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Thread: Provider drama

  1. #1
    Contributor Fireandiceshay's Avatar
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    Unhappy Provider drama

    GYAH!! Okay, so I found out I'm having twins last Wed at the END of my appt so I could barely talk to my dr about it and now I'm wishing I had had more time.

    I see a group of CNM's since I didn't like my "medical" natural birth with my oldest (don't threaten me with stuff I don't need when I'm doing just fine, thanks) while seeing an OB/GYN and as soon as I found out there were two of 'em I turned to MK (midwife) and asked if I could still see them. She said something like "yes, but you have to see the MFM dr's for backup". That made me think I could deliver with them.

    I can't. I had someone mention laws to me earlier and I did some research and called a good friend of mine and found out that in Utah the CNMs can't attend a twin birth, the second I go into labor they have to turn me over to the MFM group.

    I've REEEEEEEALLY wanted another natural birth with this pregnancy, but the more I look into it, the less likely it's looking. Very few docs will do vaginal twin births in the state and I'm feeling mildly picked on. I know I need to go in and talk to the midwives, I called and asked who was in the office the day of my next app (Oct 11, also my u/s) and it's actually the most senior midwife along with a colleague of hers, but I have it in my chart that I want to see the Sr one now.

    So now I'm trying not to freak out about it.... I've had nightmares about C sections for years. I know they aren't all bad, but I'm still really upset about the turn of events.

    I'm also concerned since I've had preterm labor with all three previous pregnancies. My second came nearly a month early and I'm concerned about these kids making it to term/maturity. So I don't want to just say screw it all and go get a lay midwife (which has crossed my mind) in case I end up with babies in distress and need a C section. As much as I'm pro natural, I do understand there are valid medical reasons for needing a C, it just freaks me out and I never thought I'd be staring down the possibility. Anyway, I know I want to still see someone in a hospital because of my history and concerns, I was just hoping to find someone to help me with a vaginal, trial at least, birth.

    Anyway, thanks for letting me just rant/vent.
    ~Elly

    Michael 11-13-05
    Jacob 12-12-07
    Tim 01-02-10
    Expecting TWIN BOYS March 4, 2012!!


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    Elly, as I said before I am in Utah, and my doc was willing to let me have a vbac with my twins, are you in the Salt Lake Valley at all? The reasons we did opt for a c/s was because of the pre-term labor and the fact that I was 4cm and 100% effaced for 5 wks and 30+ min drive across town to the hospital (I delivered at St. Mark's), and with a previous c/s neither of us felt good about induction, so a c/s was the best way to insure that I would have a medically attended birth.


    Long story short... he really was supportive of a vbac with even with it being twins as long as twin a was head down... if you want to pm me I can give you his name, I seriously love my doc. He has been with me through my first completely unmedicated hospital delivery (water broke for many hours w/o contractions, so I had pit, but no pain meds pushed, etc), my high risk pregnancy with ds, placenta previa, two missed miscarriages, d&cs, infertility, and then my multiple pregnancy.
    Rachel, momma to 4
    dd 9, ds 7, twin boys Dec 09
    I nursed my twins for 2years and 2 weeks! A little sad to be all done now.

  3. #3
    Contributor Fireandiceshay's Avatar
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    I am in the Salt Lake Valley. I'm seeing the CNM group at IMC... my insurance doesn't cover St Mark's. I'm really hoping that since the MFM group works closely with the midwives that they'll at least consider a vaginal birth, but I won't know til I can go in and talk to D next month. If they tell me I'm an automatic C section I'll probably pm ya, I just don't want to be branded a "twins, bam, C section" birth. If I have one I want it to be medically necessary.

    Just really really threw me for a loop because the short convo I had with MK make it seem that I'd be able to have them attend the birth, when it really meant I could continue seeing them for my prenatal care... not necessarily the birth.

    I just want some more info! I'm hoping my chat with D next month gives me lots of answers and I can figure out where to go from here, if I'm switching providers or hanging out with who they have... or what they think of my situation.

    Thanks for the reply. It's good to know there are supportive drs out there.
    ~Elly

    Michael 11-13-05
    Jacob 12-12-07
    Tim 01-02-10
    Expecting TWIN BOYS March 4, 2012!!


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    I'm not in the area nor do I have specific advice, but I can say that I feel as though I've had to just give up and give in with respect to a very likely c-section. The twin c-section rate where I'll be delivering is 80%. As far as I know, only one of the OBs (of eight, I think) in the practice that I go to would consider a vaginal birth for me. I would definitely prefer a vaginal birth but I do feel like it's much more out of my hands than it would be if I were having just one.

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    I am not sure about Utah, but I do believe that many providers prefer a vaginal delivery with twins as long as baby A is head down. I understand your concerns and I can really understand how all of this is just one big shock. Finding out about twins is a real adjustment, then to determine delivery and how to get twins as close to term as possible is very overwhelming.


