ISO moms who carried twins past 38 wks - Mothering Forums

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#1 of 59 Old 08-28-2007, 07:44 PM - Thread Starter
 
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i'm hoping to find some BTDT and info from people who have been in my situation. i'm at the end of a twin pregnancy, currently 39 wks. mostly midwife care and planning HB, shadow care with OB. last week OB says he wants me to start NSTs weekly, i put it off one week and finally had one today figuring that it would provide good info and i didn't want to ignore it if in case it turned up something worrisome (but i've never truly felt that these babies are anything but healthy). all tests showed that babies are great and active as they should be. sono showed plenty of fluid. response from techs and nurses was that the results of all tests were excellent.

the high risk doc came at the end to talk to me and started with this barrage of scare tactics that i really resent. her kind are exactly the reason i go to midwife care in the first place. she says that carrying twins past 38 wks puts them in great danger of stillbirth but when i asked her for data or info about likelihood of precipitous decline with babies this healthy she just stared at me (how dare i ask a question?!). she told me that if i go against her medical advice and put my babies at risk of death by continuing this pregnancy that i must go in for NSTs twice a week because the placentas are likely to break down and once again the babies could die! :
going back to that office twice a week might just make me homicidal.
i said thanks for the info and that i'd talk with my other practitioners, meaning the OB, she doesn't know i have a midwife.

i gave birth to a singleton in 2002 at 42 wks. he was fully cooked and ready and super healthy, it was just his time so he came. i feel that since these babies have never shown to be anything but healthy why would i want to mess them up with induction meds and start that cascade? i know placentas break down as the end nears, isn't that one reason that labor would start? i also saw a study online that post dates in singletons had no greater correlation to bad outcome than singletons at term. why would it be so drastically different with two?

i know there are women here who have carried twins to term and past, please share with me your thoughts, i need some support. i will see my mw tomorrow and get her take on all of this too but really value info from actual moms who have been here. i'm glad to try natural induction methods and have already done so with mild ones, but we all know that they don't work unless babies are pretty much ready to come on their own.

thanks in advance for anything you can share.
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#2 of 59 Old 08-28-2007, 10:14 PM
 
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Well, I don't have advice unfortunately as I didn't carry my babes to term but I just wanted to say congratulations on coming this far - all you ever hear about when pregnant w/ twins is how nobody ever carries them to term.
Obviously, you've been doing something right to be able to keep them that long. I hope someone on here can give you a better answer! Good luck!
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#3 of 59 Old 08-28-2007, 10:45 PM - Thread Starter
 
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thank you.. its really nice to hear something positive after the day i've had. i hope someone will have info to share too.
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#4 of 59 Old 08-28-2007, 11:45 PM
 
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Believe in yourself, Clancybaby! Your post has so many thoughtful sentiments, much more in tune with your body and those babies than any doctor will ever be!

I was due December 13th, 2006. My twins were born on December 10th (thus at 39wks 4days). All natural.

Like you, we listened to mounting, grating, fear-mongering from our doctor. Throughout November 2006, we were increasingly loathe to attend pre-natal appointments and very nearly cancelled the last few. My husband and I couldn't take it any more. Evidence-based medicine is one thing. . . the things we were told, entirely another! When the doctor left the room during our last prenatal appointment on December 7th, we decided we weren't going to any more appointments. Baring an emergency, we weren't going to interfere with the pregnancy, so why go through the fight to defend that every few days? I'm with you regarding the cascade of interventions.

We left the hospital having cancelled our appointment for December 11th. The doctor advised we book another one for later that week if I hadn't delivered. We left it with a cursory, "Mhhmm. . ."

My other kids were born at 40wks 4days, 41wks, and 41wks 4days. I really believe that I would have made the milestone of going past 40 weeks with the twins if it hadn't been that my "doula" sister-in-law was leaving for an international trip the day before my due date.

I was rather unsettled in the last week: my sister-in-law's schedule of trip preparations made it uncertain whether she or another relative would be supporting my husband and I at the birth. That Saturday night (December 9th) she came to visit me and told me happily that I could "go ahead" as she could promise to attend; her packing was finished. 3 hours later (1am) I woke up in labour. Babies were born 4:10am and 4:27am. If you try to tell me that's just a coincidence, I won't believe you!

