Twins! So you can schedule a C-Section!

When we first started trying to get pregnant, I optimistically scheduled a meeting with Diane West, a midwife, to talk about my desire for a homebirth. Husband was very, very apprehensive about the idea, but after talking extensively with Diane, became convinced that this was indeed the way he wanted to do things too.

Well, flash forward two years: We’ve been through several rounds of Clomid, one IUI, and a clinical study that gave us a free IVF cycle. And voilà! We’re pregnant! And holy crap, it’s twins!

Poof! There go my dreams of the perfect homebirth. In California, midwives are not licensed to attend twin homebirths, and birth centers are regulated by the same laws as homebirths. And while I certainly respect those who choose to birth unassisted, that path is not for me. So off to the hospital we go! I’m not happy about it, but there it is.

A fertility clinic is, by definition, a highly medicalized environment. So it probably shouldn’t have come as quite the shock it did when the first thing the (otherwise wonderful) doctor said to me after “You’re having twins!” was “So you can schedule a C-Section!” I can’t even tell you how far up her eyebrows went when I mentioned that I was still hoping for a natural, vaginal birth. Nor can I convey the skepticism in her voice as she insisted that I check to make sure my OB was on the clinic’s “approved” list, and encouraged me to keep an open mind regarding C-Section.

I have an open mind regarding C-Section. If I have an OB 1) who is supportive of my desire for a natural birth, 2) who has generally low c-section rates, and 3) for whom I have good references from midwives, doulas, and former patients who chose natural births, and that OB tells me that a C-Section is necessary for me and/or my babies, then I’m going to trust her or him and have the surgery. Frankly, even if I got stuck in a lousy situation without the above-described OB, and someone told me I had to have a C-Section, I’d probably have it, because I’d be too frightened not to.

But that coercive, bullying scenario is precisely what I intend to avoid through careful research, and by ensuring that the OB to whom I entrust my life and the lives of my babies has our best interest at heart – not just “hospital policy” or his or her malpractice insurance. Fortunately, I have a fantastic husband, a great midwife, and a wonderful friend who just happens to be a doula, all of whom will be there to support me through this adventure.

Yes, the most important thing is that the babies are healthy, but a C-Section is major surgery, and doesn’t automatically equal a healthy baby. Nor does it automatically equal a healthy mother. When it’s necessary, it’s necessary, and while of course I’m glad it’s an option available in those cases, the fact is that almost 30% of births in this country right now are C-Sections, and they’re not all necessary.

Reproductive freedom is not only about choosing whether to give birth: it’s also about choosing how to give birth. I support every woman’s right to make that decision for herself, and to be fully educated as she works through her decision-making process. This is my choice, and my opinion, and I reserve the right to change my mind at any time up to and including several years after the babies are born.

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23 Responses so far »

  1. 1

    Mom said,

    Well said. C-section rates are ridiculous, as well as highly variable around the country, often reflecting medical culture more than medical necessity.

  2. 2

    Allison said,

    Indeed, C sections are major surgery and there is a couple of weeks of recovery, but you’re not going to be running around 2 weeks after a natural birth with twins either. To be honest, it forces you to just sit and enjoy your baby(ies) and try to get breastfeeding if you are planning on doing that. I’m pretty sure that mine was medically necessary (10 lb baby,) but there is a woman in my moms/babies playgroup who scheduled her c section for 39 weeks, for no other reason than she wanted to have one. I was pretty shocked you could do this. To me that would kind of feel like ordering at the drive through. But to each her own, I suppose!

    Seems to me you’ve got a realistic POV on this in trying to keep an open mind about all forms of birth. It will make it easy to accept and make the right choice for your and the babies’ health in the heat of the moment if things don’t go as you wish and/or plan.

    Whatever you decide, it will be great. Just remember to enjoy these last months of sleep, quiet and peace. That’s my only advice!!

  3. 3

    nora said,

    Well put.

  4. 4

    Mykal said,

    If you’re interested http://indigogirl.typepad.com/ has twins and delievered them naturally, no eipidural even. If you look back through the archives you should be able to find the birth story if you’re interested.

  5. 5

    Peggydoula said,

    Go Uccelina Go! I know that you’ll do what’s best for you and your babies and that you’ll have the information and the support to know that you’re making the right decision when the time comes whether that means a vaginal birth or a cesarean! I can’t wait to meet the little twins! I love them already!!

    Also, isn’t it crazy that ANYONE would EVER say “Hooray! You can now schedule major surgery!” ?!?! I think that’s nuts!