    What is important to understand is that a twin delivery can be highly complicated. There are two babies, two cords, and many ways in which twins can end up in distress. Also, depending on how your uterus reacts to two babies, you many never have a baby that ends up head down. My MFM is a big proponent of natural vaginal birth. He told me that he wants everyone, even women pregnant with twins to attempt a vaginal birth when possible. In my case, baby A was never, ever head down. She switched between footling breech and frank breech. My baby B was head down, but was not in a position to be born first, so a c-section was my only option. Plus, I had a previous c-section and I chose to have a repeat instead of a VBAC. I did not want to risk a VBAC. It turns out that I made the right decision. I posted this in another post, but I will re-post it. My c-section was our best option and we didn't even know it until I went in for delivery. I had a uterine window, which is literally a tear or hole in the uterine wall. My uterus was so stretched with twins that if I had labored there was a high likelihood of a uterine rupture because the uterine wall was already breached.

    So, I think it is important to be very flexible with your birth plan and prepare for a possible c-section. I also think that as long as things are looking optimal, you should stand your ground on a natural vaginal birth. Best of luck in figuring everything out.

    Also, I did want to say that I had my singleton at 36 weeks and was convinced that I would have preemie twins. I went to 37w, 2 d and would have probably gone at least another week or longer. However, baby B was not growing and my MFM was concerned she was under stress. Since I was having a scheduled c-section, we decided to deliver at near-term instead of waiting and having something go wrong. So, it may be that you will make it further than you anticipate with twins. The unfortunate part of a twin pregnancy is the second and last trimester make you feel like you are playing roulette. It is all so unpredictable.
    Melanie
    DS-Isaiah 1/2/04
    DDs- Keira and Sarafina 11/28/09


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    Quote Originally Posted by melnzai View Post
    So, I think it is important to be very flexible with your birth plan and prepare for a possible c-section.
    I agree 100%. I am living proof that things can go wrong and they need a c-section. After my son was out, it became quickly apparent that they needed to take her instead of letting me push her out ( her cord had become wrapped and she was was sideways with both an arm and leg coming out first). Although I really wanted to have a natural birth with both babies I know that a c-section was needed to ensure me daughter made it out safely.

    Also, my MFM was absolutely amazing and I couldn't have asked for a better doctor. They deal with high risk pregnancies on a daily basis and know what to expect. I credit my MFM for my daughters safe arrivial. If I didn't have him looking after the birth I don't know what would have happened.

    Congrats on the multiples pregnancy. Can't wait to hear the sexes of the babies.
    Krista and Shane 01-07-11
    Sydney 07-28-07
    Bradley and Kaylee 09-06-11

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    Super Poster 3-o-me's Avatar
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    I loved my MFM, then she was out of town when I delivered. I just wish the drs/mw had more time to talk to you from the beginning - to give you the time you needed to talk and understand the future. I'm sorry things are maybe not working out the way you planned, but you will have two littles to show for the trials and tribulations.
    Best of luck!!
    Steph & John est. 8-20-05
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    I believe my doc also delivers at IMC, his practice as well, though I do not know their specific views on twin deliveries, but I would imagine they are fairly similar. Hopefully you have more answers very soon!
    Rachel, momma to 4
    dd 9, ds 7, twin boys Dec 09
    I nursed my twins for 2years and 2 weeks! A little sad to be all done now.

  9. #9
    Contributor Fireandiceshay's Avatar
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    Been a week, but I do have more info. Not LOADS, but some.

    I've been having contractions this week, which is fairly normal for me at this point in pregnancy (16 weeks), but they're more intense than usual and that had me concerned. I called the midwife office to talk to them and figured while I was on the phone that I'd ask exactly what they meant by "continuing to see them".

    Legally, a CNM cannot deliver twins, BUT, if everyone is doing well and presenting ok, they can deliver them, in the OR, with the MFM standing in the room. I'll be in the OR for vaginal OR Cesarean, which is good to know.

    I'm going to prep myself for a possible C section and have a reeeeeeeally long birth plan with lots of ifs on it (in this situation I'd like _____ etc) and just keep moving.

    And.... two and a half weeks til I can sit down with Dee Dee and REALLY chat. YAY! I'm also hoping to meet at least one of the MFM drs.
    ~Elly

    Michael 11-13-05
    Jacob 12-12-07
    Tim 01-02-10
    Expecting TWIN BOYS March 4, 2012!!


  10. #10
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    Quote Originally Posted by Fireandiceshay View Post
    I've been having contractions this week, which is fairly normal for me at this point in pregnancy (16 weeks), but they're more intense than usual and that had me concerned.
    I started getting a lot of contractions at 16 weeks also. I dealt with it mostly while exercising from weeks 16-18. At 18 weeks I was told to stop exercising, even walking too much around stores and that sort of thing. I went back to work when I was 23 weeks (end of summer, I'm a teacher) and was contracting non-stop. I was pulled out at 26 weeks because the contractions at that point started causing changes in my cervix. I'm on modified bed rest now and haven't had any increased problems. Just get ready for lots and lots of cervical checks!

    Quote Originally Posted by Fireandiceshay View Post
    Legally, a CNM cannot deliver twins, BUT, if everyone is doing well and presenting ok, they can deliver them, in the OR, with the MFM standing in the room.
    I'm glad you'll get to do something you're more comfortable with!

    Quote Originally Posted by Fireandiceshay View Post
    I'll be in the OR for vaginal OR Cesarean, which is good to know.
    Yes, my hospital requires this, too. I think most do. It's for the just-in-case scenarios (like another multiple mom had here recently.)

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