I have a consultation with a potential client on Monday. She's pregnant with twins, and as this would be my first "twins" client, I am open to any and all tips or perhaps a special focus I should take in this initial meeting. A Canadian focus would be great too, as protocols can differ between countries.
In my experience a lot of OBs tend to deem twin moms "high risk" and lead them to believe that they cannot stay pregnant for the full 40 weeks. So I'd let the mom know that just because there are 2 babies in there it does not mean she is in any kind of danger and it does not mean she will not give birth to full-term healthy babies. I don't know how twin births are where you are, but in my area OBs will only deliver twins in the O.R. and that can be scary for a mom who wants a natural birth.
Are there any drs in this world who will deliver twins vaginally?
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I have a friend who is having (or had) twins today. Induced at 38 weeks because "twins get to term early and you never know what could happen if you let them go to 40 weeks"
(insert eye roll here)
I've been praying all day that her cut happy doc doesn't decide that double vertex is too risky for twins to be born vaginally.... This doc has a 45% csec rate overall, so I was pretty shocked she agreed to "allow" my friend to "try" for a vaginal birth.
My boys birth story is in our birth experiences forum. I think it's entitled TJ and Jeffrey's birth. It is basically our story of the pg and birth. I would ask if she's been in contact with your local Mothers of Multiples club or any other "twins" club in your area. There are also some good books specifically for multiples-Having Twins by Elizabeth Noble, Mothering Multiples, sorry I can't think of the others off the top of my head.
One thing I recomend to all multiples is to contact an IBCLC before the baby's come. Even if they don't need help with breastfeeding because everything works out great it is nice to have met the person who will be helping them. Having a good pump on hand is important and PP help is paramount.
That's all I can think of right now. I'll probably remember a lot more tomorrow morning.
Good Luck!!!
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[SIGPIC][/SIGPIC]
Jill Spear, Professional Doula
Birth Doula & PP Doula
trained with Alace 00 & Dona 05, 06
trained with Cappa-Lactation Educator 06
filing legal seperation-the dude needs some help!
Kelsey 4/28/91
Charlie 6/15/93
Linzey 1/3/97
TJ & Jeffrey (twins) 1/14/99
He held you gently, whispering loving words of assurance,
"I will not forget thee, nor forsake thee. I will not fail thee..."
Then you were born.
I've had been to 3 twins births-all made it passed 38 weeks (one went past 40wks) and all went into labor spontaneously. Encourage your client to do her research and not be pressured into induction. Also many docs aren't comfortable with a vaginal birth unless both twins are head down-there is no way to know what position the baby will ultimately take until the first baby is born, so encourage her to ask about her doctor's policy on this and how he feels about breech births. Doc's can also try to insist on mom's getting epidurals "just in case" but your client can always argue that she will be a more effective pusher without one.
My one client gave birth to her twins without any interventions. Her doc wanted her to have an epidural, and deliver in the OR-she said "no". Her first was born weighing 7-14 and her second was born feet first (!) weighing 8-4. No tearing, no complications. It is possible. Encourage her to seek out POSITIVE twin birth stories.
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A friend of mine had twins vaginally (here in FL) and not only did she make it to almost 40 weeks and give birth to two 7.5 lbs babies, she also found and OB who was supportive of her delivering vaginally when the second twin was breech! I interviewed to be her Doula but then turned her over to a local HB MW because I didn't have enough twin experience and wanted her to be able to stay at home as long as possible with a skilled provider. We're still friends to this day.
I just supported a mom who was having twins and she was very assertive and strong so it was a great experience as a doula to learn what the boundaires of our local hospitals were. Basically the protocol for her was high risk so that meant she could not have a midwife (which are funded and regulated here), could not go past 38 weeks, she could labour in the birthing room but they wanted her to push in the OR, IV, epidrual - basically the works. Unfortunately her birth plan took a turn with developing preeclampsia and Baby A being breech - this meant an automatic cesarean for her on Friday That in itself is a long story that was so sad and traumatic for her.
Working on her birth plan with her though and helping her to adovcate for herself, I think what she probably would have been able to compromise on was - going full-term if she went that far, no IV but a helplock, no epidural (or maybe just the catheter) and if baby A was vertex and baby B was breech (or both vertex) she would have been 'allowed' to birth them vaginally.
It is unfortunate that moms of multiples get a high-risk label and the other unfortunate part is that there is not a lot of research out there to encourage evidence based medicine so Drs tend to be VERY conservative.
My suggestion is for her to hook up with a local multiples group, hire a doula , contact an LC (my client pumped colostrum starting at 30 weeks in case baby's were premature and baby's woudn't suckle or hospital protocols encouraged supplementing - this was one of the best decisions she made), and to do as much reading as possible on normal twin births. Postpartum is also something she should be planning for in advance.
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Shawna Lewkowitz, M.Ed., CD (DONA), CPD(CAPPA), LCCE
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very proud mama to 2 amazing little girls
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Quote:
That in itself is a long story that was so sad and traumatic for her. 
, contact an LC (my client pumped colostrum starting at 30 weeks in case baby's were premature and baby's woudn't suckle or hospital protocols encouraged supplementing - this was one of the best decisions she made), and to do as much reading as possible on normal twin births. Postpartum is also something she should be planning for in advance.