Given my healthy longer pregnancies with my other kids and the wealth of fantastic information I'd gotten from the (now sadly defunct) BirthLove site, I was totally comfortable with going to whatever it took: 42, 43 weeks. I would not have gone for any more prenatal appointments.

Your doctor trusts his/her malpractice insurance. You have the great luxury of trusting yourself.

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#5 of 59 Old 08-28-2007, 11:47 PM
 
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Clancy, you are doing so so well cooking your babies for so long.

Mine were born at 37w5days and it was so hard going for that long even! I was fully prepared to go all the way to 40+wk because my first two singletons went past their due dates as well.

We skipped our last appointments because I didn't want to hear the BS from the OB... we were planning a UC anyway though.

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#6 of 59 Old 08-29-2007, 12:10 AM
 
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Hi Clancybaby! My twins were born at 40w3d. They were born at home, 7lb2oz and 8 lbs even. They were vigorous and had a huge, healthy placenta.

What I don't get from what this doctor is saying is what she expects to change so suddenly? You had a reassuring NST? They looked at your fluid and presumeably at your placenta. You babies are reactive. How is that suddenly going to change?

I was really lucky in that in addition to my midwife, I saw probably the only homebirth-friendly perinatalogist in the US. He caught 2 of his kids at home! I never had a NST. When I last saw him (at 39w5d) he mentioned that we might consider one the next week, and that he would strip my membranes then if I wanted. Other than that all he did was a quick scan at the beginning of each visit, and I had a more detailed scan every 3 weeks starting at 30 weeks or so. I remember him saying once that he saw some calcifications on the placenta, but that that was to be expected so close to term.

We sort of induced my labor. My mw came for a regular weekly visit and checked me (at my request). I was already a really stretchy 5 cm. She lived 2 hours away, so we decided to try to get things going. We used homeopathics and nipple stim, but the castor oil is what really got things going. I used castor oil successfully with my singleton as well.

Anyway, I wouldn't do the bi-weekly NSTs. It sounds like they are looking for a reason to induce. My understanding is that the data suggests that the "optimal" time to birth twins is 38 weeks, but I'm sure that includes lots of women with variably healthy pregnancies. With a reassuring NST, I can't see what the problem would be.

You said your OB suggested weekly NSTs. The high risk Ob has no say over what your doctor orders. I was really lucky that my OB only scheduled me for u/s when he was the OB on duty at the u/s clinic. If you are comfortable with weekly, I'd stick with that. If you just don't want any more testing, than you probably need to miss an appointment or 2...

You can do it mama!! I know I am not the only twin mom who went to term around here. MDC has lots of us floating around.

If there are any more specific questions I can answer, let me know.

Trying to get my bearings...
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#7 of 59 Old 08-29-2007, 12:17 AM
 
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Mine were born at 39 wks 5 days. I had an ultrasound near the end (maybe 38 wks or 37...I don't remember). I never had any stress tests or non-stress tests--they were never suggested. I never saw the OB more than once a week. I remember asking him at my 38 or 39 week visit when he was going to start trying to stress me out by talking about induction and he said "Not yet. Everything looks good." He never did an internal exam. Just 2 u/s (the first was when I started seeing him around 35 wks) and weekly measuring, monitoring urine/blood, etc. So I guess my point is that not ALL doctors believe going past 38 weeks with twins is so "dangerous." I also had concurrent care with a midwife who would have certainly detected any problem with the babies if I were not aware of it, so I felt confident all was well. I can't speak to all pregnancies or situations, but it certainly sounds like this doctor is just trying to scare you because she is out of her comfort zone. I personally think the longer the babies develop on the inside the easier things are when they enter the world. It worries me when doctors make threats and cannot back them up with studies or data. Completely unrelated, but my father's doctor recently (mis)diagnosed him with pneumonia. When my dad asked what would have happened if he hadn't seen the doctor, she actually told him that he probably would have died! Amazingly, my mother had the same thing and recovered at the same time as my dad, with no meds and no doctor visit. Sometimes you just gotta wonder.....

