# Twins -- C-Section/Vagina



## L.A.Mamma (May 1, 2008)

This is my first pregnancy, so labor seems quite daunting. I'm seeing a traditional OBGYN and an MFM. I'm a high risk pregnancy b/c of twins, 3 previous miscarriages, had to get knocked up through IVF and maybe my asthma.

I'll admit it, labor and delivery sound hella scary!! My doc has basically told me he'll only do a Vaginal if both are head down.

I'll tell you my thoughts:

Vaginal -- natural always seems better. I'm a pretty green type of girl. Recovery time is less. Though the idea of tearing down to my bummy is scary. I also worry something will go wrong so to speak.

C-Section -- This is selfish, but I like my vagina the way it is, lol. But on a more serioius note, I'm just afraid something will go wrong with a Vaginal. I got pregnant through IVF; fertility/pregnancy, have not been my friend thus far. It's been a struggle and I just don't want anything happening to my babies. I guess I'm afraid to press my luck, since this pregnancy is such a miracle.

I feel like if both babies are head down and there are no medical obstacles, I should go and do a Vaginal. My husband thinks I'm crazy. What do you all think?

If one is in breach, I'm really just darn scared and may opt for a C-section.

UGH, I just don't know!!!!!!!!!!!!!

POINT OF CLARIFICATION AFTER READING COMMENTS:
Ladies, point of clarification. The tearing is a fear -- it's not a deal breaker here. It would be immature imo to not have a vag birth simply b/c of the fear of tearing. Obviously our bodies change after child birth=)


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## crazycandigirl (Mar 13, 2006)

Hard decisions for you to have to make. I can't offer much advice as I have only had one baby at a time, but I hope you find the decision that is right for you and your little ones.

If it was me I would try for the vaginal birth. I have had 2 vaginal births and the thought of a c-sec really does personally scare me a bit. I guess I would have to weigh the options and find out how to have the best possible chance at a safe and easy vaginal birth, but prepare myself for a possible c-sec.

Oh and to let you know (cause you made me smile with your comment) vaginal birth does not necessarily mean a big tear, and I have found absolutely no difference in how my vulva and all its wonderful bits preform from before and after. I was really worried about that before my first, but a woman's body is an amazing thing, and everything goes right back to how it is suppose to be. DH notices nothing different during sex either.









Happy birthing vibes to you no matter what decision you make!


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## Spring Sun (Jul 30, 2005)

I am photographing newborn twins in a few days and their mother did it naturally. I am so amazed by her.

I did not tear and I dont thing my vagina is any different now. Plus, remember your babies will be a bit smaller than normal so I doubt they will make a huge impact down there, you know?

It is sooooo much better for the babies to be born vaginally too. I would do a little research before you totally decide.


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## thorn (Dec 28, 2004)

I personally didn't like recovering from major surgery with a single newborn, I definitely wouldn't want to while trying to keep up with two of them!


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## Degas (Sep 13, 2007)

Not in your DDC, but I personally would be more worried about complications and things going wrong from a c-section than a vaginal birth. A c-section is major surgery. There is a greater risk of infection with a c-section as well. Take every chance you can to birth vaginally.


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## BeagleMommy (May 26, 2006)

There are a lot of things that can go wrong with a C-section. Since most don't have major complications, I think we have the impression that they are safe. Well, it is major surgery. And even if it appears that everything went well, a huge percentage of women have ongoing pain from the surgery. Not to mention the added difficulty of breastfeeding initiation. And any future pregnancies are going to be more challenging to find someone who will "let" you have the next one vaginally. My SIL had a perfectly healthy, full term baby by elective C-section and she didn't even see the baby until she was almost 4 hours old! And that was at a regional "women's hospital" with a good reputation.
I'm not saying there are no good reasons for a C-Section, but it really is a big deal whereas having a baby or two vaginally is what we were designed for. That's a much longer track record!
You have time to do some research- take advantage of it!

And, yes, many women successfully fully breastfeed twins!
Congratulations on your two little blessings!


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## Gena 22 (Jul 3, 2008)

I stumbled on your post, the title caught my eye although not in this DDC. If you're still pondering this issue, consider joining us at the Parenting Multiples board.

Having twins is different than a singleton, all the way along, even through pregnancy. You'll hear all sorts of medical concerns, some of which do need to be taken seriously. I'd strongly suggest reading on the subject. Dr. Barbara Luke has a book most MOMs swear by. It's great for guiding you through the nutrition you'll need, although I disagree with her estimate of when twins should be born and how inactive you need to be.

Anyway: to the birth aspects of twins. Like you, I went to OBs and an MFM specialist through my pregnancy. And like you, my OBs said they'd go let me go for a vaginal birth if both twins were head down. They were. But, I talked through delivery with the different OBs in the practice, thought about my mother's history (going late - long labor), and chatted with L&D nurses at the hospital. Mine had an 80% twin c/s rate. The twins were my first, so I had "an unproven pelvis."

So that left me with a decision. If I had delivered with my OB at the hospital I would have needed to be at peace with the idea of a c/s. I probably would have waited as long as I could, and ideally let at least some early labor start. Maybe I could have tried for a hospital vaginal birth, but I think it would have been best to agree to at least a semi-scheduled c/s with my OBs. I'd have wanted calm, planned agreement with my doctors.

Instead, I wasn't at all at peace with the idea of a c/s forced on me. And I didn't want to fight all through labor over every little thing. Now I liked my OBs, but we had some major philosophical and factual disagreements. I don't think twins are best born preterm. I don't think induction is safe. Etc. So I found a midwife and birthed my twins at home.

Quote:


Originally Posted by *Spring Sun* 
I did not tear and I dont thing my vagina is any different now. Plus, remember your babies will be a bit smaller than normal so I doubt they will make a huge impact down there, you know?

It is sooooo much better for the babies to be born vaginally too. I would do a little research before you totally decide.

















:

Labor was a little rough, and I caved to home induction with castor oil. But my birth went very smoothly. My twins had great heartbeats all throughout. They were born with a quick pushing phase. Birth was better for them at home by far. Then recovery was much easier on me.

Mull it over and do some research. Come to peace with what you choose. I can definitely respect women who make an informed decision to birth their twins surgically. But birthing vaginally at home can be a wonderful and healthy decision too. It's the middle ground that's tough - vaginally in a hospital. There are lots of challenges, and you'll need great fortitude, luck and help.

Feel free to PM me. Hope to see you on the Multiples Board!


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## Pernillep (Jan 2, 2007)

Personally I would say go vaginal if at all possible. Even if one shows breech. From what I understand once one is out the second often turn. There just isn't a whole lot of room to move around and before birth they take any spot they can find.
My mom did a twin vaginal (me) and one of my best friends did too. Both said it really was not a whole lot different from giving birth to just 1. Their labor was similar, the only difference was once you had a baby you still had to push.

It is a lot easier to recover from even a twin vaginal than a c-section. A c-section is major surgery and you can see complications after delivery which you rarely see in vaginal births.

Birth and labor can be scary if you have never done it before. I was a little freaked out before having DS because i just didn't know what to expect but my fear of a huge needle in my spine was much larger than that of giving birth. Your body is meant to have a baby and while for some people it is not a sunday walk in the park with pink clouds, roses and cotton candy it is doable. So much so that 5 min after DS popped out I asked when can I do this again.

About your down there bits. I asked DH about it and he says he can't tell the difference. I am not spending my days looking at it so honestly I don't really care.

Going vaginal doesn mean you will tear. I for one didn't at all and DS was suctioned out because of cord issues.

Lastly, the difficulty you had getting pregnant doesn't necessarily mean giving birth will be any harder or more complicated than if you had gotten pregnant on your first try. I do understand the fear and doubt though. You went through a medical procedure to get pregnant so it can be very difficult to trust your body and nature to take its course with the birth. You still have plenty of time before you have to make your decision. Spend some time reflecting on what type of birth you want and where your fears may be interfering with what you want and who you are as a a person (since you say you are pretty crunchy







) Then once you have made your decision you can be comfortable in knowing you did your research and made the decision that was right for you whether it being a c-section or vaginally.

(ok this got a lot longer than i expected, Sorry)


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## August09baby (Dec 3, 2008)

Hi L.A.Mamma: I am in your DDC - having twins in August. I am not sure if it helps to get other people's perspective on their own choices but here is why I am doing everything in my power to have these babies vaginally - because I genuinely and sincerely believe that having these babies vaginally is the very best thing I can do for my children:

There are very strong, valid medical reasons that babies should be born through a vagina. As a L&D and postpartum nurse for several years I can tell you from my own experience (and the medical evidence backs this up) that c-sectioned babies are more likely to need to go to a NICU, they can have more trouble latching on for breastfeeding. Without the vagina to help expel the fluid in the babies lungs, their lungs are "junkier" and they usually, if not sent to the NICU, will be kept in the well baby nursery for longer periods of time. We used to play a game in the well baby nursery for new nurses. We would have them come assess a newborn and not tell them if it was a vag or cs delivery. We would put the babies hat on so you could not see if there was head molding or not (a vaginal delivery give away!). Sure enough, after one or two assessments, even a novice nurse could tell the difference between a c-sectioned babies lungs and a vaginal birth babies lungs. That alone is a huge motivating factor for me.

Also, the recovery period for a c-section is much longer and much harder. The thought of caring for two babies after major abdominal surgery is daunting, at best. An I never forget that a c/section is major abdominal surgery. Using serious, heavy duty drugs that do also affect recovery and the babies.

I hear what you are saying about being afraid of something going wrong with a vaginal birth. Those are valid feelings. But I would maybe consider thinking about the fact that things can go wrong with a cs as well. One of the hardest things for me with the birth of my DS was getting over the fear of what could be and trusting that my own body could do the job of labor. It took a lot of work on my part - but it was worth every second of my beautiful labor and delivery for DS. And my vagina does not seem all that different after the birth of my son - 8lbs 6oz







!!!

I have a doctor who is very comfortable with a breech delivery so if baby b is breech we will deliver it vaginally. I searched for weeks to find a doctor committed to the fact that vaginal birth is how babies should arrive into the world (barring a true medical emergency).

Anyway - those are just my thoughts on the matter. In the end every woman is different and you have to make the decision that works best for you. I wish you peace as you make your decision and a wonderful birth experience with two healthy babies at the end of it all


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## snowmom5 (May 8, 2008)

Barging from July. I delivered my IVF twins vaginally (vbac, actually). Baby A was head down, baby B was transverse (really he was all over the place lol). After baby A was delivered, the OB and resident turned baby B to vertex and he was out in two pushes, five minutes after baby A. They were born at 33w due to p-prom. The pregnancy was complicated by PTL/early cervical changes, bedrest, lovenox for clotting issues, tachycardia, etc.

Let me tell you, it was a heck of a lot easier waddling around the nicu following the vaginal delivery than it would have been following a section. I *hated* the recovery from my prior scheduled section, which had been for a breech singleton. Not that recovery from the vaginal delivery didn't have its moments (like three days later in the bathroom when I thought for sure I'd bust my stitches LOL). But by comparison to the section, it was a piece of cake. (I have since had two more vbacs, which were even easier to recover from, and am hoping for one more this summer. No, not all ivf, but that's a story for another day...)

