Any of you who have read this blog for long, or know me and my husband in real life, know that we are research-oriented. I'm not sure how much of that is natural inclination, how much is background and experiences, and how much is based on the years we've spent in service to the higher education machine. Suffice to say, however, that before undertaking ANY major decision about our lives or our families, we are very likely to research the heck out of it. That's how it's been with major decisions about our
parenting and family philosophies, and it's how we've been about
our approach to becoming debt-free (something we've been working on these past 3 years, and we're now completely debt-free except for student loans and haven't used credit in over 6 years).
For those of you who haven't heard this yet, on September 14, 2006, we found out we were expecting! Back in May of last year, we began making plans for us to swap out yet again, hoping that by fall my husband would be working full time again, and I would once again be a stay at home mom. It was around that time that we decided that if I was able to be home full time again, we'd love to have a 4th child. Well, my dear husband began working full time the end of July, and we knew it was time. I believe strongly in the safety of VBACs, and many of our local hospitals have either banned VBACs or make them terribly and unnecessarily complicated (thus leading to an increase in failed VBACs and increased complications for mothers and their babies). So, we spent a couple of months researching our options, trying to find the one that would be safest for me and for our unborn. After much research, seeking referrals from friends, and reviewing our options with each other and in prayer, we knew we had found our perfect provider! We selected a certified nurse midwife in a neighboring state who we felt had the natural approach to childbirth we desired, while also having the experience and medical training we felt would be essential to our comfort level with the birth plan, and we began making plans to temporarily relocate to a city near her as the due date approached.
Then, in December, we found out we're having twins! Talk about a surprise, since there is not a family history of twins, and we have never needed any fertility assistance! Of course, our first reaction was shock. I believe our second was fear.
I spent much of the next 24 hours reading and researching about twin pregnancy, and much of what I read was fear-based. I read that 60% of all twins are born prematurely (before 36 weeks). I read about complications that can arise in twin pregnancy and birth, including complications for the babies as well as increased maternal complications such as pre-eclampsia, pregnancy induced hypertension, gestational diabetes, and more. I read that most twin pregnancies are induced before 38 weeks to prevent placental deterioration and reduce the risk of stillbirth. I also read that many twin pregnancies end up in cesarean births.
Because I believe that all other things being equal, natural childbirth is best and safest for mother AND babies, these statistics scared me. Disappointed (both for myself and worried for the safety of my babies) I called my midwife the day after we found out it was twins, told her I didn't think we could go through with it, and told her I'd be looking for a new provider.
And then I continued my research. I began to learn that the 60% prematurity figure includes both identicals (who are at risk increased complications including twin to twin transfusion syndrome) and fraternals, and mothers who have other complications of pregnancy. My babies are fraternal (boy/girl, two separate placentas for nourishment, thus no risk for TTTS), and I've never had any pregnancy complications. I learned that nutrition can often prevent pregnancy complications such as pre-eclampsia and gestational diabetes, and began to follow a modified version of the
Brewer diet, a diet for healthy pregnancy (although I increased my own protein intake above Brewer's recommendations, to provide adequate nutrition for my twins). I learned that one of the greatest risks to otherwise healthy twins is low birthweight, and that adequate protein intake could increase twin birthweights significantly. And I also learned that nutrition is the single biggest factor contributing to placental deterioration. I ordered books about natural twin pregnancy and birth, and followed the recommendations as well as I could. I also learned that twin VBACs are at no higher risk for rupture than singletons, which was reassuring.
I started to think I might be able to go with my original plan, so 2 days after calling my midwife to drop her, I called her back and asked what her experience with twins had been. Turns out, she's attended vaginal births of dozens of twins, both in and out of hospitals, including twin VBACs. She's had positive outcomes with every one, and has only lost one baby in her 20+ years of being a midwife (and that wasn't at a twin birth). She wanted to be sensitive to my needs and concerns, so she recommended that I begin nutritional changes that could enhance my pregnancy outcome. She also suggested that instead of feeling like I had to make an immediate change, to take a few weeks to continue researching, meeting with twin mamas, and praying for God's guidance regarding our birth plans. We agreed that I would call her back in almost a month and let her know what we had decided, and she agreed that she would also be taking my situation into prayer to make sure she felt confident taking me on as a patient.
I began drinking a gallon and a half of water per day, eating well over 120 grams of protein a day (usually more), and taking adequate daily supplements (prenatal vitamins, vitamin C, iron supplements, liquid chlorophyll, alfalfa, fish oil, flax oil, and probiotics). And my husband and I met (online and in real life) with several women who had safely given birth to their twins under the care of a midwife, with minimal interventions. We both carefully read the twin books I had ordered. And we discussed and prayed about my pregnancy history, which has never included any of the common twin complications that can often lead to preterm birth or birth complications. After carefully and prayerfully considering our options for a few weeks, we called our midwife back and made plans to meet again soon.
Since then, I have received competent, professional, considerate, compassionate, and personalized care from a my wonderful midwife, who clearly views this not only as her profession but as her spiritual calling. Because twins are typically considered term at 36-40 weeks, we've moved up our relocation date to late April. We have
VERY carefully researched, prayed about, and considered our options, and are solid in our conviction that we are doing what is safest for me and for our babies. If at any point something comes up that makes this plan risky or not suitable, we'll change plans. Until then, we feel we are doing the right things. And we have chosen not to discuss our decisions with anyone who can't bring anything supportive to the table. We simply don't need the stress right now!
So, if you feel you can be supportive of our choice and respect our decisions, we will gladly include you in our planning process, let you know when we're in labor, and keep you posted on how things go! If you feel you disagree too strongly to remain supportive of our plan, we'll be happy to call you after the babies are born to let you know how it went, but we'll have to request that you refrain from discussing our birth plans with us in the mean time. So far, everyone we've talked to has been wonderful and supportive, and understands that we would never take lightly our responsibility to choose the safest options for our children. We just felt it was appropriate to let folks know some of what has led us to the choices we've made, so that you can be reassured by the actual
facts about twin childbirth (as opposed to myths and fears), just as we have been reassured by them.