Hang in there and try to keep thinking positively. You have a very exciting time upon you.
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#8 of 59 Old 08-29-2007, 12:49 AM
 
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My boys were born via scheduled c-section at 39wks 1 day, they weighed 7lbs3oz & 7lbs even. I was doing NSTs twice a week from 32 weeks on. Every NST was great.
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#9 of 59 Old 08-29-2007, 12:55 AM - Thread Starter
 
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thank you ladies so much, i am feeling so much better!

i'm usually so good at sticking to my guns and going my own way...and obviously the last thing i want is for anything negative to happen to these babies - what i truly needed was just to hear the logic again from others who have done this already to combat that illogical nonsense from today.
what is so easy with the evidence based care in midwifery is just so upside down in the world of obstetrics!

i think i might actually sleep tonight now. thanks again.
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#10 of 59 Old 08-29-2007, 01:01 AM
 
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Mil carried her twins to 40 +2. She delivered them breech with an OB (1969). although they were #9 and 10. But they were both very healthy. Good Luck.

:CLC,Doula :Mama to 2
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#11 of 59 Old 08-29-2007, 10:15 AM
 
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This is why I can't deal with the medical mainstream. They just come up with this crap and expect you to believe it especially when they have NOTHING to back it up with. This is exactly why I couldn't do any medical care outside of my midwife during the twins pregnancy. I'm not that strong and I can't hear negative stuff. I just needed positive reinforcement that my babies would stay in there as long as they needed to. They were born at 39 weeks after a week dilated to 8 1/2 centimeters in early labor. We finally did some herbs to bring things on. I wonder how much longer they would have gone. So the very best to you and congrats on cooking those babies so long!

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#12 of 59 Old 08-29-2007, 12:09 PM
 
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mine were born at 40 wks on their due date. no NST's, never suggested. i skipped many appts and many ultrasounds, we were healthy and had no reason to worry. my dr said we could go to 42wks before he would even think of inducing. try not to stress out and stay very positive! way to go mama!!!
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#13 of 59 Old 08-29-2007, 01:29 PM
 
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I carried my babies 39 weeks. DH took my blood pressure every day, and I saw a doctor twice a week (I alternated between an OB and my beloved family doctor). One morning my BP was perfect in the morning when DH took it, but at the doctor at 11 it was through the roof. I was admitted to the hospital, and blood work revealed HELLP toxemia, so I had an emergency C-section under general anesthesia. My risk of seizure and astronomical blood pressure were too great to risk induction (I hadn't even started to dilate yet).

But the babies were perfectly healthy, and weighed 8 pounds each. They were ready to go home from the hospital before I was.

I never had a NST.

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#14 of 59 Old 08-29-2007, 01:31 PM
 
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I only went to 37 weeks, but I had to have a C-section. I went to UCSF for my prenatal care & they tend to be very evidence based. Anyway, they would not schedule a C-section a day before 38-weeks. (I asked -- 38 weeks was St. Patrick's Day & I didn't want my babies to have to drink green beer on their birthdays in their 20s : ) We scheduled it a few days after 38 weeks, but I went into labor earlier and got pre-e & hence my 37-weekers.

So, anyway, it doesn't make sense that 38 weeks is grand, but a week later means antenatal death. Sorry you're having to put up with that kind of crap.

SAHM to F & P, : fraternal twins born 3/05, : I, born 12/07 & at 5 weeks in July 2009
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#15 of 59 Old 08-29-2007, 02:32 PM
 
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Sorry, didn't have a chance to read all the replies and a babe just started crying, so I only have a second.

But my twins were born at 39 weeks 5 days, and would have been later - I had an arom induction for signds of pih. And they thought my placentas were stage 3 at 33 weeks...
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#16 of 59 Old 08-29-2007, 05:28 PM
 
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I've never heard of any dangers "just because" when everything has been going normally and well.
My boys were born on their actual (well, "estimated" ) due date.
My doctor "offered" to induce "any time" after 36, but understood that I was going the natural route. He wanted to monitor fairly often, but was not stressed at the least, and in fact had breathed a sigh of relief once we got to 36 and said "any time is good now, whenever they are ready!"