So, if you can manage it, I totally vote for going vaginal. There are plenty of complications that you can't control, but if baby A is head down I'd go for it. Of course, if your provider isn't willing (or experienced) to turn baby B then you're in a pickle, unless you switch to someone who is. If both are head down, it's a no-brainer to me. Seriously.

(As for effects on the vagina, section vs. vaginal, I think my pelvic floor muscles were shot long before I ever attempted a vag delivery anyway, and honestly three vag deliveries later I think I like it better. I think it's a weak argument when it comes to choice of delivery.)

There's another factor: your future deliveries. I know it's hard to imagine now, after all you've been through, but it's a whole lot easier to have more babies vaginally if you don't have to worry about vbac issues (e.g. you can ask your doc now - do they do vbacs at your hospital?).

Many congrats on your hard-won pregnancy! I hope all goes well no matter what sort of delivery you end up with!


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## tankgirl136 (Dec 13, 2008)

I think so many people have given you some great advice!!!

I am only having one as have most of my friends, but honestly seeing the difference in recovery between my friends who went vaginally and C-section, there is a huge difference. My C-section friend had so many more issues and pain and found caring for her son to be so hard afterwards. She had a teenage daughter to help thank goodness. My other friend had three other young children and she seemed up and ready to go so much faster.

I also hate to say this but another friend had one of the scary things that can happen from a badly stiched up prior C-section, make sure if you have to have a c-section that they do a double stitch closure not a single!!! Her son was fine but things became very scary for her for a bit there.

I have to say I am scared too and I am only in for one! I think that a huge incision on my belly is way scarier then anything that can happen to my vagina in this case, since that is where babies are supposed to come from. That and the thought of a big needle in my spine is SCARY!!!!!!! We all have to be educated and do what is best for us and our lil ones. All the best to you!


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## NaturalMindedMomma (Feb 5, 2007)

Quote:


Originally Posted by *L.A.Mamma* 
This is my first pregnancy, so labor seems quite daunting. I'm seeing a traditional OBGYN and an MFM. I'm a high risk pregnancy b/c of twins, 3 previous miscarriages, had to get knocked up through IVF and maybe my asthma.

I'll admit it, labor and delivery sound hella scary!! My doc has basically told me he'll only do a Vaginal if both are head down.

I'll tell you my thoughts:

Vaginal -- natural always seems better. I'm a pretty green type of girl. Recovery time is less. Though the idea of tearing down to my bummy is scary. I also worry something will go wrong so to speak.

C-Section -- This is selfish, but I like my vagina the way it is, lol. But on a more serioius note, I'm just afraid something will go wrong with a Vaginal. I got pregnant through IVF; fertility/pregnancy, have not been my friend thus far. It's been a struggle and I just don't want anything happening to my babies. I guess I'm afraid to press my luck, since this pregnancy is such a miracle.

I feel like if both babies are head down and there are no medical obstacles, I should go and do a Vaginal. My husband thinks I'm crazy. What do you all think?

If one is in breach, I'm really just darn scared and may opt for a C-section.

UGH, I just don't know!!!!!!!!!!!!!


It's hard when you go through fertility treatments.

First off, your vagina will be fine after the vaginal birth. Its a muscle and it recovers. LOL I promise









Men think any type of vaginal birth is crazy (most anyway), their bodies are not made to do and their brains are not programmed to accept it, they dont NEED to biologically, we do for the survival of our race. Until the techno medical model of care became so prevalent in this country, midwives attended births at home and babies were born all sorts of ways. He will think its crazy after a c section when he sees the healing/help you will need to recover. Either way, they are in AWE of us and the whole experience! I would talk to him and tell him you really need his support for a vaginal birth. Show him research of why vaginal birth is better.

labor was tough. Delivery was not (for me). I think your HCP makes all the difference in that. I pushed in a great gravity using position and no one counted or yelled. it was gentle. Albor was so worth it in the end and mine was 41 hours, lol. I'm doing it again, I promise it's not THAT bad. No one would do it twice! HAHAA

Twins alone, does not qualify you as high risk. The miscarriages may, it depends on the circumstances. Try (I know this is hard) to not consider yourself high risk until something truly goes wrong. Birth is psychological. Therefore as a woman who has obviously been traumatized by infertility, miscarriages, and is deemed high risk, will naturally doubt her bodies ability to birth as well, its part of anatomy (I went through this and so is my best friend and countless other women I know). By thinking this way, you actually can inhibit birth and pregnancy to work for you. Get a pregnancy affirmations CD (hypnobabies has an awesome one). PLEASE get the idea of elected C section out of your head. I hate to see a woman who is completely capable of delivery throw away her chances because she doubts herself. Most likely, both babies will not be head down. A lot of HCP will not deliver breech singletons nevermind twins, this is due to medical malpractice insurance and hospital policy rather than actual statistics or true factual information. Breech birth can happen with singletons and can happen with twins.

Read as much as you can, as many positive birth stories, especially about twins and surround yourself with knowledge. Don't rely on your Dr for that.

Please remember, C sections are not guarantees either. Birth comes with no guarantees, it is risky no matter how we look at it.

Good luck sweetie, it is a hard decision to make and you will not be wrong either way. I wish you a healthy, easy, pregnancy and birth.


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## L.A.Mamma (May 1, 2008)

Thanks ladies! Lots of invaluable information.

My instinct is that vaginal is better. But the first issue I have is that my OBGYN will not do a vaginal delivery if one baby is in breech (for reasons discussed above, i.e. malpractice). So the question is do I continue with this OBGYN? My gut is saying yes. Also, I only want to deliver at a specific hospital at LA, my thoughts are that it will be very difficult finding a OBGYN that would deliver a breeched baby. The idea of changing up my OBGYN/MFM team is daunting. I'll have to reflect on this.

Now I agree with everyone, 2 babies head down, w/o any other medical complications seems like a no brainer. I'm not denying being scared sh*tless, but my decision can't ever be motivated by fear. I agree, what's difficult at this point is trusting my body. After infertility, it's been tough having faith in my body. But I'm joining a women's circle here in LA and I think it will help.

I've got to do tons of research. My brother-in-law is a brilliant doctor and he really is advising for a C-section as well. It's hard to not put a lot of weight on his advice b/c I trust him. Still, it's my decision to make. I know my husband is on board with whatever I choose.

I'll do my research. And be prepared for whatever happens in this pregnancy.


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## jeliphish (Jul 18, 2007)

Not in your DDC but I wanted to comment that the vagina is a muscle and it recovers extremely fast and well. I think mine is in better condition after having a baby - my orgasms are certainly much better


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## Talula Fairie (Jan 7, 2005)

If it were me, I'd do everything in my power to get those babies out of my vaj, even going so far as traveling to a midwife who will do it naturally. I'd also avoid an epidural at all costs in this situation. Previous miscarriages and IVF do not hinder a possible vaginal delivery or make you totally "high risk" (although I am not 100% sure on that, I don't think they do). Twins do carry a higher risk for many things, but there are midwives out there who will attend to you.

I hate to say it, but your body is not going to be the same after having children. That's just part of having babies, yakno? Your vagina will likely be about the same, and won't feel any different, and even if it would be...would you really be willing to add a threefold risk to your chance of death, and the chance of losing your babies...for that? Probably not, but I just thought I'd give a different perspective. I often say "ok this is a sacrifice I'm making for my kids" and I think it's important for every woman to have a reverence, respect and acceptance about the way their body changes after birth. I know our society tells us a lot of these changes are ugly, but in a way, they are beautiful too.

To help with the fear, I recommend not watching ANY of those scary baby shows on TV. They only reinforce the negative birth culture in our country. Try watching some movies that talk about how wonderful birth can be, and how normal it really is, like The Business of Being Born. You may also want to read Ina May Gaskin's books (either of them, and in both there is talk of delivering twins naturally, even if both are not head down). Her books really helped me with a lot of my fear. And hire a doula or birth coach! They will be invaluable to you for keeping you calm. I was kicking myself for not hiring one when I was in labor with #1.

Oh, and btw: I birthed two full term, POSTERIOR, average-to-large size babies (7 lbs, 11 ounces and 8 lbs, 10 ounces) out my vaj. I did tear both times, but I healed quickly and honestly, sex is even better now. So if there was a change in my vagina...which I can't really feel with my hands and neither can my husband, it was positive if anything. The vagina is an incredible organ, and most of the time, it totally recovers from birth. Remember, this is something our bodies were designed to do.


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## Flower of Bliss (Jun 13, 2006)

Well, I'm not having twins, and I haven't done the research on vaginal twin births and which circumstances truly warrant a c-section...

However, I wanted to chime in on the tearing concerns. I had a 4th degree ("tearing down to my bummy" as you put it). DD was a compound presentation (hand at head) and a very fast birth, and her little elbow ripped right through me. DD was a tiny 5lbs 14oz. It was the presentation and speed of the birth, not her size that was an issue.

My recovery was honestly fine. I was able to walk up and down the stairs easily when I went home the next day. I was going on walks around the neighborhood with DD in her first few days. I traveled to a wedding in my home town about a 5 hour drive away 3.5 weeks postpartum, and again for my BIL's wedding 12 hours away at 6.5 weeks postpartum.

We had some issues with pain during intercourse in the first 4 months postpartum. These were complicated by limited time and energy caring for a newborn and by the typical dryness of a breastfeeding mother. Finding a lube I liked made a huge difference. By 6 months sex was wonderful. I'd say it's been better in the last 2 years than it ever was before DD was born. DH has absolutely no complaints.

The idea of major abdominal surgery scares me. The idea of another 4th degree tear sounds unattractive, but it really doesn't scare me. My biggest concern about a 3rd or 4th degree tear this go round is that my home birth midwife only stitches 1st and second degree tears, so I'd have to transfer for the stitching (she's only had this happen once, and I'm highly doubting that I'll deal with it again).

I hope that this helps settle some of your fears about tears. Of course, you might not tear at all, but I wanted to tell you about my experience with a really bad tear.


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## L.A.Mamma (May 1, 2008)

Ladies, point of clarification. The tearing is a fear -- it's not a deal breaker here. It would be immature imo to not have a vag birth simply b/c of the fear of tearing. (I'll be adding this to the top of my post since this seems to be a hot issue).

I need to do my own research. And honor my body in a way that I think is best. All the insight is helpful, especially if you've delivered twins.


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## L.A.Mamma (May 1, 2008)

Talula: "If it were me, I'd do everything in my power to get those babies out of my vaj, even going so far as traveling to a midwife who will do it naturally." I respect that. Unfortunately, I don't feel comfortable with having a midwife delivery vs. an OBGYN. I have too many doctors in the family that have shaped my way of thinking. Not to disrespect midwives -- it's a wonderful service they provide, unfortunately not for me.


