Homebirthing mamas: Do you also see an OB?? - Mothering Forums
 
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#1 of 13 Old 05-28-2009, 08:04 PM - Thread Starter
 
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I have two great midwives (one is a CPM and one is a direct-entry). We are planning to homebirth our twins due in January. I had a very traumatic birth with my son and am very afraid of hospitals and doctors in general.

However, I have to face reality here; there is a possibility that these babies may come early. Now, I cannot imagine going into labor at 34 weeks (or whatever) and walking into the nearest ER. : That would mean I would get whoever was on call and we all know how doctors (well most of them anyway) view twin vaginal birth. I would be cut open before I could say "wait!".

So my question is, what does everyone else do? Do you have two different care providers? Did you tell your midwives?? Should I start the search for an OB who isn't going to mind me refusing testing and is open to vaginal twin birth (is there such a doctor?!) or do I take my chances??

Help me mamas!!

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#2 of 13 Old 05-28-2009, 08:24 PM
 
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Welcome, Nummies, and congrats! You're already way ahead of where I was at your stage in the pregnancy. I started out with OBs; discovered the twins at 19 weeks. Gradually got the picture of what a medical birth would be like and wasn't OK with that. Found a midwife willing to assist a twin mom at about 30 weeks, and stopped going to OB appointments around 34 weeks, although I had my last u/s at 37 weeks. Then birth at home at 39 weeks. Loved being at home!

So you're considering going to an OB in case your twins come early. Smart to plan for it, and hope you won't need any of your preparations!

Ask your midwives and Find Your Tribe forum about naturally minded OBs. There are a good number of OBs who will say they are willing to deliver twins vaginally, and some actually are, given the "right" conditions. Since you seem to want as little involvement with doctors as possible, I might recommend doing parallel care with an OB from weeks 28 - 36. That would be no more than four doctor's appointments, and would cover the early birth window.

Something to consider, and that way, should you need to transfer during your homebirth, you might also have someone to go to.

For the record, I'm not suggesting telling this OB about your homebirth, personally I think that would cause more problems than it solves. I would just claim I was transferring care to them, and then miss the last few appointments and birth at home.

Mom to : Belle and Izzy
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#3 of 13 Old 05-28-2009, 09:26 PM
 
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I lived in Texas at the time where midwifery is legal and supported by legislature but CPMs are not backed up by obstetrical care. I decided to hire a kick ass doula and we talked extensively about my desires should we end up in the ER with preterm labor or another condition. I would have just said "no thank you" over and over and over and over until the babies came out of my vagina. Unless, of course, I REALLY felt a c-section was in order and then I would make the choice to consent. And honestly, we got pretty close to that thanks to the presentation. But they were successfully born at home at 39 weeks. :

Good luck! There are so many choices to make when you find out you're carrying twins!!!

And CONGRATS! Welcome to the wonderful world of twins!
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#4 of 13 Old 05-29-2009, 12:19 AM
 
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Congrats on your pregnancy! ::

We had concurrent MW / OB care and planned for a HB. My two main reasons for concurrent care were:
1. My twins were Mono/Di, which carries risk of TTTS and therefore calls for regular & routine monitoring throughout pregnancy; and
2. The chance we'd need to birth at the hospital in the case of premature birth or transfer.

We found a VERY forward-thinking OB by asking around in our local area. We were actually able to tell him of our HB plans, and he was supportive.

We ended up with a hospital transfer during labor, and I was so so happy to see my OB at the hospital! I believe that had we not had him at the hospital, I would have had a much lower chance of delivering two healthy babies vaginally.

I hope that you are able to either find a supportive OB or find a way to see an OB without feeling like you are holding back/lying/stressed.

Mama to twin girls Adele and Nadia, born 5/2008
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#5 of 13 Old 05-29-2009, 12:36 AM
 
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This was one of the hardest decisions for me to make in my twin pregnancy once we had decided on a homebirth. I knew if I went into labor early, I'd have to go in and say I had been doing unassisted prenatal and was planning an unassisted birth (neither of which is true, as I had excellent prenatal care from a hospital and home trained provider). I also knew that if I saw an OB, I'd have to lie that I was planning a hospital birth, and play along with a lot of intervention (even before the birth) that I didn't want. I am a horrible liar, and really feel strongly about honesty and integrity and saying what you mean, so either way it was a losing situation for me.

In the end, you just need to weigh it all out and make sure you are comfortable with your plan, whichever way you go. It needs to be a plan that works to keep you and the babies safe and healthy up until and during the birth, but that doesn't weigh too heavily on your emotions and personal paradigm for understanding pregnancy and birth, either. No small task.

Best of everything in your birth planning!