    I’ll start digging through my doula resources and look for birth stories of twins just for your further edification. I’ve seen video of successful, unmedicated vaginal birth of twins so it is possible. Being pregnant with twins does not mandate a cesarean so just keep playing it by ear and surrounding yourself with birth professionals that you trust and respect. (by the way, I know you know these things, I’m just saying them anyway:) )

  6. 6

    SilliGirl said,

    With the utmost respect for individual situations, I just want to let
    folks know that I birthed a 10 1/2 pound baby at home with no medical
    interventions. I say this not to impress or compare myself to anyone
    else, but to let future birthers know that every woman is different
    and that having a large baby doesn’t automatically equal a c-section.

    Also, Uccellina, I know of a number of women who have had their twins vaginally (I don’t know about unmedicated or not) and this link: http://www.earthbirthproductions.com/ will get you to a site about a family that had their twins unassisted. They have the video I was telling you about. (Sorry about the link, I’m not so hot with the html.)

    Lastly, good luck finding an OB you feel good about!!! And I’m so glad you’ll have a doula to support you as well. I continue to be so excited and thrilled for you guys that I can hardly contain myself!

  7. 7

    SilliGirl said,

    ooh, the link worked anyway!

  8. 8

    uccellina said,

    Mykal, I just read that birth story! Thank you so much for directing me there.

    For everyone else, the link.

  9. 9

    miss kendra said,

    i support whatever you want to do, as long as it’s safe for all involved.

    unrelated, this is amusing.

  10. 10

    Celeste said,

    I think you need to do all you can to get the birth you want. I just think it’s really sad that so many women find themselves having to FIGHT for it. Birth is not supposed to be adversarial, you know? I definitely feel that some OBs feel that the needs of the mother and the baby are in conflict, and they think they’ll take the baby’s side. I think it’s demeaning to the mother to ever act is if she is somehow not invested in the baby’s well-being…but prenatal care by an OB often seems to impart this message, that somebody has to save the babies from the mothers. Birth is so broken in our country.

    I know a lot of things can really mean a c/s is a good thing. I truly believe it. I just highly resent the glossing over of risks. One risk? Cutting the baby. Most often it’s on the face or arm/hand. Talk about birth trauma. I was at a birthday party and one little girl saw me looking at her scarred wrist; she said, “I got that when I was borned.” If my baby got cut just getting born, then it would need to be because it was a medical emergency–and not just somebody’s choice for no medical reason. I only learned about the reality of babies getting cut once I was already a mom. It’s something to discuss with your doctor, because it does happen. I’d discuss it simply because I’d want to make sure the baby can have pain relief for the sutures. It sounds crazy to assume this, but boys don’t get anything for circumcision.

    I’m rambling now, but I definitely support you in going for a vag delivery. Have a talk with your doctor about what he means by “natural childbirth”. They so often mean “vaginal with tons of interventions” when they say “natural”.

  11. 11

    MonkeyGurrl said,

    Birthing isn’t fun, no matter which way you slice it. I *wished* they would give me a c-section (came *this* close) b/c I was SOOOOOO tired after 3+ hours of pushing, and the recovery took MONTHS.

    I just hope you don’t plan on birthin’ your babes at Cedars. At least 9 years ago, they had the HIGHEST rate of c-sections (necessary or otherwise).

    As long as you, the babes and the Husband are happy and healthy, whatever it takes to get you there, you have all our support and well wishes.

  12. 12

    Linda said,

    Hi,

    I saw you on my referrals page. Congratulations on your twins and on being educated about your birthing options. Yes, I had a very positive birth experience with mine. If there’re any questions I can answer for you, feel free to drop me an email. Good luck!

  13. 13

    pamela wynne said,

    Oh, well said! And excellent links — I forwarded to all my pregnant friends. 🙂

  14. 14

    Andree said,

    Speaking as a member of the “knock me out/hand me that baby when I wake up” school, you have to do what is right for you and the babies….NOT the doctor.

    Here is an interesting follow-up to the “Billy Graham” post. Slidell, Louisiana gave Jesus some company.

    http://blog.nola.com/times-picayune/2007/09/jesus_gets_company_on_slidell.html

  15. 15

    Emily said,

    Congratulations! So happy for you!