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## Gena 22 (Jul 3, 2008)

Sounds like you're a strong lady, LA Momma. Vaginal twin births, even unmedicated ones, can be had in the hospital. Maybe you can use some of your medico family members to your benefit. Get educated, and make sure your OB is on the same page you are. I hated the idea of changing providers too, but it might be a good idea. Ask around and see what the L&D nurses think of your OB, and how many vaginal twin births she / he's done. FYI - I'd hope that your OB would be on board for a vaginal birth so long as Baby A is head down. Baby B can be turned afterwords. The instance of a first baby vaginally and a second by c/s is really rare.

If you do switch OBs, one piece of advice I've heard is to look for one that specializes in multiples. To a doctor who does, twins are no big deal! Otherwise be really savvy about a doctor's history. Ask around, that will tell you more than an interview will. Also, understand that the risks in twin births and pregnancies vary. If, like mine, yours are fraternal, each with sac of their own, the risks are much less. In the words of Ina Mae, twins are just a variation of normal. My Baby B was swimming happily in her "apartment" right up until minutes before birth! She floated right through the birth of her sister.

Here's a birth story that might be right for you:
http://www.mothering.com/discussions...d.php?t=613772

And here's mine, although I know you're not into the midwife route, there are parts you might be interested in:
http://www.mothering.com/discussions...d.php?t=925854

PS - Hire a doula and labor at home as long as possible. Those two things will do a lot to help you with a smooth and comfortable birth!


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## ChichosMama (Aug 20, 2004)

Quote:


Originally Posted by *L.A.Mamma* 
Talula: "If it were me, I'd do everything in my power to get those babies out of my vaj, even going so far as traveling to a midwife who will do it naturally." I respect that. Unfortunately, I don't feel comfortable with having a midwife delivery vs. an OBGYN. I have too many doctors in the family that have shaped my way of thinking. Not to disrespect midwives -- it's a wonderful service they provide, unfortunately not for me.


That is a serious statement right there. Not to offend you, nor your family(I have drs in my family too), but they are not god and certainly DO NOT know everything, ESPECIALLY when it comes to having a baby. In fact, this is midwife territory that MDs stomped on, making it wayyyyy more complicated than it needs to be. Midwives are the ORIGINAL providers! The medical world has been screwing with nature for years. Research the way birth has been treated over the decades; in 20 years people are going to look back and say omg can't blv we did THAT in a hospital.
You should change your obgyn; she wants to cut you open bc of the possibility of a malpractice case? I mean Im sure there are other reasons, but if an ob said something like that to me, I'd peace out.
Is the hospital you are talking about Cedars? I've never been, but I know the nurses mucked up with a dosage and almost killed twins. Im pretty sure they have a crazy high c/s rate; Drs make more money doing c/s, but im sure you know that.
Check out Huntington Hospital in Pasadena. I had my son there; the staff was amazing. However, they also have a high c/s rate. That being said I would never have a baby in a hospital again. Its totally unnecessary, it saddens me that you think otherwise.
It seems to me you have not truly researched the possibilities. You need to read up. Mothering has great past articles where they actually cite sources. You need to research both sides without bias. This is so important.


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## thepoet (Mar 16, 2004)

Quote:


Originally Posted by *L.A.Mamma* 
Talula: "If it were me, I'd do everything in my power to get those babies out of my vaj, even going so far as traveling to a midwife who will do it naturally." I respect that. Unfortunately, I don't feel comfortable with having a midwife delivery vs. an OBGYN. I have too many doctors in the family that have shaped my way of thinking. Not to disrespect midwives -- it's a wonderful service they provide, unfortunately not for me.

So you're letting your family's opinion shape yours of midwives? May I suggest that you actually meet with a midwife for a prenatal visit so you can form your own opinion of them instead of using someone elses.


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## Jilian (Jun 16, 2003)

I didn't read all of the replies but here are my thoughts:

- There are far more complications that can arise from a cesarean for both mom and baby, which makes it a lot more risky

- With a cesarean birth a majority of the time you don't get to see the baby for quite some time after. In our local hospital it is a minimum of 4 hours until you can see the baby, this is common.

- On average twins tend to be smaller than singletons, and a smaller baby usually reduces your chances of tearing.

*Tearing*: I swear that my vagina is made of paper because it rips to shreds during birth. But they stitch me up, I invest in earth mama angel baby bottom balm, and do pp soaks and all is well. It is really only a PITA for the first 5 days or so. After 2 births and two pretty hefty tears all is well with my va-jay-jay. BTW, a 4th degree is very, very uncommon unless you have a vacuum delivery, forceps delivery, and/or episiotomy. DO NOT OPT FOR AN EPISIOTOMY EVER!

Honestly, I think vaginal delivery is a pretty damn awesome experience. I've done it without meds twice and it wasn't so bad. It feels good to know that your body can accomplish such an amazing thing. Nature made babies come out of vaginas for a reason, cesareans are best left as an emergency and life-saving tool.


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## snowmom5 (May 8, 2008)

Quote:


Originally Posted by *ChichosMama* 
That being said I would never have a baby in a hospital again. Its totally unnecessary, it saddens me that you think otherwise.
It seems to me you have not truly researched the possibilities. You need to read up. Mothering has great past articles where they actually cite sources. You need to research both sides without bias. This is so important.

I think it's going a little too far to say that birthing twins in a hospital is totally unnecessary. Without getting into a large debate (not my intention), at least consider the fact that half of all twins are born pre-term and thus it's possible that, in fact, it might turn out to be quite necessary in the OP's case.


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## wombatclay (Sep 4, 2005)

Ok... I did read the whole thread.







