doctor's visit @ 20 weeks

Now that I'm done announcing that we're having girls, on to the appointment.

Did the ultrasound first. Babies looked good. Measured exactly where they should for 20 weeks. Heart beats seen, all parts of heart and brain seen as best as possible considering the ultrasound machine wasn't one of the high-resolution ones. The OB wanted to schedule me for a level II ultrasound to make sure everything else is OK. I said, no I'm trying to avoid unnecessary ultrasound. He said, Oh, but ultrasound is very very safe. I didn't say but thought, Yeah right... show me the research that proves that. I told him that for us, Less is More. I'm okay with an ultrasound or two, but not 6 - 10 which is what would happen with most twin pregnancies!

Then we sat down to talk. Dayton and I had a list of questions written up.
1) Q: Are there any routine procedures that are different for this hospital when it comes to vaginal birth of twins? (The reason I was asking is because a lot of hospitals require the birth in the OR, with an IV, and an empty epidural.) A: Nope, this hospital still practices Active Birth set up by the WHO (world health organization).
2) Q: Under what conditions are your comfortable with a vaginal birth of twins? (I asked it this way to get his true comfort level with philosophy). A: Vertex/vertex. This is with both babies head down. Dayton asked, well what if the 2nd one is breech? (All over the world this is typical and is still a vaginal birth.) The OB said, oh no, Cesarean is safer. Which is absolutely NOT TRUE!!! Well, with those answers, we had no need to go further, because vertex/vertex is the only way for vaginal birth with him. Unfortunately, he's my ONLY chance for a vaginal birth at any hospital here.

I asked my son's pediatrician an hour later at his appointment what she thought about it. She's very pro-natural birth and said that my OB has tons of experience with breech but is now scared of litigation. Blech. The upside is that I was able to ask her about the NICU here in case the babies come early, and she said they can handle babies born at 26 wk gestation, insist on breastmilk from the beginning, and that was her original specialty before wanting better working hours and going back to general pediatrics. So happy to have her on our side!

I did consent to all of my bloodwork being checked. I usually decline the gestational diabetes test, but since it was offered so soon, I knew I'd pass. It's totally flawed for twin pregnancies... easy to fail later on even if not diabetic. So I figured with a passing test, it might give me bartering power later on. I don't want to appear like a problem client. My iron levels were great for me. I'm always anemic during pregnancy, and this time they were the highest ever. I'm going to keep doing what I'm doing to keep them up and push them higher. The biggest iron drop happens between 20 and 28 weeks, so I'm doubling up. My Rh+ antibodies were also checked. Isaiah was Rh+ and I'm Rh-, so I had to have the Rhogam shot to fix any blood mix possibilities after his birth to not have an affect on future babies. If one of these is Rh+, my body would possibly attack it as a threat to my immune system. But no sign of that!

So what do I do? At this point, I am not going back to the doctor. I can do my own prenatal care. I can go to a local clinic to get my iron rechecked later. I will not content to unnecessary testing and ultrasounds. I will not consent to a Cesarean that is not for a very good reason. If I feel like something is wrong, of course I'll go get checked out. BUT, I have the philosophy that birth is safe, and all will go as God wills it to go. Interventions/testing are the risky parts. As for where to give birth? I will stay home unless I need a C-section. Why go to the hospital for a vertex/vertex birth when that's easily done at home. Will I have a midwife? If mine is available. If not, we'll do it ourselves. I know not all people agree with this, but research shows it is safe, and our health and medical issues (if you can call birth a medical issue) are best without doctor intervention. We are well-informed and prepared.

I'm so excited to see where all of this leads!

we are having...

Went in for our appointment and found out what we're having...


...


...


...


...


...


...


...


...


...


...


...


...


...


...


2


...


...


...


...


...


...


...


...


...


...


...


...


...


...


GIRLS!!!!

Stressing out

I will be so glad to have my appointment on Friday.