    Just wanted to share my thoughts since this discussion is really timely for me … my son Henry was born via c-section two weeks ago today …

    We hadn’t planned for a c-section … but, a couple days before my due date an ultrasound showed that my amniotic fluid level was really low … so we monitored the situation for about two days … and then on the second day (which happened to be my due date) our ultrasound showed that the fluid levels had decreased some more … so, we went straight to the hospital to be induced. After 12 hours of pitocin and contractions galore, I had not dilated at all (i.e., I was still less than 1 cm) … so, together with my doctor, nurse midwife and husband, we decided that a c-section would be safest given the low fluid levels …

    I was SO scared of the c-section … I am really squeamis and afraid of all things medical … so, I was sort of panic-stricken when we made the decision …

    But … my fears turned out to be unfounded … There was a mirror on the ceiling of the OR, and I watched as Henry was pulled out of me … it was amazing and beautiful … and my recovery has been no problem … After the meds in the epidural wore off (they last for about 12-16 hrs after surgery) I was offered narcotic painkillers, but I didn’t feel the need to take them (just took Motrin) … I was up and walking within 12 hours of the surgery … and I never had any problems with bending or lifting etc … Now, two weeks later, I am a little sore in the lower abdomen … but otherwise feeling fine … and so happy to have such a strong, healthy, beautiful son …

    Anyway … just wanted to share my experience … thought it might be reassuring for you to hear in case you wind up needing to have a c-section, too … 🙂

  16. 16

    Allison said,

    Just to clarify about big babies…of course, yes, some people can deliver big babies, but sometimes there are other factors that contribute to the requirement for c section. I got a fever and there was meconium so 3 hours of pushing was all I got. Evan just also happened to have a large head (and be 10 pounds,) which is why he wasn’t moving in the 3 hours I had. After 36 hours of labor a c section wasn’t really that bad. I just wanted my kid out of me already!!

    And I also have a friend who gave birth naturally to twins. The good news is that I believe twins tend to be a bit smaller.

  17. 17

    liz said,

    Do what you need to do to have a safe and respectful birth experience!

  18. 18

    Sarah said,

    Just some words of encouragement there was a woman in my bradley class two years ago when I was pregnant with my son and she was having twins and had a natural vaginal hospital birth. We are in seattle but the idea is still the same twins – c section, big baby c-section, small baby – c section.

    But good for you for researching as much as possible! That is the best thing that you can do is just inform yourself like a mad woman!

  19. 19

    DebbieS said,

    Well said!! Also, LOL on the little imaginary workmen around your belly~! I remember going for the 3-D ultrasound and seeing my daughter’s face for the first time..it was awesome, but also slightly squicky in an “Aliens”-type sense!

    I didn’t realize you were in CA! We should get together sometime before I move! I can tell you that Sicilian rhyme in person since I’m still trying to figure out how to spell in Sicilian to write it down (it looks something like Welsh!)

  20. 20

    Gina said,

    My pregnancy coincided with the unavailability of my regular ob-gyn, which left me in search of a new one at the most inopportune moment. I live in the SF Bay Area, so even 20 years ago there were quite a few female ob’s. I chose Dr. Lisa for my first interview because she had a midwife-nurse practitioner in her practice. When she was late for my first appointment because she was doing a vaginal delivery of twins, I had a feeling she was the right doctor for me. When she told me that she was a runner who supported my intentions to keep dancing throughout my pregnancy, we bonded instantly.

    Unfortunately, I ended up having a C-section due to complications (pre-eclampsia). However, I bounced right back after the surgery, and was up and feeling great after only a couple of days. I credit Dr. Lisa’s support of my exercising during pregnancy for my quick recovery.

    Good luck! Your choices will be the correct ones for you and the squidlets.

  21. 21

    […] for me, I am very sore, very emotional, and very tired. I didn’t manage to have my homebirth, or my vaginal birth, and my babies are maybe a little undercooked, but I am happier than I can ever express to have […]

  22. 22

    shelly said,

    I have had 3 c/s and all of my kids were extra large (2 over 9lbs and 1 almost 10) and I’m not ever 5 ft. tall. I have had no problems since all three births, I’ve nursed all of them (the last one almost 3 years, so no bonding problems there).
    I did labor for the first 2 and just never progressed (I know, I know I should have walked longer, used the birthing ball, squatted, stood on my head to make it happen) so for the 3rd we (my husband decided, as well) scheduled a c/s. That was much easier than laboring and still having a c/s. My doctors did not suggest a c/s for any of my kids (contrary to popular belief that they just want you to have a c/s) that’s just how it turned out. And after talking to many women who have chosen to be honest about the problems they’ve had after a vaginal delivery I’m glad that with the size of my kids I ended up with the c/s. After gaining 50 lbs per baby and not being totally thrilled with myself post babies I couldn’t imagine having sexual, bladder or bowel problems at the same time. One problem at a time, please. I know some women have problems after their c/s too but the story is that if you have a vaginal birth that everything just pops back into place. Like I said, those who choose to be honest will share that when you have a baby either way you are never the same physically as well as emotionally.

  23. 23

    Respect to op , some excellent selective information .


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