Midwife kicked me out-Have to find an OB! HELP! — The Bump
Multiples

Midwife kicked me out-Have to find an OB! HELP!

So, we had planned on going to the same Midwifery practice that we used in our last two pregnancies and giving birth at their freestanding birth center.  At our first prenatal appointment at ten weeks, we discovered twins! In the state of Idaho, midwives are no longer allowed to oversee twin pregnancies, so we now have to find a new provider.  I'm terrified!

Obviously, I'm a huge believer in natural childbirth if at all possible. Our oldest (5) was a natural childbirth at the birth center.  With our youngest (3), we were able to labor at the birth center, but after my water broke it was discovered that he was breech. Apparently he flipped during labor - he'd been head down the whole end of pregnancy.  My labor would not progress and we ended up having to transfer to the hospital for a c-section.

So, I'm looking for advice on how to choose an OB.  My midwife gave us a list of names that they recommended, but I have a million questions! Obviously, I understand that having multipes is a huge game changer, but I want to find an OB who is willing to let me try for a VBAC, is open to a breech extraction, etc. etc.  (as long as that is a healthy and safe option given whatever the circumstances end up being).  So, do I just start calling offices and asking these questions? Do I need to make an appt and discuss everything with each doctor? I'm so lost.
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Re: Midwife kicked me out-Have to find an OB! HELP!

  • I would start by finding out which hospitals each OB office has rights to deliver at, and then check to see if that hospital allows VBACs. Many flat out won't do them, so that would be a nonstarter. That should help narrow the list down. Did your midwife give you any specific information on each OB? I had to switch from a midwife to an OB at 20 weeks when we found twins, so I understand your concerns. In my case, my midwife worked out of a joint midwife-OB practice, so she recommended an OB to me from the same practice. She picked one that she felt would be open to my desire for more natural practices, and it worked out perfectly. I wound up with a C section because both babies were breech, but my OB was very on board with most of the natural options I was hoping for. Maybe your midwife could narrow down the list of names she gave you to one or two doctors that she knows from experience are open to more natural care?
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  • Thanks for your advice. I know all the names on the list were recommended to me because they are open to a more natural model of care.  Also, all our local hospitals allow VBACS so it's really just a matter of finding a doctor I like. I'm just clueless how to figure that part out! :)
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  • I would also look for your local MoMs group and get some recommendations from them. They will know what's up!
  • SWA80SWA80
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    Also, depending on type of twins you have you may need to see a MFM as well. Some OBs play nicer with MFMs than others so this is a question you may want to ask. I had to switch at 18 weeks because the OB I was seeing wouldn't let me have scans at the MFM and I was uncomfortable with the knowledge of twins from some of the other doctors in the practice.
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  • edited July 2013
    I would look for a hospital with a high level NICU and a MFM/High Risk OB/Gyn.  I only see an MFM and not an OB and I like it much better that way.  With twins, you have to change all expectations.  My doctor told me that twin pregnancies result 50/50 in vaginal v. c-section births.  I imagine that it is a different statistic for women who have already had c-sections.  My doctor will perform breech delivery but only if Baby A is in the correct position and Baby B is breech.  If Baby A is breech, it will 100% be a c-section. 

    D & L are here at 34 weeks 4 days by vaginal and breech delivery on 11/19/2013
    Two healthy boys weighing 4 lbs 15 ozs and 4 lbs 5 ozs.  Only 6 days in the NICU and getting bigger, stronger and cuter every day! 
  • edited July 2013

    Thanks for your advice. I know all the names on the list were recommended to me because they are open to a more natural model of care.  Also, all our local hospitals allow VBACS so it's really just a matter of finding a doctor I like. I'm just clueless how to figure that part out! :)

    I haven't read all the PPs' comments yet so not sure if this has already been said, but I would first choose the hospital, looking for one with a level III NICU, and then choose an OB with privileges at that hospital who will do a breech extraction of baby B (many will, but not if baby A is breech) and a VBAC (not sure about that since with twins, your uterus is going to be more distended than with a singleton anyway, but I don't know a lot about VBACs).

    With multiples you just never know when you'll deliver or what complications may arise and I personally would want to be in the same hospital as my babies if they needed NICU time, and I'd want them in the best NICU possible.

    Congratulations on your pregnancy!

    ETA it looks like PinkinProvence beat me to it. Sorry for the duplicate advice.
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  • Thanks so much to everyone for your help! We've been asking around and getting recommendations from our birth center, our childbirth educator, friends, etc. 

    I have two OB's high on the list so I'll be starting there! Wish me luck!
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