place in the OR. Hope this helps and good luck.
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#23 of 31 Old 12-21-2005, 02:40 PM
 
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Quote:
Originally Posted by Karen Gromada
Karen (who had an unmedicated birth with her vertex A and surprise vertex B -- surprise as he'd been obviously breech up to within hours of birth and we have no clue as to when or how he turned; can't believe he found room!)
Is it likely he turned after baby A was born? My two were vertex, but there was concern that after A was born, B would turn breech, so I am guessing it could work the other way. At least there would be a lot of room after A was born!

OK, now back to the OP. I have been hesitating to post just because it is going to be long and maybe not really even directly answering any of your questions. But here goes. I hope something in here my help you, even if only as a way for you to prevent having to fight some of the same battles.

I had a hospital birth. In my case I would have been comfortable with a midwife attended homebirth, but couldn't find someone who would do it in this area. I was not comfortable with an unassisted birth though, so ended up planning a hospital birth when I found out about the twins at 34 weeks. Up to that point I was planning a homebirth with a midwife.

Anyway, my OB is very natural birth friendly, but the hospital really isn't. So the difficulty was in my OB having to basically walk a thin line to keep the birth natural but also to not cause problems at the hospital. If the birth had a negative outcome, and he was considered by the very conservative hospital to have not intervened enough, then he probably would lose his ability to practice there.

So, when I talked with my OB initially he told me that I would not have to be in the OR. Then at a later appt. he said we would have to move to a bigger room for stage 2. Later after that, I realized he probably meant the OR, but just honestly didn't have the energy to contest it any more.

There were a few "battles" at the hospital.

The nurse doing my check in claimed that baby B was showing stress, based on heartrate, and she thought I must be dehydrated. She wanted to start IV fluids. I showed her my water bottle, and said I would drink more water, and I would be okay with a heplock but not actually starting an IV. When I thought she was setting up a heplock, she actually started IV fluids. I did not want that but didn't know I could unhook it. When the nurse left, my husband unhooked it for me. Later they did put a helplock on instead, but I did not have an IV connected throughout.

During stage one labor, the staff was trying to maintain continuous monitoring with external fetal monitors. It didn't work very well, because whenever I moved, one of the monitors would lose a heartbeat. At any rate, someone on the staff suggested baby A was experiencing delayed accelerations, meaning the heartbeat was accelerating after the contraction was over. There are a lot of reasons I question whether that was a problem (I don't completely believe the contraction monitor to be accurate in the first place), but that person was using that to pressure my OB to use an internal fetal monitor. He basically gave in, and even my midwife said it might be a good idea. I was completely against it and so negotiated to start pushing early instead. The OB checked how things looked and thought that would be okay. So the internal monitor was never used.

One other note about stage one. I had brought food to eat, but did not eat anything. I also do not remember drinking water. I think at home I might have done these things. It just was that in the hospital I felt like I had to spend all of my energy keeping the staff from escalating things. I don't remember really having a moment where I could just kind of retreat for a bit an take a drink of water. Either the anesthesiologist was giving me a long talk (through transitional contractions) about what he would do in the case of an emergency, or they were fussing with the monitors pushing them hard to try to pick up baby A, or etc.

So then we moved to the OR. I am not sure if it would be possible to just refuse to move into the OR at that point. It sure didn't seem like it at that time. My husband then had to do a lot of negotiating to get my midwife and doula to be allowed to come into the OR with us.

In the OR, I had to lay on my back while pushing. It hurt alot. I don't know whether this was because I was pushing a little too soon, or because I was on my back, or because I just truly did not want to be there, or because it would have just hurt regardless. At some point I did insist on trying to stand/squat on the OR table. My husband supported me. But it really was not a good enough arrangement, in that I really could find a position to relax between contractions and soon my legs were tired and I was on my back again.

At this point monitoring was with an ultrasound. They were pushing hard on my belly to see the babies. That hurt a lot too. So between pushing I didn't really get a rest from pain...just more pain of a different sort. Also, some people were kind yelling/coaching "push" which really irritated me and made be feel like I was being attacked.

I also felt a lot of stress that if I took to long with pushing they would pressure a c-section. So I feel the whole pushing stage was really poorly managed.

Baby A was born three hours after I checked into the hospital. I think it was only an hour of pushing, but am not sure. (I had second degree tearing from her birth, but again don't know if it was because the pushing stage was rushed or because her hand was up by her face, or because it just would have happened anyway.) Then I think my OB used an amniohook and baby B was born three minutes later. Both were vertex.

It was the first natural birth of twins witnessed by everyone in the room except my midwife and my OB.

My midwife and doula helped get both babies nursing before we even left the OR.

The way to the recovery room passed by the nursery. Even though from the start we made it known that we did not want our babies in the nursery, I guess the head nurse did not know in advance. She tried very hard to get the babies and was very upset when she didn't. I think if I did not have my midwife, my doula, my babies' pediatrician and my husband surrounding me and the babies, she might have got them. Later my husband talk with her to smooth things out.

After being in the recovery room for a bit, some nurses came in and said I should try to pee. I heard them talking about smelling salts but didn't really make the connection. I made it to the bathroom and then started to pass out and the smelling salts appeared. Turns out they were insisting I pee because they assumed I had an epidural. Because I felt so weak after that I decided to stay overnight. Otherwise I had really wanted to go home. My husband was not allowed to stay overnight in the room with me.