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#17 of 59 Old 08-30-2007, 12:17 AM
 
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Hi there! I'm going to go against the flow of responses here, and suggest that you be really careful. Doctors aren't making up the whole placentas being more likely to break down after 38 weeks thing. Also the twins are term at 38 weeks, and there is not much benefit as compared to the potential risks of them staying in there longer. It is, of course, your body, your babies, and your decision, and I hope that you have a happy and healthy birth experience!
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#18 of 59 Old 08-30-2007, 04:33 AM
 
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Quote:
Originally Posted by SeaBird View Post
Doctors aren't making up the whole placentas being more likely to break down after 38 weeks thing. Also the twins are term at 38 weeks, and there is not much benefit as compared to the potential risks of them staying in there longer.
: Um.... where exactly are you getting this information? Please link to some studies or articles that back up your opinion.

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#19 of 59 Old 08-30-2007, 04:36 AM
 
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my sister and i were born at 41 weeks, we were undiagnosed twins. everything was fine except we were tiny (9 lbs together). it was a good thing we got to cook as long as we did! good for you mama!
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#20 of 59 Old 08-30-2007, 10:27 AM - Thread Starter
 
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Quote:
Originally Posted by YumaDoula View Post
: Um.... where exactly are you getting this information? Please link to some studies or articles that back up your opinion.
Thanks for asking this YumaDoula, I'd like some follow up also. Placentas certainly break down at the end of pregnancy but I refuse to believe that there is any specific expiration date, whether multiples or singletons, its more likely based on individual health of mother/babies or other individual indicators. Yes its a handy thing for the docs to pull out and say, but none of them have given me any evidence or provided data as I've requested.

Also SeaBird, this is illogical - "not much benefit as compared to the potential risks of them staying in there longer" - if we think through that then induction or c are my options since my babies are evidently not ready to come on their own. I sincerely doubt that going to hospital and setting myself up for a cascade of interventions that will definitely not be a positive experience for the babies is going to do them much good. From my own personal experience with my post dates singleton birth and seeing him big and robust next to these poor shriveled up little darlings who had been yanked out before they were ready, I'm just not on board. As mentioned in my original query, I have read studies that show zero correlation between post dates and bad outcomes at birth so where is the study that refutes that - if there is one I'd like to read it so that I can weigh the two.

If you have data please share it as I'd truly like to understand your POV; that's been the point all along is that statements like yours with no backup are meaningless and frustrating. As is these statements sound like doctor speak spit back out and goodness knows we already have plenty of that.
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#21 of 59 Old 08-30-2007, 11:17 AM
 
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My first pregnancy was a twin pregnancy, and I carried my boys to 40 or 41 weeks (not sure of dates). 7.0 and 8.0 pounds of pure healthiness!

We were also given some scare tactics, though my OB was a little less hardcore. To get them off my back, I had the stress tests done twice a week. My boys also had very large heads (probably related to their genetic condition), so I gave in and had a CT of my hips (to make sure their heads would pass).

I told them I would be induced (after tons of pressure) when I was a few days over 40 weeks (I estimated that that would mean I was a few days past 41 weeks). Two days before the induction date, after weeks of stress tests showing everything was fine, I went into labor. I'm not sure if I ever would have gone in for the induction...perhaps...but it turns out I went into labor so we'll never know!

Labor was odd.... my uterus was SO stretched out, it had a hard time creating effective contractions. My water broke at 10am, but I didn't have a strong (tight/uncomfortable) contraction until around 11pm. I had no contractions AT ALL until 5pm or so. We stayed at home until around 11pm...I didn't want to have a ticking clock over my head. We went to the hospital when contractions started getting sorta uncomfortable (using info from "The Birth Partner" book to make sure that everything was okay in terms of movement, mecomium (none) and good fluid levels). We lied and told the doctors that my water had just broken.

Labor continued to be a little "different" because my uterus was so large. The muscle groups seemed to take forever to coordinate an effective contraction. I gave birth around 10 the next morning (24 hours since my water broke). Pushing ds1 took three hours. Ds2 was a breech extraction (OB reached up, grabbed ds2 by the feet, and pulled him out). Given the size of ds2's head, and truly it was HUGE, I'm not sure how pushing him out would have gone. Ds1 was fine, because he came out head first and had time to reshape his head during labor, but I would have worried about taking the time to push ds2 out.

It was a drug free delivery, except for right before ds2 was born. To keep me relaxed the OB gave me a local aenesthetic shot in my vaginal wall.