And I do hope that everyone stays gentle and on topic... there is a whole (very passionate) debate just waiting to pop out here and I don't think that's what the OP needs or wants!

~~~~~~~~~

OP- I would second the suggestion that you explore care provider options. Perhaps attend a local ICAN meeting (the mothers there tend to know which care providers/hospitals are all talk, and which ones will actually listen to you). The multiples, vbac, and birth trauma forums here at MDC might be good places to visit as well. However, I totally understand having been told something over and over and over and accepting that 9 months just isn't enough time to change. It's worth trying out different scenarios in your mind, just to see how they feel... be open to the options, but go with what you are truly at peace with! (and again, the forums I mentioned above might help in giving you the details to "flesh out" those different scenarios)

And for a slightly different perspective.







I've had both a c/s (with my first babe) and a 4th degree tear (with my vbac babe). Both were unpleasant and painful, but the recovery time from the 4th degree was a lot shorter and I felt less "disabled" during the recovery process. So barring medical need I'd personally avoid a certain c/s when the option is a possible tear. And yes, I realize that tearing is a fear and not a deal breaker!







But it's something I have experience with so I thought I'd chime in.

Also, research is just showing up to suggest that c/s doesn't actually protect the pelvic floor and might even increase your risk for pelvic organ prolapse. It's all in the "early days" of the research process, but prolapse rates in young women are soaring and the ever increasing c/s rate seems to be one of the few factors that could account for the increase. (which makes a certain sense if you consider the fact that in a c/s the bladder is moved, pretty forcefully, out of the way and as a result it may be more prone to "falling" in the future). In my case, I do have pelvic organ prolapse, and it's been attributed to the c/s, _not_ to the vaginal birth (even with the tearing). So while many OBs suggest automatic c/s for women with prolapse, I'm opting out of the surgery since that's what started the whole circus to beghin with!

Anyway, I just wanted to chime in with that tidbit... a c/s does mean you wont have a baby passing through the vagina, but it doesn't mean you wont have a significant "change" to the pelvic geography. If anything, a c/s is a bigger shift for your body to adapt to.


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## Talula Fairie (Jan 7, 2005)

Quote:


Originally Posted by *L.A.Mamma* 
Talula: "If it were me, I'd do everything in my power to get those babies out of my vaj, even going so far as traveling to a midwife who will do it naturally." I respect that. Unfortunately, I don't feel comfortable with having a midwife delivery vs. an OBGYN. I have too many doctors in the family that have shaped my way of thinking. Not to disrespect midwives -- it's a wonderful service they provide, unfortunately not for me.

I would research this yourself if I were you.

Here's some bullet points you might find interesting:

The US has the second worst infant mortality rate in the developed world. If you look only at the countries that had at least 400,000 births, it's ranked last.
http://www.cnn.com/2006/HEALTH/paren...mothers.index/
https://www.cia.gov/library/publicat.../2091rank.html

The US has one of the worst maternal mortality rates in the developed world.

In every other developed country (except Brazil, and they are the ones with the worst infant mortality rate in the developed world) including Great Britain, France, Germany, Spain, Holland, The Netherlands, Japan, ect...midwives attend 70 to 80 percent of all births, and the OB/GYN doctors are there to attend the smaller percentage that develop complications. This is the proven system, and the US _stands alone_.

Birth with a midwife (at a birth center or at home) is proven to be as safe if not safer than hospital birth. Midwives come to your house with pitocin, items for infant resuscitation, dopplers, other drugs for postpartum hemorrhage, oxygyn, ect. The myth is that everything has to go perfectly well and that a midwife isn't trained for complications, but actually, they are just as trained in birth if not more so than OB/GYNs (the exception to this would be surgical procedures of course, which is what OBs are specialized in. In fact, that's what they're best for). Most OB doctors have no idea what the Gaskin maneuver is, for example.

Midwives know all kinds of tricks like that for getting a baby out. Most OBs also have little training if any at all in vaginal breech birth, whereas midwives do. And if there is a point where a midwife realizes the woman needs intervention, they are trained to make the judgment call in time and transfer to a hospital.

This is YOUR baby. Not your family's baby. Most doctors don't have a high opinion of midwifery in general...but you know what? Most doctors are wrong. If they weren't? The US would have the #1 infant and maternal mortality rate in the world, since only 8% of US women deliver with a midwife (and of those, only .05% deliver at home). And we don't.

But don't take my word for it. Read some books on it! The Thinking Woman's Guide to A Better Birth is a good place to start, as well as any article about birth in Mothering or any of the Mothering books, and Ina May's Guide To Childbirth. You may also want to watch The Business Of Being Born and Pregnant in America. Check out some informative websites too, this forum is great as well as gentlebirth.org which lists many of the studies in relation to the safety of midwifery.

I would just like to add that whatever you want to do is your choice, and I totally respect either decision especially considering your situation. I just want you to make that choice based on accurate information, not what people are telling you. And like I was saying, don't just listen to me. Do some research yourself on it. And do look into different care providers, especially if you don't feel comfortable with your current one.


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## NaturalMindedMomma (Feb 5, 2007)

Quote:


Originally Posted by *snowmom5* 
I think it's going a little too far to say that birthing twins in a hospital is totally unnecessary. Without getting into a large debate (not my intention), at least consider the fact that half of all twins are born pre-term and thus it's possible that, in fact, it might turn out to be quite necessary in the OP's case.

Twins are notoriously preterm because moms are almost always induced. Your lucky to get to 36 weeks without some "problem" some are real, some are not.

A normal healthy twin birth in the hospital IS unnecessary. Most Homebirth midwives will not attend before 37-38 weeks at home.

To the OP- A brilliant Dr (no offense) would not blindly recommend a c section at this point in pregnancy. You have no current factors that would decide a C section is better. Birth was always attended by midwives until Dr's realized they were missing the monopoly on that part of the market (they claim they wanted to improve outcome which is funny because we have a high maternal/infant mortality rate, I think we are second?). You will most likely have a C section if you are attended in the hospital and will almost certainly have one if attended by your current OB. She is blatantly telling you a malpractice suit is more important than what research says is better







. She cares more about her bottom line than your gynecological and obstetrical health at the end of the day.

Midwives are amazing and if I were you I would take into consideration that someone who has something to lose and may have a huge bias may not be the best person to ask for advice, KWIM?


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *L.A.Mamma* 
Thanks ladies! Lots of invaluable information.

My instinct is that vaginal is better. But the first issue I have is that my OBGYN will not do a vaginal delivery if one baby is in breech (for reasons discussed above, i.e. malpractice). So the question is do I continue with this OBGYN? My gut is saying yes. Also, I only want to deliver at a specific hospital at LA, my thoughts are that it will be very difficult finding a OBGYN that would deliver a breeched baby. The idea of changing up my OBGYN/MFM team is daunting. I'll have to reflect on this.

Now I agree with everyone, 2 babies head down, w/o any other medical complications seems like a no brainer. I'm not denying being scared sh*tless, but my decision can't ever be motivated by fear. I agree, what's difficult at this point is trusting my body. After infertility, it's been tough having faith in my body. But I'm joining a women's circle here in LA and I think it will help.

I've got to do tons of research. My brother-in-law is a brilliant doctor and he really is advising for a C-section as well. It's hard to not put a lot of weight on his advice b/c I trust him. Still, it's my decision to make. I know my husband is on board with whatever I choose.

I'll do my research. And be prepared for whatever happens in this pregnancy.

This is my situation. I have had one epidural vag in the hospital, 1 "natural" hospital birth, and one homebirth turned hospital transfer that was still as natural as it can be in a hospital setting.

That all said I am OB/hospital birth all the way with these twins. I know that the doc will not deliver a breech baby even if A is head down. It'd be great if he would but honestly sometimes OBs with a higher risk of a section are better than the alternative. Disagree all you want mamas, frankly you aren't in my shoes. I am coming from a traumatic birth stemming from a very abusive midwife. She is the only one within 2 hours in my area. Even if I did go nuts and decide to use her again she does not deliver twins (that one was a red flag when she told me during baby #3's pregnancy). I do not have the money, the emotional strength, or the want to go to another midwife 2 hours + away. Twins sealed the deal for me as my grandmother had 3 sets and out of all 3 only 1 baby made it. I am scared to death of giving birth again and even more so to TWINS!!!

Now my gma's situation was something totally not likely nowadays (this was in the late 50's early 60's afterall) I realize. I also realize a c-section is no walk in the park. I also love midwives (just not the one I had uke) and under different circumstances would jump at the chance to use one. When we thought this pregnancy was a singleton we were planning a UC.

My point is that you have to find your own ideal. People (especially mothers) are full of opinions but they don't mean much when it is happening to you personally. I would most certainly do research on every option. Even if you don't want to UC it could be something that just happens for you so look into it! Be prepared! Even mamas going in for the natural experience may end up with intervention so prepare for that too. Cover your bases. And then really look inward and you will know.

Besides all that c-sections are going to cause more physical damage and I and several people I know personally (not all female) like vaginas after birth more so then before









ETA- don't force yourself into any birth environment! Midwives are great but only if you are comfortable and calm with them. If a homebirth is a source of stress for you it's not a good idea.


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *snowmom5* 
I think it's going a little too far to say that birthing twins in a hospital is totally unnecessary. Without getting into a large debate (not my intention), at least consider the fact that half of all twins are born pre-term and thus it's possible that, in fact, it might turn out to be quite necessary in the OP's case.

That is true. I know in my case I have small babies so there is some concern over getting these 2 to grow grow grow. I also have only carried 1 of my 3 babies to 40 weeks.


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## Talula Fairie (Jan 7, 2005)

I don't think anyone here is faulting or would fault you for your choices, magstphil.

All we were saying is that the "midwives are not as good as doctors period" message is inaccurate.

Also, who said birthing twins in the hospital is "totally unnecessary" ? I don't think that's true. That's an awfully sweeping generalization, too.


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *Talula Fairie* 
I don't think anyone here is faulting or would fault you for your choices, magstphil.

All we were saying is that the "midwives are not as good as doctors period" message is inaccurate.

Also, who said birthing twins in the hospital is "totally unnecessary" ? I don't think that's true. That's an awfully sweeping generalization, too.

I'm not disagreeing.

But there are plenty here and in the Natural Birth community as a whole who would and have faulted me. That's just it, for some people even a NATURAL birth in a hospital setting isn't good enough and for others it's the only thing they are comfortable wit h (and that's just to name 2 options). All I'm saying is to each their own and look into every option just in case.


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## FernG (Feb 14, 2008)

I would consider interviewing some other OBs. I don't know which hospital you are wanting to deliver at, but I know that some OBs at Good Sam will deliver vaginally when Baby B is breach.


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## Talula Fairie (Jan 7, 2005)

I'd be pretty surprised to see that on MDC specifically, and if you did, the mods are pretty good at taking care of stuff like that.

I don't think it's the natural birth community that's like that, I think it's the INTERNET that is like that. People are mean on the internetz!

I agree, look into every option. That's what I was suggesting. I only wish I had looked into -and could have afforded- other options when pregnant with my first and second baby.


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## ChichosMama (Aug 20, 2004)

Quote:


Originally Posted by *snowmom5* 
I think it's going a little too far to say that birthing twins in a hospital is totally unnecessary. Without getting into a large debate (not my intention), at least consider the fact that half of all twins are born pre-term and thus it's possible that, in fact, it might turn out to be quite necessary in the OP's case.


I didn't say twins. Must I really point out that this is for the majority women? Really? Okay.

Unless you/baby has a serious medical condition(you and/or baby will CERTAINLY die if you don't have c/s), birthing in a hospital is totally unnecessary.


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *ChichosMama* 
I didn't say twins. Must I really point out that this is for the majority women? Really? Okay.

Unless you/baby has a serious medical condition(you and/or baby will CERTAINLY die if you don't have c/s), birthing in a hospital is totally unnecessary.

Well in that case birthing with a midwife is also totally unnecessary.

