This thread on twin births is most interesting and insightful.I have been fortunate to atttend twin births several times over the years, but it never used to be considered the drama that it seems to be nowadays, and I think this is largely due to ill-advised interference which gives rise to problems, which gives rise to the perception that the twins are the problem rather than the way they were managed!
This month we have had 5 sets of twins where I work.Only one set was born vaginally! I visited this mother today and we talked about the birth. No 1 was spontaneous SVD ( 3790g!) by the midwife, and then the dr took over for no 2. There was only 6 minutes between 1 & 2 - the second bag of waters was ruptured and bub delivered by high Keillands - obviously great haste to get second twin born. The woman had an epidural but it was not effective and she found the second birth very painful (what a surprise!) Both babies are doing very well.
I remember a twin birth about 20 years ago in UK. No 1 was SVD but again the doc took over from midwife for no 2, did ARM before the secong baby had entered the pelvis, got a cord prolapse, panicked and rushed to theatre. There was unfortunately a 20 minute delay in performing the emergency C/S and twin 2 sustained injury causing cerebral palsy. I knew this family and it took about 15 years for them to get any compensation, they had to undergo a lengthy and distressing legal battle, as well as raising a child with significant disability.
It seems that the medical view is to get twin 2 out as quickly as possible with no regard for physiology. Most insist on an epidural so that they can manually extract no. 2 by reaching in to grasp a foot and bring it down.
I don't know what the answer is to having a 'normal' twin birth. I can understand the view of the parents in the DVD wishing to go it alone and trust their own instincts. But it is a tricky one. Few midwives are able to take on care of twins, they would certainly be villified by the medical profession. Yet hospital twin birth is almost always highly medicalised.
Sue"The only thing necessary for the triumph of evil is for good men to do nothing"
Edmund Burke----- Original Message ----- From: <[EMAIL PROTECTED]>
To: <[email protected]> Sent: Saturday, July 30, 2005 1:44 AM Subject: Re: Fw: [ozmidwifery] Encouraging twins into a good presentation.
The risk of cord prolapse is increased with a presenting part that is NOTcephalic, however, there is a great deal of adrenalin production obstetrics which I am dubious about. Nature does have another protection in the event of cord prolapse called Wharton's jelly in the cord. When we try to ligate the vessels after birth by tying cord tape or dental floss around it, we have to really put our whole body weight and strength into getting it tight enough to stop blood flow through those vessels EVEN WHEN THE PULSE HAS STOPPED in thecord for many minutes. So, although no one wants to have a cord prolapse,and, of course, smart, prompt action should be taken, I have come to suspectpronouncements by obstetricians about what would have happened if ____________had not occurred. The greatest danger in cord prolapse, in myview, is during second stage with a primip having the cord pinched between the bony pelvis and the bony head. Another extreme danger might be the pack a day (Or more) smoking mom who has a skinny umbilical cord and already compromisedbaby. I think that a big part of midwifery is educating each other and pregnant women to look more objectively at the drama that surrounds complications in birth and ask ourselves "is the mythology actually true".Thanks for posting that story, Jo, because it's definately not right to just quote wonderful stories where everything turned out perfectly by just sittingon hands. My question that I always come down to with modern obstetricsis "How many are killed or injured by the fear who would have lived if they had gone out and squatted in the woods somewhere?" It's a juggling act, for sure. There have been so many second twins that die or are injured in medical care and somehow those stories are buried. I think this is one of the reasons that more families in N. America are saying "The hell with it, we'll take our chances with Mother Nature and accept responsibility for the consequences."Gloria Lemay Quoting Lindsay & Yvette <[EMAIL PROTECTED]>:----- Original Message ----- From: "Lindsay & Yvette" <[EMAIL PROTECTED]>To: "Jo Bourne" <[EMAIL PROTECTED]> Sent: Friday, July 29, 2005 12:42 PM Subject: Re: [ozmidwifery] Encouraging twins into a good presentation. > Thanks Jo, that's really good to know just in case that happened to me. > I'll mention possible cord prolapse to the midwife & Ob when I see them > next. > > Gloria I've seen that website, & seen the stills & read the birth story > though not bought the DVD. I've seen another DVD of a planned twins > homebirth in Melbourne of boy/girl twins, where the second baby was> breech, and it's truly inspiring. The babies were born into water & > both> so alert, calm & healthy looking. The website for that one is > http://www.womenofspirit.asn.au/welcome.html > > My website for this pregnancy is > http://www.babiesonline.com/babies/t/twingirlslb/ > where I've been keeping a journal. > > Yvette >> ----- Original Message ----- > From: "Jo Bourne" <[EMAIL PROTECTED]>> To: "Lindsay & Yvette" <[EMAIL PROTECTED]> > Sent: Friday, July 29, 2005 9:27 AM > Subject: Re: [ozmidwifery] Encouraging twins into a good presentation. > > >> Hi Yvette, >>>> I hate hate hate conveying less good outcomes on a list like ozmid (or >> at>> all for that matter) so I nearly didn't send this. A friend of mine >> who>> had two previous text book natural births was pregnant with identical>> twins in separate sacks for her third pregnancy, she fought very hard >> to>> organise at least the opportunity to birth in her hospitals birth>> center - if she made it to term then she was to birth in the birth >> center>> and she alternated her appts with the birth center midwives and her>> assigned OB (who was the head of obstetrics). At her 34 week appt her >> OB >> started saying that he thought she would definitely need a ceaser >> because>> of her twins position (transverse and facing each other) but they >> would>> wait one more week to be sure. 2 days later her waters broke with full >> cord prolapse at home. With a combination of instinct and what she had>> learned at our EXCELLENT yoga classes she shoved the cord back in and >> got>> in the knees chest position (butt in the air head on the ! >> ground). >>>> When the ambos came (they were there within 10 mins) they tried to >> force>> her to lie down on the trolley thing for the trip to hospital and her >> husband had a screaming argument with them on the street to the effect >> that lying on her back would kill the babies and she was NOT under any>> circumstances going to lie down so they could either take her in the >> knee>> chest position or he would drive her in that position in their own >> car.>> The ambos gave in. She had a ceaser under general literally 3-4 mins >> after arrival in the hospital (the closest to her, not her hospital of >> choice) and both boys were ok but the OB that did the ceaser told her>> that she saved her babies lives by refusing to lie down for the >> ambos... >> So good outcome in the end but very scary and not the birth she had >> hoped>> for. Also once her waters broke and contractions started the >> contractions>> locked the babies together in their transverse positions and neither >> baby>> could move down, she could not have birthed vaginall! >> y so the transverse position caused prolapse and prevented her babies >> from moving down, it was all round a bad thing for her. >>>> I have been reading your story with interest and cannot tell you how >> much>> I hope that your babies turn and you get the birth you want. I guess I>> just wanted to be sure you were aware of the cord prolapse risk if >> your>> waters break while both twins are transverse. The knee chest position>> will slow labour down if anything can and takes as much pressure off >> the >> cervix as possible so it is a good thing to know in a precipitous >> labour>> that you need to slow down. >> >> Take care! >> Jo >> > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.-- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.9.7/60 - Release Date: 28/07/2005
-- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
