I had a long conversation today with a woman who was 33 weeks pregnant and expecting twins. At this stage, both babies were thought to be breech and she had read the article I had posted on the website regarding turning breech babies, an decided to phone me to disucss it further.

This woman, well read, articulate and clear in her feeling that everything would be normal with this labour and birth, was meeting the usual negativity from the doctor at the hospital. She had chosen this maternity unit with care, liking its small size and the positive attitude of the midwives on the staff. The larger referral hospital, which is actually closer to her home, she felt was too large to enable personal care and she wanted to avoid finding herself on a treadmill of obstetric policy and medical management.

Her first battle was to negotiate being able to see the midwives for pregnancy check-ups not just the doctor. Her twin pregnancy has tipped her into the “high risk” category and it was assumed that she would just follow the normal path - obstetric care and an elective caesarean. This is precisely what she wants to avoid, and she is receiving good support from the midwives, who have stated that if all is well, she can expect to have a straightforward vaginal birth (as long as she avoids the one doctor in the unit).

The doctor’s attitude has been to emphasis that the babies need to be carefully looked after, especially at the birth and that is why a caesarean is recommended, because a full team of specialists can be guaranteed. I explained (in fact she already knew) that if she went into labour naturally, she would avoid the first major obstacle that most twins face - that of prematurity. The labour contractions themselves would help to ready the babies’ lungs for breathing spontaneously (a second major hazard, and a common problem after elective caesareans), and so she thought, quite reasonably, that if had a spontaneous vaginal birth she would have much less chance of needing the full paediatric team. If an emergency did occur, help would be found, as it always is in a hospital, and if there was some delay, then that was a risk she was prepared to take.

The doctor was also insisting that she have serial ultrasounds to check on the babies’ growth. I explained that no test should be undertaken unless the results were likely to alter the management plan, and that just “having a look” was a poor reason for overexposure of the babies to unnecessary ultrasound. She agreed, having researched this topic herself in some detail.

We discussed the issue of encouraging the baby to turn, and I suggested that she consider using the Moxa Sticks to achieve this outcome. This is worth a try, and if successful, should eliminate the pressure for the elective caesarean. We also talked about her need to surround herself with people who are confident and supportive, and if that means missing a few visits to the doctor (whilst keeping her midwifery appointments) then that was an option she could consider. She liked the sound of that idea.

Why is such a fuss made about twin births? This woman became pregnant at the first try, is in excellent health, the babies are growing well and she is confident and happy about having two babies instead of one. She is knowledgeable and trusting of herself and nature. Yes, her babies may be breech now, but they may turn, and it is too early to know what will happen as her pregnancy nears term. It is morally unacceptable that she be coerced into the medical model of care when she neither wants or needs it. I hope she can stay strong and that everything turns out as it should - a normal vaginal birth with midwives doing the honours. As I said to her, she will have quite a story to tell after this is all over! Posted by andrea at June 09, 2005 05:39 PM