Unless of course mama is more comfortable with either option which is helpful in creating a safe birth as much as anything.


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *Talula Fairie* 
I'd be pretty surprised to see that on MDC specifically, and if you did, the mods are pretty good at taking care of stuff like that.

I don't think it's the natural birth community that's like that, I think it's the INTERNET that is like that. People are mean on the internetz!

I agree, look into every option. That's what I was suggesting. I only wish I had looked into -and could have afforded- other options when pregnant with my first and second baby.

I agree about the internet but no I have NB friends IRL who aren't too happy that I am not fighting tooth and nail/driving the hours to another MW to escape a c-section. I understand that they are looking out for my well being so it doesn't really bother me. I just wish people would understand things are not usually black and white.


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## rhiandmoi (Apr 28, 2006)

My SIL delivered her twins vaginally, but they had to use vacuum extraction for TwinB, because he did not engage well and SIL was fairly exhausted at that point. TwinA is usually not the problem, unless that one is breech, it's TwinB that has a lot of the risk.


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## ChichosMama (Aug 20, 2004)

Quote:


Originally Posted by *magstphil* 
Well in that case birthing with a midwife is also totally unnecessary.

Unless of course mama is more comfortable with either option which is helpful in creating a safe birth as much as anything.

What? My pregnant brain is not letting me understand what you are saying.

People do what they want, this doesn't mean it's necessary. Like, "I'm going to call a cab to drive me around, even though I have a car, bc I dont know this area very well." It's not necessary, but this is what the person _wants_ to do.


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *ChichosMama* 
What? My pregnant brain is not letting me understand what you are saying.

People do what they want, this doesn't mean it's necessary. Like, "I'm going to call a cab to drive me around, even though I have a car, bc I dont know this area very well." It's not necessary, but this is what the person _wants_ to do.










In birth mama needs to be as comfortable as possible. A frazzled mama can equal a difficult birth and turn it dangerous. If mama is scared out of her mind to be out of a hospital then it's not a good idea to be out of one. If she walks into a homebirth scared and unprepared and freaking out it won't be beneficial to the process.

So in that case a hospital setting is necessary to that mama beyond the situations you named. Mama's well-being/peace of mind should be a necessity.

Hope that made more sense.


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## snowmom5 (May 8, 2008)

Quote:


Originally Posted by *NaturalMindedMomma* 
Twins are notoriously preterm because moms are almost always induced. Your lucky to get to 36 weeks without some "problem" some are real, some are not.

I don't know of any twin moms who were induced, so if you have a statistic on that I'd be interested to see it. Multiples tend to be born preterm because of preterm labor, which is by far the most prevalent complication of multiple pregnancy. See e.g. Barbara Luke, "When You're Expecting Twins, Triplets or Quads" (1999), (ch. 5).

For every twin mom who had a blessedly uneventful pregnancy to term, there is another one who did not. I did not. I did vbac them, at the hospital, after going into spontaneous labor due to a gross rupture of membranes (as in, they could see hair) at 33w. Oddly enough, of the twin moms I know, they seem to be about evenly split between those who delivered at 37 weeks and those who delivered prior to 34 weeks like me (some well prior).

Some docs do tend to be a bit quicker to section twins, that much is true - about half are delivered by section, I think. But I don't know of any docs who would deliver early over problems that were not real. The nicu experience isn't remotely worth it.


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## Talula Fairie (Jan 7, 2005)

Quote:


Originally Posted by *magstphil* 
Well in that case birthing with a midwife is also totally unnecessary.

Unless of course mama is more comfortable with either option which is helpful in creating a safe birth as much as anything.

I think what she meant is that the hospital has all kinds of monitors, machines, nurses, ect...and you don't need all that for a normal, singleton, low risk birth. I do think you need a midwife there, however, because birth doesn't always go perfectly and you do need someone there just in case. I don't think saying a hospital is overkill means _all_ birth professionals are always overkill. I know some women choose to UC, and to each their own. I think if you're well researched and prepared, that's fine. I personally wouldn't feel comfortable with it, but more power to women that do. And I can't speak for anyone else, but I've yet to see even a UCer say midwifes are totally unnecessary.

I agree that it's important for a woman to feel safe. Being afraid increases pain, not to mention decreases enjoyment.


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## snowmom5 (May 8, 2008)

Quote:


Originally Posted by *ChichosMama* 
I didn't say twins. Must I really point out that this is for the majority women? Really? Okay.

I did not mean to misinterpret you. The OP is about a twin delivery. Thanks for the clarification.


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## ChichosMama (Aug 20, 2004)

Quote:


Originally Posted by *snowmom5* 
I did not mean to misinterpret you. I apologize for having gone on a tanget about twins.

Its okay. Im pregnant and bleeding so im a double btch. sokay. <3


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *Talula Fairie* 
I think what she meant is that the hospital has all kinds of monitors, machines, nurses, ect...and you don't need all that for a normal, singleton, low risk birth.

That's different then saying a hospital birth is unnecessary- to say the latter is a leap and a generalization.

Quote:

I do think you need a midwife there, however, because birth doesn't always go perfectly and you do need someone there just in case. I don't think saying a hospital is overkill means _all_ birth professionals are always overkill. I know some women choose to UC, and to each their own. I think if you're well researched and prepared, that's fine. I personally wouldn't feel comfortable with it, but more power to women that do. And I can't speak for anyone else, but I've yet to see even a UCer say midwifes are totally unnecessary.
What the PP said was hospitals=unnecessary in "normal" births because there is no need for intervention. Following that same line of thought why would a MW be needed? If all is well why do you need a birth professional at all? I know a lot of mamas don't feel you do- hence UCing. I know that's why I was going to UC. The only reason most women do need a birth professional present is for peace of mind which I believe is very much a necessity. So again going back to the original statement of hospitals being unnecessary in normal births- it's too broad a statement. A hospital birth may be unnecessary for Mama X but for Mama Y who has the same exact "perfect" pregnancy it may be necessary to put her at ease.

Your line of thought that a MW is necessary in case of an emergency is the same one used by those opting for a hospital. Again this is all just going back to "to each their own".

And we are going OT here! Sorry! Just had to address that. It's just really important to me that women are supported and put at ease during birth no matter their choice and that we acknowlegde that a particular choice is not going to provide that for all women everywhere. Mama's feeling are just as important in all of this to make the birth safe.


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## Talula Fairie (Jan 7, 2005)

I think the term necessary refers to physical need in that particular post.

As for putting your mind at ease...I do think every woman's mind should be at ease during her birth. But the fact is that scary things can and do happen at the hospital. I think every woman should be informed of those things before she makes her choice.


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## ChichosMama (Aug 20, 2004)

Quote:


Originally Posted by *magstphil* 
That's different then saying a hospital birth is unnecessary- to say the latter is a leap and a generalization.

What the PP said was hospitals=unnecessary in "normal" births because there is no need for intervention. Following that same line of thought why would a MW be needed? If all is well why do you need a birth professional at all? I know a lot of mamas don't feel you do- hence UCing. I know that's why I was going to UC. The only reason most women do need a birth professional present is for peace of mind which I believe is very much a necessity. So again going back to the original statement of hospitals being unnecessary in normal births- it's too broad a statement. A hospital birth may be unnecessary for Mama X but for Mama Y who has the same exact "perfect" pregnancy it may be necessary to put her at ease.

Your line of thought that a MW is necessary in case of an emergency is the same one used by those opting for a hospital. Again this is all just going back to "to each their own".

And we are going OT here! Sorry! Just had to address that. It's just really important to me that women are supported and put at ease during birth no matter their choice and that we acknowlegde that a particular choice is not going to provide that for all women everywhere. Mama's feeling are just as important in all of this to make the birth safe.

How is having a midwife intervention? Meh, never mind. You and I obviously have completely different views on this and MDC isn't the best place to have these types of conversations. OP is going to do what she wants, thats what most people do. Im not here to talk down to anyone, nor not be "supportive," however, I stand by what I said. I can write a research paper on it after I have my child.


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *Talula Fairie* 
I think the term necessary refers to physical need in that particular post.

As for putting your mind at ease...I do think every woman's mind should be at ease during her birth. But the fact is that scary things can and do happen at the hospital. I think every woman should be informed of those things before she makes her choice.

I completely agree!

CM~ Some MW's are very invasive. But that's not what I was meaning. You said unnecessary because there is no need for that sort of thing in a "normal" birth and you are right on the physical level. But then why would you need a MW? You wouldn't and they would therefore be just as unnecessary. It really is that simple. MW, like hospitals, are often used just for peace of mind. If we are going off of purely the physical then they are both often times unnecessary.









Thing is birth isn't just a physical action. Not by a long shot.


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## User101 (Mar 3, 2002)

Mamas, I am going to move this to Birth and Beyond since it's more of a general birth discussion than a DDC-specific one. Be gentle with one another, please.


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## Talula Fairie (Jan 7, 2005)

Actually, even a normal low risk birth could need certain tricks when delivering a baby. Like unwrapping a wrapped umbilical cord, or doing the Gaskin maneuver for a stuck baby. Those are things that are harder to do by yourself. Just because you don't NEED the hospital doesn't mean you will never need anyone. It doesn't have to be a choice between UC or hospital.


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## homewithtwinsmama (Jan 5, 2005)

Quote:


Originally Posted by *L.A.Mamma* 
This is my first pregnancy, so labor seems quite daunting. I'm seeing a traditional OBGYN and an MFM. I'm a high risk pregnancy b/c of twins, 3 previous miscarriages, had to get knocked up through IVF and maybe my asthma.

I'll admit it, labor and delivery sound hella scary!! My doc has basically told me he'll only do a Vaginal if both are head down.

I'll tell you my thoughts:

Vaginal -- natural always seems better. I'm a pretty green type of girl. Recovery time is less. Though the idea of tearing down to my bummy is scary. I also worry something will go wrong so to speak.

C-Section -- This is selfish, but I like my vagina the way it is, lol. But on a more serioius note, I'm just afraid something will go wrong with a Vaginal. I got pregnant through IVF; fertility/pregnancy, have not been my friend thus far. It's been a struggle and I just don't want anything happening to my babies. I guess I'm afraid to press my luck, since this pregnancy is such a miracle.

I feel like if both babies are head down and there are no medical obstacles, I should go and do a Vaginal. My husband thinks I'm crazy. What do you all think?

If one is in breach, I'm really just darn scared and may opt for a C-section.

UGH, I just don't know!!!!!!!!!!!!!

POINT OF CLARIFICATION AFTER READING COMMENTS:
Ladies, point of clarification. The tearing is a fear -- it's not a deal breaker here. It would be immature imo to not have a vag birth simply b/c of the fear of tearing. Obviously our bodies change after child birth=)


I have had twins twice and attended many mamas of twins. A cesarean recovery is no joke. Now picture trying to take care of two babies and recover from major abdominal surgery. It makes breastfeeding more difficult and then there is the pain factor. I would far rather have pain with a purpose that has an end point (babies arrive).

Please take my word that you need to find a different OB. You are not high risk, you are special needs. In other words you need to be cared for more closely. But, if you carry to 36+ weeks you are probably going to have nothing to worry about at all. I would call a local Bradley teacher and ask for a recommendation for a midwife/doctor practice that do a good job with twins. (I teach Bradley and we are required to be knowledgeable about good practices in our areas) The midwife (if she is a true and good one) will take care of you not just physically, but guide the mental and emotional ups and downs of a pregnancy times two. The OB is there if you have complications, but if not the midwife can attend. Find a practice that understands that Baby B can be in any freaking position and come out. Once Baby A has made the way, a skilled midwife or OB can get Baby B out and they almost always come out fast. I had one client whose pushing with first baby was long and tough (because she could not feel effective pushing from the over strong epidural). She was ready to let them section the second one. I promised her the second would not only be easier but that she would ENJOY pushing her out. Immediately after Baby B flew out like butter--she agreed with me. I would also strongly recommend you take a Bradley class so you and your husband have a very complete and personalized childbirth class. Lastly, about your husband. I tell my folks no vagina no vote, frankly, but is he prepared to take care of all the cooking, cleaning and diapering and pacing with crying babies for not just days but weeks after this birth or wealthy enough to hire that out? Because surgical recovery means a 3-6 week rest and take it easy period for you. A natural birth is usually 1 week of total rest and recovery (maybe getting up and going downstairs once or twice a day briefly) and a second week of slowly getting more active and independent.

