Leilah McCracken just posted this on a list I'm on and I thought I'd pass it along.
Excerpt from Having Twins and more, 3rd edition, 2003. Boston, Houghton
Mifflin. Elizabeth Noble. www.elizabethnoble.com
Triplets Born at Home after a Previous Caesarean
The three bouncing babies shown in the birth announcement were all born at home.
This story began when Mary simply sought a natural birth after her first child was delivered by Caesarean. While the general policy held by the doctors in her small town was to allow a trial of labor for a subsequent birth she felt she would have had was "hope with a very uncertain outcome."
Therefore, Mary looked for a midwife who would assist her at home. When it become apparent that "twins" were on the way, she felt it would be impossible to achieve the vaginal birth she wanted if she "plugged in to the medical establishment." Thus, she decided against an ultrasound, feeling that it would be only the beginning of a lot of medical interference. As the
midwives would never have agreed to a home birth for triplets, Mary is glad that she did not have the ultrasound!
Carrying twins under the care of any of her local doctors would have meant a Caesarean at thirty-eight weeks "to avoid uterine rupture from the uterus growing too large." Mary¹s midwife says,
"I agreed to help Mary and her husband do their prenatal care and see what things felt like when she got closer to term. I didn¹t feel right sending her off for a lot of obstetric technology she didn¹t want and a C section she didn¹t need, so we started looking for ways to make it feel safe at home. They didn¹t want an ultrasound and I didn¹t take the possibility of more than two babies very seriously, although the father asked if I thought
there could be more than two after reading Having Twins."
Mary¹s husband was working in the home and available to help at the end of pregnancy. During the last few weeks, Mary rested in bed a lot of the time and was lucky to have a good friend staying with her. She helped feed Mary and provided the couple with invaluable emotional support. Eating every couple of hours, Mary took in about 200 grams of protein a day and gained
nearly 70 pounds.
Two midwives took turns visiting Mary every other day to check her urine and blood pressure, which remained normal. One week after the due date, labor began. The first two babies were born, head-first and uneventfully, nine minutes apart. At this point the family doctor, who had been listening to the heart rates and checking her belly, said that she felt a head. The midwife reached in and felt a foot way up high, but the baby was facing Mary¹s front so the midwife turned her around to face the back. This breech baby was delivered ten minutes after the second. Next, with three umbilical cords dangling from her vagina, Mary pushed out the one single placenta and two fused placentas. No episiotomy was necessary, and there was only a slight tear after delivering the breech baby. The first-born was a boy of 6
1/2 pounds. The second-born was a girl who weighed 6 pounds, 14 ounces, and the third, the largest, was a girl weighing 7 pounds. The total weight of the three babies was over 20 pounds! All three babies nursed within the first hour and were entirely breast-fed for five months.
Mary had a little trouble urinating at first, as the size and stretch reflex of her bladder was diminished from months of pressure. This cleared up within a few hours after birth. For a week or so, her balance was shaky when walking because her skin and muscles were so loose that "her belly swung back and forth" when she moved! But she has three wonderful, healthy
children, born without any medical intervention and for a total financial outlay of only $1,000 (although the midwives did not even ask for that much).
As midwifery services were not covered in her state by health insurance, the family practice doctor billed the insurance company. However because there were no complications or special equipment, the insurance paid only for a single birth! This is deplorable, when a hospital birth of a singleton could
not be had for as little as $1,000 at that time. Perversely inverse
insurance reimbursement is yet another way to penalize natural birth. In this "triple high-risk" pregnancy- triplet, vaginal birth after previous Caesarean, home birth- the mother¹s competence and self-reliance should have been rewarded. She saved herself, the insurance company and society at large, hundreds of thousands of dollars in costs. In fact, Mary had a friend
in her town who also had triplets, but under the "care" of an obstetrician who restricted her weight again and put her on bed rest. The babies were preterm and low birth weight, spending weeks in NICU and costing a fortune paid for by health insurance.
I believe all women should be supported in their birth choices. It is better to plan intelligently with committed caregivers than to do as one mother of twins did: she tricked a doctor into responding to her "single" delivery in a motel room because she didn¹t want a hospital birth!
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