I would go for the stress tests. I know it's a total headache (), but it's a compromise that's worth making. They'll know your babies are healthy and hopefully not put as much pressure on you, and you'll have a little extra information to comfort your decision as you continue to go against the grain. Stay strong, and do what you feel is right. And if, heaven forbid, you feel something *isn't* right, trust your gut and get where you need to be.

PM me if I can be of any help. You can do this!

RedOak ~ Momma to DS (8) , DS (4) , DD (3) , & DD 9/10 ~
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#22 of 59 Old 08-30-2007, 11:22 AM
 
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I carried mine to 40 weeks 1 day. They were 6 lbs 10 oz and 8 lbs 4 oz. I had a homebirth so I never went to the hospital for any kinds of tests. But my midwife never was concerned. I think she said at 41 or 42 weeks we would talk options.

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#23 of 59 Old 08-30-2007, 11:55 AM
 
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double post

Trying to get my bearings...
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#24 of 59 Old 08-30-2007, 12:22 PM
 
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I would also like links Seabird, but I just did a quick search of pubmed, and found this interesting and recent study
No advantage to delivering twins before 40 weeksI think these results could be read as 38 weeks is the optimal time to deliver, but I actually read them as a caution not to deliver before 38 weeks and to get more cautious after 40 weeks. They do say that babies in the 39th and 40th week were less likely to need ventilation assistance. I am at work and don't have time to read the whole paper now, but I will try to later.

Again, I think even studies like this represent the aggregate and not one particular person's experience. You are healthy and have had good prenatal care. Your NSTs have been reassuring. You and your babies are doing great mama!!

Trying to get my bearings...
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#25 of 59 Old 08-30-2007, 12:36 PM
 
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mwherbs here on mdc (she's mostly on Birth Professionals) has the most access to studies, and I believe once she posted a link to a Pub Med article that twins do best when born between 40-41w.

FWIW, I was told at 34w that my placenta was getting old and calcifying. The docs mentioned it several times. I was induced at 34w1d and my boys were born, both vaginally, at 34w2d -- and so was the most beautiful, healthy, red placenta you've ever seen. I even have pics of it. I'm a dork.

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#26 of 59 Old 08-30-2007, 12:41 PM
 
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I have no data for you other than my own.

My twins came at 40 weeks and 2 days.

How are you doing? Will you keep us posted on the birth of your twins?
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#27 of 59 Old 08-30-2007, 12:47 PM
 
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OT: Hotmamcita, I'm so glad to see you here! You were my inspiration to have my twins at home!...

Trying to get my bearings...
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#28 of 59 Old 08-30-2007, 04:00 PM - Thread Starter
 
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i am so delighted to hear from so many twin moms about this, thank you so much for sharing with me! my midwife is not concerned either and i had a lovely visit with her yesterday. my body is making ready, so they might come tomorrow or they might wait a little while but i'm feeling so much happier about all of this and thinking that maybe they'll just come so i can stop worrying about it.

Ellie'sMom - thanks for posting that link, I read the objective but can't seem to figure out how to reach the full study. either way I think you're on target with the overview and that's quite helpful.

hotmamacita - i'll do my best to let you guys know, certainly. my mw has given me the ok to try castor oil if i want, i don't know if i want to or not, didn't do that with #1 and don't know if i should mess with the process, but since we did check and my body seems to be readying itself (4 cm, mostly effaced) it might be best to just try it, if i make it to 40, and see if i can end the worrying. i'll have to sort that through in the next few days.

thank you again, it is so nice to benefit from your experiences and thanks so much for the positive vibes!!
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#29 of 59 Old 08-30-2007, 08:19 PM
 
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Originally Posted by Ellie'sMom View Post
OT: Hotmamcita, I'm so glad to see you here! You were my inspiration to have my twins at home!...
Thank you. That means a lot to me.
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#30 of 59 Old 08-30-2007, 08:20 PM
 
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Originally Posted by clancybaby View Post
hotmamacita - i'll do my best to let you guys know, certainly. my mw has given me the ok to try castor oil if i want, i don't know if i want to or not, didn't do that with #1 and don't know if i should mess with the process, but since we did check and my body seems to be readying itself (4 cm, mostly effaced) it might be best to just try it, if i make it to 40, and see if i can end the worrying. i'll have to sort that through in the next few days.
Ooooh. You are going to have some babies.

Trust your instincts. Enjoy labor and love those babies. We'll be thinking of you.....

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