Re tearing: a good midwife will be good at protecting your perineum with hot compresses and a neutral or homeopathic oil, there are things you can do prenatally to have a more prepared perineal area, twins are generally smaller at birth even at term so less likely to tear at all. I have passed 6 babies through and have tightened up just fine with lots of Kegel exercises. There are also physical therapists who specialize in restoring the pelvic floor. In France all women get this therapy through their healthcare system. Here you would need a referral from a midwife/OB.

Feel free to PM me if you like.


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *Talula Fairie* 
Actually, even a normal low risk birth could need certain tricks when delivering a baby. Like unwrapping a wrapped umbilical cord, or doing the Gaskin maneuver for a stuck baby. Those are things that are harder to do by yourself. Just because you don't NEED the hospital doesn't mean you will never need anyone. It doesn't have to be a choice between UC or hospital.

Again, I agree. But you do realize you can do those things yourself? Just ask the UC mamas. Most things that go wrong aren't really that big of an emergency and can be remedied quickly without a birth professional present. So we're right back to it being about peace of mind.


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## Talula Fairie (Jan 7, 2005)

Quote:


Originally Posted by *magstphil* 
Again, I agree. But you do realize you can do those things yourself? Just ask the UC mamas. Most things that go wrong aren't really that big of an emergency and can be remedied quickly without a birth professional present. So we're right back to it being about peace of mind.

I don't think it's just about peace of mind. I just don't. Not saying UC is horribly dangerous or anything like that, I just do not think it is that simple.

I also did not say you can't do those things by yourself, I said they are *harder* meaning that I do realize it is possible to do those things yourself.


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## pixiekisses (Oct 14, 2008)

Quote:


Originally Posted by *Talula Fairie* 
I would research this yourself if I were you.

Here's some bullet points you might find interesting:

The US has the second worst infant mortality rate in the developed world. If you look only at the countries that had at least 400,000 births, it's ranked last.
http://www.cnn.com/2006/HEALTH/paren...mothers.index/
https://www.cia.gov/library/publicat.../2091rank.html

The US has one of the worst maternal mortality rates in the developed world.

In every other developed country (except Brazil, and they are the ones with the worst infant mortality rate in the developed world) including Great Britain, France, Germany, Spain, Holland, The Netherlands, Japan, ect...midwives attend 70 to 80 percent of all births, and the OB/GYN doctors are there to attend the smaller percentage that develop complications. This is the proven system, and the US _stands alone_.

Birth with a midwife (at a birth center or at home) is proven to be as safe if not safer than hospital birth. Midwives come to your house with pitocin, items for infant resuscitation, dopplers, other drugs for postpartum hemorrhage, oxygyn, ect. The myth is that everything has to go perfectly well and that a midwife isn't trained for complications, but actually, they are just as trained in birth if not more so than OB/GYNs (the exception to this would be surgical procedures of course, which is what OBs are specialized in. In fact, that's what they're best for). Most OB doctors have no idea what the Gaskin maneuver is, for example.

Midwives know all kinds of tricks like that for getting a baby out. Most OBs also have little training if any at all in vaginal breech birth, whereas midwives do. And if there is a point where a midwife realizes the woman needs intervention, they are trained to make the judgment call in time and transfer to a hospital.

This is YOUR baby. Not your family's baby. Most doctors don't have a high opinion of midwifery in general...but you know what? Most doctors are wrong. If they weren't? The US would have the #1 infant and maternal mortality rate in the world, since only 8% of US women deliver with a midwife (and of those, only .05% deliver at home). And we don't.

But don't take my word for it. Read some books on it! The Thinking Woman's Guide to A Better Birth is a good place to start, as well as any article about birth in Mothering or any of the Mothering books, and Ina May's Guide To Childbirth. You may also want to watch The Business Of Being Born and Pregnant in America. Check out some informative websites too, this forum is great as well as gentlebirth.org which lists many of the studies in relation to the safety of midwifery.

I would just like to add that whatever you want to do is your choice, and I totally respect either decision especially considering your situation. I just want you to make that choice based on accurate information, not what people are telling you. And like I was saying, don't just listen to me. Do some research yourself on it. And do look into different care providers, especially if you don't feel comfortable with your current one.

Yes, indeed, what she said.
I live in a country where the perinatal mortality rate is less than half of what it is in the USA, and the standard here is that you have a midwife with you for the birth, just a midwife. The doc./obgyn. is only called if there are complications or a situation where the midwife needs assistance, but they are rare, usually it's just a midwife and that's fine.
Here, only 4,4 infants in 1000 die (perinatal), and _less_ than 2 in 1000 die during birth (when it's not a premature birth), so it's mostly sick infants who die. And that's actually so low that they don't expect it to ever get lower.


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## Storm Bride (Mar 2, 2005)

First, a random observation. I'm pregnant (term) for the fifth time. I've also had three miscarriages. All of my children have been singletons, and all have arrived via c-section. My SIL has four kids, including a set of twins. Her children were all born vaginally. My sister has four kids, including a set of twins. Three of them were born vaginally, with her second twin being a c-section. (FWIW, after three labours, one of them very long, and one c-section, my sister told me that she "wouldn't wish a c-section on my worst enemy". Make of that what you will.)

Quote:


Originally Posted by *L.A.Mamma* 
This is my first pregnancy, so labor seems quite daunting. I'm seeing a traditional OBGYN and an MFM. I'm a high risk pregnancy b/c of twins, 3 previous miscarriages, had to get knocked up through IVF and maybe my asthma.

Do your miscarriages classify you as high risk? I've also had three, and nobody ever mentioned it as a risk factor. That seems kind of odd. My ex-SIL also had asthma, and nobody ever mentioned that.

Quote:

I'll admit it, labor and delivery sound hella scary!! My doc has basically told me he'll only do a Vaginal if both are head down.
Personal peeve...your doctor won't "do a Vaginal" under any circumstances. You say "he", so I'm assuming it's a male. He doesn't have a vagina, so if your babies are a vaginal birth, _you_ are the one doing it. The way doctors claim the credit for birth drives me nuts.

Quote:

Vaginal -- natural always seems better. I'm a pretty green type of girl. Recovery time is less. Though the idea of tearing down to my bummy is scary. I also worry something will go wrong so to speak.

C-Section -- This is selfish, but I like my vagina the way it is, lol. But on a more serioius note, I'm just afraid something will go wrong with a Vaginal. I got pregnant through IVF; fertility/pregnancy, have not been my friend thus far. It's been a struggle and I just don't want anything happening to my babies. I guess I'm afraid to press my luck, since this pregnancy is such a miracle.
I have various comments about this.

1) A c-section, despite the spin from doctors, isn't actually a guarantee that nothing will happen to your babies. If nothing else, they're at higher risk for breathing problems and an NICU stay with a scheduled cesarean. In addition, if you decide to have more children (no idea how you feel about that), they - and you - are at even higher risk because of having had the surgery. Surgery's not a guarantee.

2) My vagina is just the way it always was, according to cultural myth, since I've never pushed a baby out. However, I've lost a lot of tone in my pelvic floor, due largely to multiple pregnancies, so it's not as simple as that. In addition, I find kegels _extremely_ difficult since I have permanent pelvic nerve damage from my third c-section. It affects my ability to isolate my pelvic floor muscle (can't remember the actual name atm) _and_ I had no clitoral sensation for six months.

3) Things can go wrong with a c-section, too. As I said in point 1 - there are no guarantees. I don't know how much research you've done, but the risks to _you_, while small, are greater with a section than with a natural birth.

Quote:

I feel like if both babies are head down and there are no medical obstacles, I should go and do a Vaginal. My husband thinks I'm crazy. What do you all think?
After four c-sections, I think anybody who opts for a scheduled section without a solid reason is crazy. That's just me. I realize we all have psychological factors, but it's not something I can wrap my brain around no matter how hard I try. Why does your husband think you're crazy? Does he think your belly was designed to pull a baby out of, and your vagina isn't?

My, admittedly biased, opinion is that a c-section is something that should be done when _necessary_, not when a doctor deems it prudent.

I might also add that I had a very long, hard labour with my last baby, who ended up stillborn by c-section. (Reproduction hasn't been kind to me, either.) I'd trade that whole labour for 15 minutes of c-section recovery. Natural childbirth at least has the advantage that, as long as things go well, most of the pain comes _before_ you have a baby to look after. The fact that sections are done so often for twins boggles me - the mom now has surgery to recover from, and _two_ babies to look after.

Anyway, that's just my take. I'm scheduling a repeat c-section in June. I'm doing so because dh and I agreed before ttc again (he doesn't want to go through what he went through with Aaron ever again), because I don't want social services or the police in my face or my family again. I still wish I could run away and give birth under a tree.


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## Storm Bride (Mar 2, 2005)

Okay - I've read further in the thread, and come across some of the "doctors vs. midwives" discussion. So, I'll throw in my further two bits:

I had a GP for prenatal care with ds2. When I went into the hospital, the OB on-call did a c-section, after I said "no". Not impressed - traumatized, in fact.

I had a GP for primary care, and an OB consult twice, when pregnant with dd. I was going to have a VBAC...until she turned up breech at 39 weeks, and I was told it was "impossible" for her to turn, and bullied into a repeat. Horrible, horrible experience - the incision pain lasted 7-8 _months_, and dd had breathing problems. (She's also the only one of my babies who was jaundiced - no idea if that has anything to do with being the only baby I didn't labour with or not.)

I fought for a VBA2C in the system with ds2. I had concurrent "care" from my GP and the OB I'd seen with dd. I was coerced into another section at 41w, 5d by the OB, who threatened to drop me from care. Looking back, I really wish I'd taken him up on his generous offer.

I went through hell with all of these. None of those doctors has ever followed up, asked how I am, or anything else. They were soooo concerned about "my" health that they pushed me into unwanted surgery - but not concerned enough to find out how I was afterwards.

I attempted a HBA3C with a "lay" midwife. Things went very bad. She did recommend a transfer, and I finally went (didn't go quickly enough, because my experiences have made me too afraid of the way I'll be treated in a hospital). The hospital staff didn't think there was anything major wrong, until the emergency section was called for my dead son. (He wasn't dead when we transferred - we heard his heart stop on the monitor, and that's when the section was called.)

So...six months later, my midwife came to my house with flowers for me to plant, in honour of my son (and a couple cupcakes for my kids, because she remembered that the six month anniversary of my son's death was also dd's 5th birthday). She's checked back in with me a few times since.

I've caved and I'm having another section. I have a new OB, and for an OB, she's awesome. I still came home in tears after I went back into the medical system. Aside from women who end up dealing with abusive midwives (I know they do exist), I cannot fathom why any woman who had received midwifery care would voluntarily go back to the medical model. I'm finding the "care" I'm receiving absolutely depressing, and I hate being back on the assembly line.

I pray that dd never, ever sees an OB.


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## Talula Fairie (Jan 7, 2005)

Lisa, your story is heartwrenching. Just wanted to say I appreciate your willingness to share and give you a big


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## holyhelianthus (Jul 15, 2006)

Lisa~
















Quote:

I cannot fathom why any woman who had received midwifery care would voluntarily go back to the medical model.
For me it is a lack of choice but if I had to choose between going back to the MW I had and going to my current OB I would leap into the arms of my OB. He is far more gentle and caring then the MW who wouldn't allow me to labor out of the pool, forced me to do things I didn't want to do, stuck needles in me with little and no warning (while in labor and at prenatal visits), and then decided to call me hours after birth to tell me I am a failure and that I wanted to fail and that she had never seen a woman so intent on not having a baby as me.







Not all OBs and not all MWs are created equal.