My first appointment at 12 weeks was exciting to find out we were expecting twins, but very disappointing in discussion with my OB. He said that he did have experience with twins and breech birth. Breech birth is a big issue, because a lot of the time one baby is breech. He then proceeded to tell me that C-section is safer for breech birth. So I said, what about the statement put out by ACOG (he's a member) that said they had to retract C-section being safer and restate it as equal risk by C-section or vaginal birth. He says, oh no no, C-section is safer. This makes me upset. Here's why. He uses the ACOG statements only when he feels like it. He ignores them for me, yet insists on them for other women. Basically he uses what he wants to get the results he wants. So I guess he's willing to "let" me "attempt" a vaginal birth if XYZ are in place. We are writing up an in depth list of questions for him for Friday. But wording them in a way so as to find out his real philosophy and intentions.

I attended a waterbirth presentation by Dr. Tanit a couple weeks ago. He is more like a midwife than a doctor. He trained my OB, started the natural birth and waterbirth suites at my hospital, and is just an amazing man. At 70 years old, he has over 40 years experience and just a 5% c-section rate... well below the World Health Organization recommendations! I was able to talk with him at length, and he said that even if they were double breech, vaginal birth is still better for twins, especially since this is my 3rd pregnancy. Too bad he'll be back in the UK when they're due! He was so positive about my situation but said pretty much "good luck" at finding a provider who wouldn't emotionally blackmail me into a C-section. Sooo, not looking good huh.

My favorite quote from his presentation: "Obstetrics is the number one medical profession that does not practice evidence-based care." I totally agree... based on routines, not current research.

Friday's appointment should glean some good info for Dayton and I to make some better decisions.

Here are two pictures (finally). The belly pic I took tonight. The ultrasound is from 8 weeks ago. Hopefully I'll have new ones to share soon!

Long Update

Identical or Fraternal?

Of all twin pregnancies, 30% are identical and 70% are fraternal.

For those of you wanting a mini-science lesson, the midwifery student in me is dying to explain a little more.

Identical twins are actually "monozygotic" (MZ) meaning 1 egg, 1 sperm, then it splits.

Fraternal twins are "dizygotic" (DZ) meaning 2 eggs, 2 sperm, and no split. Well if it then split, it would be triplets. DZ twins are siblings of the same age.

Did you know there's a 3rd kind of twin... quite rare. "Sesquizygotic" (SZ) is when one egg splits and then the two halves are fertilized by different sperm. So they're fraternal from the dad's side but identical from the mom's side.

We are most likely having DZ twins. Because of late cycle ovulation and because of still breastfeeding, it's more likely to have 2 eggs pop out. Also, my OB studied the placenta(s) and showed markers in the placenta that point toward DZ.

We find out Mar. 16 what the genders are. We weren't going to find out, but now that it's two, I've just gotta know. If they are the same gender, then we'll do genetic testing to make sure of MZ/DZ. If they are MZ, it's good to know for future medical issues that may come up. If they are DZ, we have a 25% chance of them being boy/boy, 25% for girl/girl, and 50% for boy/girl.

Prenatal Care
I had planned on doing all prenatal care myself this time around. But at this point, I do need a care provider who will be willing to help me if we decide to have the birth at the hospital. I'm not sure how happy he's going to be when I go in next week, and I'd skipped my other appointment. Instead of going in every 4 weeks, I'm doing every 8. The reason? I don't want multiple ultrasounds and testing done. Pregnancy is not an illness and I'm not going to be treated like I'm sick. I called my midwife in Australia and she said, "Do not consent to any test unless something can be done with the results." I'm holding to that, especially with ultrasounds. My OB said, well we have to do an ultrasound everytime to make sure they're growing. Huh? And if they're not? Not like anything can be done about that!

BUT, it's not like I'm not getting any care. I'm doing it myself. And having fun. Every week, I check my weight, blood pressure, height of the uterus, check for babies' heartbeats, and urine. I can do all of that myself. All of which the doctor would do each time anyway. But I can do that myself w/out the ultrasound risks.

I found a heartbeat!
I was using my fetoscope last week to try to find heartbeats. 18 weeks is the earliest one can be used and I just happened to find one baby! Nice and loud and strong, but then the baby floated away. I think I found the other baby last night. I'm feeling more movement on my left side and very little on the right. By listening with the fetoscope, I can hear more placenta on the front side on my right, so that's probably what's blocking heartbeat and movement from the other baby.