The next day we let them do hearing tests on the babies in the room. In retrospect, I think I should have skipped it. It took a lot of time with one baby, who basically cried the whole time.

Then we checked out and went home.

The big picture is that I did manage to have a natural birth in an OR. My OB supports natural birth, the hospital does not. If I had time to search for another OB, I would have tried to find one at a hospital that was more supportive of natural childbirth. I felt very violated after the whole experience, but I am pretty sensitive, and I think another person would really have not had any problem with any of it. I think it also would have helped if I could have somehow come to better terms with the fact I was going to give birth in the hospital beforehand. With only four weeks to prepare, I just never really accepted it, so the reality hit kind of hard.

Hopefully that was not more than you wanted to read. I am very glad to read about people who had a better experience. I guess I just wanted to post my experience so maybe at least if you run into any of these things while you are in the hospital it might help.
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#24 of 31 Old 12-23-2005, 07:53 PM
 
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Ugh...Kristi, that is exactly what I am afraid of with my twins! I am having to go to a doc and hospital who are used to twins being delivered by csection unless both are vertex, and then they are still USUALLY born by csection...I think all the ppl around here just like the idea of scheduled csections, ya know? Anyway, I am waiting to hear from a midwife who will let me know if she's willing to take me as her patient for a homebirth! I am praying so hard! I SO do not wanna deliver at that hospital or even with my doc. I have had 3 babies all natural, but since we've moved, there are no docs around here that I can find who are natural-childbirth-friendly. OK...gtg...kids calling :-)
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#25 of 31 Old 12-23-2005, 10:45 PM
 
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i love this username: 3+2=5:-)

we were 3 + 2 as well.

as for the op, i saw a midwife/ob-gyn team during pregnancy. one water broke at 34 weeks and even though i fully dilated i was not comfortable with an attempt at vaginal delivery. both babies were in an oblique transverse presentation with one twin's feet around the other's neck (this part being what would have presented).

the dr was willing to attempt a version and vaginal birth in the or since i was fully dilated and neither baby was showing signs of distress. but yes, we had to be in the or.

i, however, am a soggy weakling and decided i would rather just have the c-section.
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#26 of 31 Old 12-24-2005, 03:47 PM
 
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LOL!!!! soggy weakling! I don't know what I'd do in such a unique situation!! I am praying mine will be both vertex!!!! Or at least regular old breech, lol. :-)
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#27 of 31 Old 12-24-2005, 04:12 PM
 
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I think there are risks you take no matter where you birth.It is what you are comfortable with and who you can get to help you birth in that situation.A dear friend of mine just birthed her twin sons a few weeks ago.She wanted a home birth,she felt very confident about it and got a midwife who supported her.During the birth there was a prolapsed cord and she was rushed to the hospital but one of her twins died if she would have been at the hospital this would not have been the case.But again there is a risk no matter what.I birthed 4 kids at home and my last was a shoulder dystocia.We made it through that just fine.But then my friend homebirthed a son one month after me and he had shoulder dystocia and he died.I think if you feel confident enough then keep looking and you will find someone who can assist you to have the birth you want.Happy birthing!
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#28 of 31 Old 12-30-2005, 02:26 AM
 
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I was not happy to hear that I wasn't able to have the homebirth I wanted with my twins. Then I was told I had to deliver in an oR I was MAD. I was also given the line into my spine just incase. My delivery was not my dream at all I was so mad at my OB I couldn't even look at him. In the middle of delivering my first born my second born Elizabeth's heart stopped. I was given the spinal in seconds and in less then one minute Emma was delivered and my Ob reached up into my uterus and pulled Eliza out feet first. She was dead a total of two minutes before they got her heart going again, she is a perfect little girl today. I am glad my Ob didn't listen to me. I don't think my little girl would be here today if they had followed my orders. I thank god for the OR the Spinal and the fetal monitors.
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#29 of 31 Old 12-31-2005, 12:05 AM
 
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Quote:
Originally Posted by Ravenmoon
I think there are risks you take no matter where you birth.It is what you are comfortable with and who you can get to help you birth in that situation.A dear friend of mine just birthed her twin sons a few weeks ago.She wanted a home birth,she felt very confident about it and got a midwife who supported her.During the birth there was a prolapsed cord and she was rushed to the hospital but one of her twins died if she would have been at the hospital this would not have been the case.But again there is a risk no matter what.I birthed 4 kids at home and my last was a shoulder dystocia.We made it through that just fine.But then my friend homebirthed a son one month after me and he had shoulder dystocia and he died.I think if you feel confident enough then keep looking and you will find someone who can assist you to have the birth you want.Happy birthing!

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.

Karen
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#30 of 31 Old 01-01-2006, 08:51 PM - Thread Starter
 
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:

We actually found out that I am carrying Monoamniotic twins, so unless we find a membrane there won't even be a discussion about where I will push... I simply won't be pushing. In my opinion, the risk of cord compression is too great to leave it to fate that the girls would make it through a vaginal birth both healthly and alive.

The whole roller coaster actually put a lot in perspective for me. Would I love a VBAC? You bet! However, there does come a point where you simply have to weigh the risks against the rewards. At this point, I am willing to do most anything to have two, healthy girls.
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