ETA- I don't want to sound anti-MW because I am so not! I would love to be able to have the birth I envision (with a caring MW in my own home) and I mourn that loss. I am just trying to point out that MWs aren't alway the kind loving women people expect them to be. My OB, on the other hand, goes out of his way to talk with his patients and treat them like humans (a shock I know. I didn't trust OBs until I met him either).


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## Talula Fairie (Jan 7, 2005)

Maggie, I think your story is so sad







I'm so sorry that happened to you. If I were in your shoes and had to choose between that person and an OB, I would go with the OB too! I think most people would.

I had a negative experience with two different "midwives" (medwives is more like it) at the hospital. One of them randomly decided to break my water even though I was 1cm dilated...that was my first birth...my second birth, I had a midwife strip my membranes at the beginning of my induction to "get things going." She didn't even warn me first! I thought it was just a cervical check







:


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## Storm Bride (Mar 2, 2005)

Maggie: That's why I mentioned abusive midwives. IMO, stories like that prove that one doesn't always get midwifery care, even from a midwife, yk?

My current OB is pretty cool, especially as OBs go. She says things like, "what things can we do to make the experience (the next section) better for you? I know it won't be _good_, no matter what". I'm still sort of shocked that she was actually hearing what I said. She also looked _really_ PO'd when I told her I'd said "no" to my first section, and got cut, anyway...


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## MeepyCat (Oct 11, 2006)

L.A. Mamma, I am also having trouble figuring out what part of your history makes you high risk. Twins are riskier than singletons, but there are degrees to everything. Risk isn't just low or high. The miscarriages don't affect any of your risks in this pregnancy, strange as that may seem, nor does IVF. Having trouble getting pregnant and/or staying pregnant doesn't equate to trouble delivering. Asthma, I don't know as much about, but it doesn't seem like a huge thing.

My mom is a doctor, and I am also pretty comfy with the medical establishment. For that reason, I was fine with the highly medical experience I had with my first pregnancy, right up until labor, when it was suddenly not okay. Shaking up your OB team in mid-pregnancy is better, IMO, than wishing you had when you're in labor.

The OB practice I went to had some doctors (like the one I saw for prenatal visits) who were very comfortable with vaginal delivery, and some who didn't think anyone should have a baby vaginally ever. The problem was, I had no control over which of those doctors would actually attend my delivery. (I got lucky. And now that I'm pregnant again, I'm not going back there to take my chances.)

Also keep in mind: medical opinion is not some monolith. There are plenty of brilliant doctors who disagree with each other, practice in their different ways, and achieve equally good results.

I think it's a bit silly of your doctor to insist that he won't let you deliver vaginally unless both babies are head down, because the second baby does so often flip once the first one is out of the way.

Also remember, it's not like your choices are limited to obstetrical surgery or home birth. Most midwives work in hospitals, in conjunction with obstetricians. IF they judge that you need more help and more medicine, it's their job to get you to someone who can provide that.

One of the reasons I'm switching to a midwifery practice staffed by CNMs is the observation that most of the care I received during pregnancy and delivery was provided by nurses. Nurses weighed and measured and chatted and ran the doppler before the doctor came in, took a ceremonial poke at my belly and asked if I had any questions. Nurses held my hand and fetched me water, and listened to the monitors and made my husband eat lunch so he wouldn't pass out while I was in labor. Doctors stood by and had opinions about what I should do, but until I was in the pushing phase, they were only there for a few minutes at a time. I was in the pushing phase for five hours, and the only thing I remember about it was the crowd of goggled, gloved doctors standing by and waiting for something to happen. The nurses were clearly capable of handling the whole show, and I liked them a lot better.


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## skolbut (Feb 18, 2008)

Hey, OP I just wanted to weigh in with my 2 cents...

My first was a section.... recovery was awful. So sick I couldn't even hold my baby during inital bonding time (mil did it and he loves her sooo much!) Bonding, breastfeeding, everything was horrible. Clothes hurt to wear. I couldn't lift (anything including the baby), do stairs, I was a nasty person to my husband, felt like a failure, etc. and so on. Hurt lots, took a long time to heal. Even showering was a chore.

Fast forward to baby #2... textbook vbac... bonding wonderful, colostrum leaking all over my gown, got skin to skin time, called my girlfriends, got to walk and eat and shower and pee, went on a 1 mile walk with new baby, ds1, and my sister the DAY we got home from the hospital. Recovery was amazing.

I would not wish a section on anyone, it is major surgery, worse than any surgery I've had (appendectomy, breast reduction, laproscopy, wrist repair). It had lingering emotional and physical effect.

Now.... I've never had twins so this is a whole new ball game. There are other concerns for twins than singletons (although I would think a vaginal vertex/breech delivery would be straightforward enough for an OBGYN). However, IMO, if you have the opportunity to try for a vaginal delivery, I think you should go for it!!! Really, it is truly a miracle and nothing, nothing, nothing can describe that feeling of being able to birth your own babe.


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## AlexisT (May 6, 2007)

Just FYI, infant mortality is all deaths in the first year--it's not a measure of obstetric care. The US does very poorly because of bad access to primary healthcare. We actually do fairly well on perinatal mortality (deaths in the first 7 days)--something which comes at a big cost, and which could be achieved without that cost.

To the OP: I had a CS, though not for twins, and I would never do it again by choice. I would ask around for OBs. My understanding is that the usual requirement is that Baby A be vertex, but some OBs will do vertex-breech. With twins, you do need to be prepared for the strong possibility of CS in any case because positioning is more difficult, but I wouldn't rule out vaginal birth yet.


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## TwinsTwicePlusTwo (Dec 7, 2008)

I didn't read the whole thread, but have to chime in since we're talking about birthing twins.









I had both my sets of twins completely naturally. One of mine was breech too. It CAN be done. Not to mention all the risks involved with a c-section, both for you and the babies, and the longer recovery time.

Anyway, just thought I'd weigh in as someone who's BTDT--twice.


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## Gena 22 (Jul 3, 2008)

Quote:


Originally Posted by *rhiandmoi* 
My SIL delivered her twins vaginally, but they had to use vacuum extraction for TwinB, because he did not engage well and SIL was fairly exhausted at that point. TwinA is usually not the problem, unless that one is breech, it's TwinB that has a lot of the risk.

This is something I heard and went into my birth thinking too. It may or may not be true, but having been through a twin birth, I think difficulty with Baby B is more common when the twins share a sac. When they each have their own sac, Baby B can ride through birth of Baby A without a problem. It seems like just one birth after another in that case. And even if Baby B is breech, turning is a possibility after Baby A is born, either spontaneously or with help.

I wish the risks were broken down for the very different situations.


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## Gena 22 (Jul 3, 2008)

Quote:


Originally Posted by *snowmom5* 
I don't know of any twin moms who were induced, so if you have a statistic on that I'd be interested to see it. Multiples tend to be born preterm because of preterm labor, which is by far the most prevalent complication of multiple pregnancy. See e.g. Barbara Luke, "When You're Expecting Twins, Triplets or Quads" (1999), (ch. 5).

For every twin mom who had a blessedly uneventful pregnancy to term, there is another one who did not. I did not. I did vbac them, at the hospital, after going into spontaneous labor due to a gross rupture of membranes (as in, they could see hair) at 33w. Oddly enough, of the twin moms I know, they seem to be about evenly split between those who delivered at 37 weeks and those who delivered prior to 34 weeks like me (some well prior).

Some docs do tend to be a bit quicker to section twins, that much is true - about half are delivered by section, I think. But I don't know of any docs who would deliver early over problems that were not real. The nicu experience isn't remotely worth it.

Glad this is the case in your area. It's not in mine. Of the twin moms I know IRL, either they had preterm labor, scheduled c/s, or induction. Once you get to 38 weeks with twins in NoVA, you get induced or sectioned. It happens all the time. Many of my friends were induced, and I was really pressured. It's bad practice and results in preterm babies.

And I've read the 50% c/s rate for twins. I have no idea where that number comes from. It's MUCH higher here, around 80%.

No published stats for you, just my local experience.


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## NaturalMindedMomma (Feb 5, 2007)

Quote:


Originally Posted by *snowmom5* 
I don't know of any twin moms who were induced, so if you have a statistic on that I'd be interested to see it. Multiples tend to be born preterm because of preterm labor, which is by far the most prevalent complication of multiple pregnancy. See e.g. Barbara Luke, "When You're Expecting Twins, Triplets or Quads" (1999), (ch. 5).

For every twin mom who had a blessedly uneventful pregnancy to term, there is another one who did not. I did not. I did vbac them, at the hospital, after going into spontaneous labor due to a gross rupture of membranes (as in, they could see hair) at 33w. Oddly enough, of the twin moms I know, they seem to be about evenly split between those who delivered at 37 weeks and those who delivered prior to 34 weeks like me (some well prior).

Some docs do tend to be a bit quicker to section twins, that much is true - about half are delivered by section, I think. But I don't know of any docs who would deliver early over problems that were not real. The nicu experience isn't remotely worth it.


The nicu experience for whom? The Dr doesn't experience the Nicu, the child and parents do. Im not seeing that correlation? I do not want to sound like I hate Dr's, but I will tell you the major thing on their mind is the health and well being of their JOB. They have interest in a live baby and mom because their jobs depend on it. So it's better to have a live baby in the Nicu than to even *risk* an injury or death. They have been traumatized by malpractice suits and THAT is what shapes todays practices, fear, not facts.

Most moms around here that have twins are induced. I have seen at least 6 cases of MILD PIH and all of a sudden it's better to have that 34-35 out? No, not so much.

Most twin moms here ARE pressured to induce around 36-37 weeks if they make it that long. I am not completely sure why? Convenience?

All I know is that babies that cook until THEY are ready usually result in babies that are in good position for labor, hence lowering complications that may result in a C section.

I am by no means saying if there is a true emergency you should not act, but knowing what is really an emergency is important.


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## smeep (May 12, 2006)

I could be wrong and maybe someone can confirm this (if they haven't already) but isn't it common for one twin to be breech and then turn for their birth after the first has been born?

I would definitely look for a HCP experienced in twins and breech births...in AND out of a hospital. Most twin births are called "unsafe" for vaginal birth, not because mom can't do it, but because most HCPs have little or no experience because their training primarily, or solely, consists of cesareans for twin births. Don't let someone's ignorance-based inexperience determine what's safest for you and your babies.


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## mtlmommy (Sep 15, 2006)

I have not had twins, but I have had one c/s and one vaginal birth and you cannot even begin to compare the two. I had severe bonding issues with my son after his birth (c/s), trouble breastfeeding, pain for weeks, etc, etc. My daughter was born at 31 weeks due to a placental abruption (possibly caused by my previous c/s) and even though she was not able to breastfeed right away and we were seperated almost immediately after birth (had to go to the NICU) I had no bonding issues or troubles nursing (once she had a better sucking reflex around 34 weeks, before that she was getting my milk through a feeding tube). I was also worried about tearing, but I didn't (granted, she was small). Also, since twins usually come earlier, they will probably be smaller than singletons, and you may be less likely to tear (assuming there are no funky presentations, like hand up near the face).

IRL, I know of 4 twin mothers who all gave birth vaginally. 3 of these mothers had both babies head down, and one had baby A head down, baby B breech (OB turned baby B before it came out). Oddly enough, I don't know of any twin moms who had c-sections (and these are not crunchy people by any means).


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## Meg08 (Aug 13, 2008)

Just my 2 cents.

I haven't carried twins, so I can't comment on that. I have one child. Born via forced c-section because she was breech (that's a whole other story). I completely understand you wanting to be under the care of an OB instead of a midwife, even though I would never opt for that after my experience. The midwifery care I experienced was exceptional, even through the c-section. I also understand you wanting to be in a hospital environment for the birth of your children. I did for my first. I do not for my next. We are told things prior to experiencing child birth that we just can't believe or understand fully until we experience them for ourselves.