Wife of one and mom of five, including my HBAC twins!
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#6 of 13 Old 05-29-2009, 11:01 AM - Thread Starter
 
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Thanks for all your thoughts ladies. I still have no idea what I am going to do, but I really think that I probably need to find some back up care. I do not really WANT to do this, but I need to be responsible. I am planning on interviewing several people about it.

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#7 of 13 Old 05-29-2009, 12:35 PM
 
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This thread is timely, at my appointment on Wednesday I was asked to consider finding an OB for concurrent care since none of my three midwives have hospital priveleges (our homebirth plans didn't change at all after finding the twins, in fact we became more strong in our conviction to homebirth again). Ugh. I've never, ever seen an OB except for once at one of my first baby's prenatal visits, I saw the midwives' supervising OB to check my scoleosis and its possible impedement on the birth canal. All my well woman care has been done by midwives or NPs, my prenatal and birth care has been done by midwives.

I can't lie, so I need to find an OB who will just see me as a backup and knows it. Good luck with that, hunh? I'm hoping to have just one or two appointments and never need to see him again. I'm also hoping not to have to consent to any testing or invasive exams by him (or her), we'll see how that goes. I'm not overly hopeful.

Bean : Mama to DSs and (& :, 4 goats & 7 ) and two fraternal twin BOYS 9-19-09 (+ 1 daytime boy)
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#8 of 13 Old 05-30-2009, 07:03 PM
 
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First, I am so sorry you had a traumatic experience previously!

Quote:
Originally Posted by nummies View Post

However, I have to face reality here; there is a possibility that these babies may come early.

Why do you say this?
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#9 of 13 Old 05-30-2009, 07:16 PM
 
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It is a very good idea to plan in case of prematurity. Twins don't always come early, of course we know this, but in case they do it would be good to have a like-minded OB. I spoke with midwives and had them recommend an OB. I lived in DC and they would only recommend one OB in the entire metro area. He is very practical and was known to deliver breech babies, etc. I gave birth at 30 weeks 5 days and had a vaginal birth that was great under the circumstances.

As someone who had preemies it is also good to find out about the NICUs in your area. Mine had private rooms. I did not know this in advance. At one point my babies were transferred to another NICU in a larger hospital and there were very few private rooms and could only be used for very special circumstances. I think I would have been terribly stressed (like I wasn't already!) if we spent the entire 6 weeks at that NICU b/c you have very little privacy for breastfeeding (it took so much patience to get them to nurse and I am relatively modest about my breasts) and just seeing your babies.

I would not have felt comfortable just going into an ER either. You just never know who you're going to get. It's good that you have a plan b/c you'll be relaxed about things.

Mama to lovely twin girls 1/08
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#10 of 13 Old 05-30-2009, 07:49 PM - Thread Starter
 
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Quote:
Originally Posted by hotmamacita View Post

Why do you say this?
I guess just hearing about preterm babies and how much more often it happens with multiple pregnancies. I have no reason to think that I won't carry them to term, but it is something that is in the back of my mind. And thanks for the hugs.

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#11 of 13 Old 05-30-2009, 07:51 PM
 
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Quote:
Originally Posted by nummies View Post
I guess just hearing about preterm babies and how much more often it happens with multiple pregnancies. I have no reason to think that I won't carry them to term, but it is something that is in the back of my mind. And thanks for the hugs.
It was there for me as well. I knew the chances of not having a home birth or of having them preterm went up with the second baby! It didn't dissuade me from my goals but it was there and we for sure planned for it more heavily than we would have with a singleton (which we had also talked about what we would do in those circumstances).
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#12 of 13 Old 06-04-2009, 09:32 PM
 
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Two things,...

If you find an OB who says he will let you try for a vaginal birth, ask him how many patients of his have actually had a successful one...letting you 'try' is not the same as supporting it and helping you to get the birth you want.

And one of the big reasons twins are born early (excluding complications) is because a lot of OB's wont let you carry them past a certain gestation. It is just a routine procedure to do a section. You can carry them to term and many people have. So be wary of doctors who just like to get them out at a certain time regardless of how well they are growing.
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#13 of 13 Old 06-05-2009, 10:54 PM
 
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I had a perinatologist for concurrent care starting at about 28 weeks or so. I felt like the reports from the peri's office were the only things that my family and some friends were interested in. I always felt like my midwives, however, gave me the best care. I ended up in the hospital when planning a homebirth w/DD1, and didn't want to walk cold into the hospital again. I did a lot of asking around for a provider who seemed the most liberal and homebirth "friendly". In the end, I really decided after my water broke that it was home where I most wanted to be. I was glad that I had both for some reasons, but ultimately, my midwives rocked and I would have done great w/just seeing them.
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