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Discussion Starter #1
<p>(Cross-posted in VBAC)</p>
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<p>Hi all,</p>
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<p>I'm a birth doula and a colleague of mine has a client who is seeking a vaginal birth for her twins. Her first birth was a cesarean. The client has been working with a hospital-based midwifery group and is starting to wonder whether they will truly support this as a vaginal birth. They've said they handle about one twin vaginal birth a year- not one twin VBAC, one twin vaginal birth. Is that typical? It sounds low to me, especially given the rising rate of twin pregnancies.</p>
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<p>What questions should the client ask her providers?</p>
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<p>Do most hospital-based midwives support twin vaginal birth? twin VBAC?</p>
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<p>Do you think she may be better off with an OB who has lots of experience with vaginal twin birth than with midwives who are more used to singletons?</p>
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<p>Any resources that would be helpful for her?</p>
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<p>Thanks! :)</p>
 

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<p>I would recommend her feeling out each person in the practice to see exactly how supportive they are of her having a natural birth.</p>
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<p>How is her mindset? Does she seem confident and comfortable with trusting her body to birth her babies? (I attended a twin birth with a less than supportive provider, but the mom had the birth she wanted because she was set on what she wanted.)</p>
 

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<p>I would find out what the status or pecking order rank these midwives have at the hospital.  At our local hospital the CNMs bow down to even the charge nurses and have to tiptoe around not to be reprimanded or lose priviledges.  The older, senior, male O.B.s can do whatever they darn well please so for VBACs I always recommend the backup doc for the midwives.  That way if she ends up laboring for a long time or if there are any minor irregularities, no one will question him for letting her labor.  The midwives always have the attending docs breathing down their backs.  </p>
 

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<p>She is in NY?</p>
<p>In NY it is nearly impossible to have a vaginal twin birth in a hospital.</p>
<p>Most OB/GYNs will let you 'trial' labor but will inevitably find a reason for a c-section- most often position of babies.</p>
<p>I  would be shocked if an obgyn would even consider a vbac with twins because of its double 'high risk' status.</p>
<p>I would say her best bet is to stay with the midwives who will at least give her a chance- but the truth is, she may end up with a c section in the hospital. Thats just the way it is.</p>
<p>There are some midwives in the NY area who will do twin HBAC if this is something she wants to consider.</p>
 

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<p>I'm not surprised she's been told they only do one vaginal twin birth a year.  Many women don't question the suggestion for a csection and many drs/hospital mws have high requirements for 'attempting' a twin birth (babies' position, weight, gestation, etc).</p>
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<p>I attended a twin vbac last month and it was A LOT of work for the mama.  Not the labor or the delivery, but the prep work.  If your friend wants a twin vbac she's going to have to interview everyone under the sun and find out who can support her best.  My client's mws helped her find the ONLY ob in town who would consider a twin vbac and but even with that ob, it was a fight every step of the way.</p>
 

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Discussion Starter #6
<p>Yes, she's in New York. And we've been suspecting that she's sort of getting yessed to death but then when she gets to 37, 38 weeks, people are going to start hemming and hawing and suggesting surgery.</p>
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<p>Thanks all for the info. I'll pass it along.<br>
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<div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>Zangua</strong> <a href="/community/forum/thread/1279154/twin-vbac-need-info#post_16049798"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br><br><p>She is in NY?</p>
<p>In NY it is nearly impossible to have a vaginal twin birth in a hospital.</p>
<p>Most OB/GYNs will let you 'trial' labor but will inevitably find a reason for a c-section- most often position of babies.</p>
<p>I  would be shocked if an obgyn would even consider a vbac with twins because of its double 'high risk' status.</p>
<p>I would say her best bet is to stay with the midwives who will at least give her a chance- but the truth is, she may end up with a c section in the hospital. Thats just the way it is.</p>
<p>There are some midwives in the NY area who will do twin HBAC if this is something she wants to consider.</p>
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<p>"In NY it is nearly impossible to have a vaginal twin birth in a hospital."</p>
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<p>I'm in upstate NY and I have attended two vaginal twin births in hospitals. It's tough to find a good provider, but there are providers who will attend her.</p>
 
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