That said, I will never agree to another c-section unless it is blatently obvious that either my life or my child's life is in danger. Barring my not-so-good surgical experience because I was obviously not in agreement, the recovery just isn't worth it, and have been told by multiple health care providers that I healed extremely well and quickly. I felt completely helpless. The physical inability to properly take care of an infant because you've just had surgery is heartbreaking - and you are having 2. The frustration and pain. You will NEED help. Lots of help. Your DH will be taking care of you and 2 babies for weeks. He will have to do everything. You will be extremely limited in what you can and should do. Is he prepared for that? He will have to change all the diapers, bring the babies to you for feedings, bring you food and drink, help you move around, help you get set up for breastfeeding, just to name a few. He has to be completely on board. It will be a lot of work for him, and you will need even more rest because you will also be recovering from surgery. I also had a hard time with breastfeeding because of thrush, likely the result of the antibiotics they give you for surgery. So, ignoring the dimished birth experience, the medication required for the c-section, the risks involved with a c-s (for mom & baby), and the problems a c-s leads to with subsequent births, I would try to avoid one based on recovery alone.

I would suggest you look for another OB that is more skilled in or comfortable with multiples delivery, or at least comfortable with flipping the second twin. If they aren't, it could become more risky.

I would highly recommend looking into the benefits of going into labour, even if you choose a c-section. I did that with mine, and will never regret it.

If I were you, I would not give up on the chance at a vaginal delivery. Good luck with your decision, and your pregnancy.


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## snowmom5 (May 8, 2008)

Quote:


Originally Posted by *NaturalMindedMomma* 
The nicu experience for whom? The Dr doesn't experience the Nicu, the child and parents do. Im not seeing that correlation? I do not want to sound like I hate Dr's, but I will tell you the major thing on their mind is the health and well being of their JOB. They have interest in a live baby and mom because their jobs depend on it. So it's better to have a live baby in the Nicu than to even *risk* an injury or death. They have been traumatized by malpractice suits and THAT is what shapes todays practices, fear, not facts.

Most moms around here that have twins are induced. I have seen at least 6 cases of MILD PIH and all of a sudden it's better to have that 34-35 out? No, not so much.

Most twin moms here ARE pressured to induce around 36-37 weeks if they make it that long. I am not completely sure why? Convenience?

All I know is that babies that cook until THEY are ready usually result in babies that are in good position for labor, hence lowering complications that may result in a C section.

I am by no means saying if there is a true emergency you should not act, but knowing what is really an emergency is important.

Here's a little study that discusses the different causes of preterm delivery for twins (I didn't do any kind of big search, it was just in the bibliograpy of the book I cited earlier. So I don't know what else is out there). I'll try to underline the relevant portions. http://www.ncbi.nlm.nih.gov/pubmed/7898832

Quote:


Originally Posted by
METHODS: The March of Dimes Multicenter Prematurity and Prevention Study included a total of 33,873 women who delivered between 1982-1986, 432 (1.3%) of which delivered twins. Women were classified by reason for preterm birth and ethnicity. RESULTS: Of the deliveries in the data set, 54% of twins were preterm compared with 9.6% among singletons. Of those born preterm, twins were born at a significantly earlier gestational age than were singletons. Only 2.6% of all neonates born were twins, but they represented 12.2% of all preterm infants, 15.4% of all neonatal deaths, and 9.5% of all fetal deaths. Spontaneous labor accounted for 54% of twin births, premature rupture of membranes accounted for 22%, and indicated deliveries accounted for 23%. Of the indicated preterm births in twins, 44% were due to maternal hypertension, 33% to fetal distress or fetal growth restriction, 9% to placental abruption, and 7% to fetal death.

Unfortunately I have only seen the abstract; it would be interesting to see the data, charted by gestational age and so forth.

I realize this isn't going to change anyone's mind, and so we'll have to agree to disagree, but I think a lot of people would be surprised at the amount of effort that goes into avoiding prematurity.


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## Talula Fairie (Jan 7, 2005)

Quote:


Originally Posted by *AlexisT* 
Just FYI, infant mortality is all deaths in the first year--it's not a measure of obstetric care. The US does very poorly because of bad access to primary healthcare. We actually do fairly well on perinatal mortality (deaths in the first 7 days)--something which comes at a big cost, and which could be achieved without that cost.

I don't think that's true. If you look at the list, there are *several* countries with notoriously bad health care that are actually ranked ABOVE us in terms of infant mortality.

Also the US has one of the worst maternal mortality death rates as well.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *AlexisT* 
Just FYI, infant mortality is all deaths in the first year--it's not a measure of obstetric care.

How do we know? Babies born by c/s have higher rates of respiratory distress, so how do we know that there are other serious consequences of c/s _to the baby_ that haven't been identified?

The history of obstetrics (like many other endeavours) is heavily laced with practices that were considered benign, and that later research proved were not benign - or even safe, in many cases. There is no reason whatsoever to believe that we've identified all the repercussions of c/s - for moms or babies.

The woman I knew who had her twins vaginally _and_ c/s had a rough time. Twin B dropped into a bad position and someone said the arm was blue. All hell broke loose, and the mom was put under for an emergency c/s. Because of the problems they "knew" the baby was going to have, due to the - entirely unproven - oxygen deprivation, the baby was transferred to a different hospital for the first week, so that she could be monitored. The mom, home with a toddler and the other newborn and a fresh surgical incision couldn't get there. She made it _once_, with the help of family (there were problems with the toddler melting down over mommy not being there, too). The baby was then transferred back to the original hospital for another...can't remember - 4 or 5 days, before being allowed to go home. That baby is almost 6. She's never had a hint of a health problem, is bright, active, etc. There was never _any_ evidence, in any of the monitoring going on, that she had any kind of brain damage, whatsoever. Nonetheless, she was separated from her mother and her twin, because the staff _thought_ she'd been off colour at birth.

I was lucky. DD's breathing problems (as in - she frequently _stopped_ breathing, for no apparent reason) didn't result in any such drastic actions. They were brushed off with "that's common for c/s babies". If stopping breathing is _common_ with c/s babies, I'd say it's fairly obvious that the surgery carries some odd consequences for the babies, yk?


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## wombatclay (Sep 4, 2005)

If anyone is interested, the book Cesarean Voices (and the associated website here) discuss some possible implications of c/s on the babe. I'm going to be very up front and say I think some of their conclusions are off the wall, but it's an interesting area of study (physical, emotional, psychological impact of cesarean surgery/birth) that hasn't gotten a lot of attention as yet.

I'm guessing that as the rate of c/s continues to rise there will be more research done, if for no other reason than these kiddos are going to be the cohorts in other research programs and there will be a need to "rule out" c/s as a factor in those studies.


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## Storm Bride (Mar 2, 2005)

Since wombatclay brought up psychological impact, I'll throw one other comment in here.

OP: I've been focusing on having had my babies by c-section in this thread. I was also a c-section baby. I've hated that fact my whole life. I hate that my mom's scar was how I got here (kind of off the wall, as the scar originally came from my brother, anyway). I hate that I was born like an alien pod person, by an OB, instead of by my mother, the way the whole of humanity was born until recently. (This isn't a result of my natural birth leanings - if anything, the converse is true. I value natural birth, because I wasn't born.) I couldn't begin to quantify the impact that my method of arrival on this earth had on me, psychologically - but it's real.

To be fair, I'll add that this seems to be a highly individual thing, and I've only ever talked to a very few other people who share it - but it's real, and there's no way of knowing who will be affected by it, and who won't.


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## AlexisT (May 6, 2007)

Quote:


Originally Posted by *Gena 22* 
This is something I heard and went into my birth thinking too. It may or may not be true, but having been through a twin birth, I think difficulty with Baby B is more common when the twins share a sac. When they each have their own sac, Baby B can ride through birth of Baby A without a problem. It seems like just one birth after another in that case. And even if Baby B is breech, turning is a possibility after Baby A is born, either spontaneously or with help.

I wish the risks were broken down for the very different situations.

If the twins share a sac (Mo-Mo) it's an EXTREMELY high risk pregnancy and (AIUI) the babies are born by c/s, usually early to prevent the babies from strangling each other. Thankfully, this is very rare.


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## holyhelianthus (Jul 15, 2006)

Quote:


Originally Posted by *AlexisT* 
If the twins share a sac (Mo-Mo) it's an EXTREMELY high risk pregnancy and (AIUI) the babies are born by c/s, usually early to prevent the babies from strangling each other. Thankfully, this is very rare.

This is what I was going to say. Momo twins are not as common as people think- I say this because people assume twins do share sacs or at least identical twins do. Not true. Most twins have separate sacs.


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## JesiLynne (Aug 25, 2004)

I haven't read all the responses but I just wanted to chime in.

My water broke at 34 weeks and baby A, ( the baby coming out first ) was breach. For me, there was risk of the twins locking chins and since my water had already broken the chances of baby turning was very small. Which is why I needed a c/s. It sucked, even knowing I was out of options wasn't enough to make me feel good. It is not just physical, but tonnnnnnnnssssssssss of emotions that comes along with it.
Postpartum with twins is rough as hell. I never want to go through it again.
Never ever choose a c/s if you don't need one.


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## JesiLynne (Aug 25, 2004)

One last thing, dealing with breeches is dependent upon the drs. training. Med schools aren't teaching how to deal with breech babies, and so if you have a dr. who doesn't know, you are going to end up with a c/s.


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## L.A.Mamma (May 1, 2008)

Thank you ladies for so much valuable input.

I've made up my mind in 2 ways:
1) I will deliver in a hospital
2) I will not change my OBGYN.

I hope all of you have wonderful births. I know all of us will choose what's best for our bodies. I know myself well enough to know that the above 2 items mentioned are best for me.

Happy Pregnancy Mammas=)


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## Storm Bride (Mar 2, 2005)

Everybody has to make their own decisions. I wish you a good recovery, if you do have a c-section.

All the best.


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## holyhelianthus (Jul 15, 2006)

Best wishes!!


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## Sudonk (Nov 29, 2005)

Quote:


Originally Posted by *L.A.Mamma* 
Thank you ladies for so much valuable input.

I've made up my mind in 2 ways:
1) I will deliver in a hospital
2) I will not change my OBGYN.

I hope all of you have wonderful births. I know all of us will choose what's best for our bodies. I know myself well enough to know that the above 2 items mentioned are best for me.

Happy Pregnancy Mammas=)

LA Mamma, I just wanted to give you a link to a very inspirational video that a friend of mine put together after her twin vaginal birth (and VBAC!)






I also wanted to let you know that there is an EXCELLENT CD set sold by Hypnobabies that helps women feel more confident about their twin pregnancies and births. It's an excellent way to help you overcome or at least minimize your fears, so you don't have unnecessary stress interfering with your pregnancy or happiness at what should be a really wonderful time in your life.

http://hypnobabies.com/store/shop.ph...&cid=4&start=0

If it turns out that you do need a c-section, there is also a great CD for preparing yourself for that as well. It even has handouts talking about ways to minimize trauma and risk for the babies if surgery becomes necessary. And of course, there is also the wonderful childbirth preparation home study program that could help you learn more about the process, and understand all the choices you have along the way, and how the risk/benefit ratio fits your situation. And it also gives excellent information on avoiding or minimizing tears.

Good luck with a very healthy, happy pregnancy, birth and life with your obviously much-loved twins!


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## Talula Fairie (Jan 7, 2005)

Good luck.


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## wombatclay (Sep 4, 2005)

A brief message from your friendly neighborhood Birth & Beyond moderator.









MDC is an online community devoted to the values of Natural Family Living. As such:

Quote:

MDC serves an online community of parents, families, and parent, child and family advocates considering, learning, practicing, and advocating attachment parenting and natural family living. Our discussions concern the real world of mothering and are first and foremost, for support, information, and community. Mothering invites you to read and participate in the discussions. In doing so we ask that you agree to respect and uphold the integrity of this community. Through your direct or indirect participation here you agree to make a personal effort to maintain a comfortable and respectful atmosphere for our guests and members.
Although we may not all agree with the choices made by all the people we meet here, we do need to respect their choices. If you have any concerns about individual members or the direction a thread is/has taken, please contact a moderator directly (via PM) so that we can take a look.

Thank you all for contributing to these discussions and for making MDC such a wonderful, and encouraging, community to be part of!

Ok... back to your regularly scheduled thread.


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