Tuesday, April 10, 2012

Knowing His Shit

Tidy and I met with my OB yesterday to start talking about a birth plan.. ehem... I mean, preference.

(Oh, and I weighed in... fun fun. I was 1 lb less than my estimate from last week's post).

Have I mentioned that I like my OB?

Tidy thought he was a bit arrogant, well, I guess more than a bit.

But have I mentioned that I like my OB?

I think the arrogance makes me feel like he knows his shit.

Arrogance, however, does not necessarily imply knowing ones shit, but from my research based inquiries, our discussions/debates, and his ability to make a sound argument about our next steps, I feel like he knows his shit and thus can be arrogant.

And I need to feel confident that he does know his shit so we can get these babies out of me in the best possible way. Now, I suppose the term "best possible" is up for debate, but for me, that entails a vaginal birth, if at all possible.

"Best possible" though, is really not defined by an agreed upon industry method, but by the skill of the OB. Per my doctor, the amount of OBs in the US that are skilled in birthing twins vaginally is decreasing. That is why so many twin births end up in C-section... over 50%! (I even saw in a magazine saying that last year 75% twin births were C-section, however I'm not sure if that's valid or not). One of the biggest wild cards in a twin birth, is the position of baby B (the second one out). Many OB's are fine with doing a vaginal twin birth if both Baby A and Baby B are head down, but (an again, per my OB) about 1/3 of the time, after Baby A is born, Baby B will change positions.

So, a skilled OB will be able to birth Baby B in a feet first position. And it has been shown that this is still very safe and in fact preferred for the baby rather than going to a C-section at that point. The trouble is, though, is that the percent of OB's in the U.S. that will birth Baby B feet first, is getting smaller and smaller. Luckily my OB will do this and in fact, is skilled at it.

I like my OB! I mentioned that, right?

So, while we haven't created a birth "plan" or as we should call it a birth "preference" yet, I at least know a few of the extra considerations that come with birthing twins. This knowledge will also help us decide if we want to induce at some point or not. As many of you I'm sure know, in a doctor group, you won't necessarily get your OB to birth your babies unless you schedule your birth with her/him.... aka schedule a C-section or an induction. At least that's how it works for us. So, we will have to make some decisions as this gets closer, but for now, knowledge is making me feel a bit more comfortable.

(And ... to those of you who are reading this and have been through birth and are saying, silly Tippy... you have no control over this... I do know that. But I also know that having more information about how things could go, empowers us to go through this as best we can)


RunningMama said...

Well, I hope everything works out. I have had a friend witha singleton that did an induction and everything worked out. My sister was induced with her twins, but they said she had a difficult pelvis and she ended up doing a c-section. Both of her babies were head down, so she was pretty dissappointed. But, the babies are healthy and her scar is really tiny. Good to keep an open mind!

Lara said...

Having a doctor who is competent is so important to helping you relax. One thing to ask when considering an induction is will you keep your doctor if the induction lasts several days or will you get whatever doctor is on call when the labor finally progresses. We started my induction on a Thursday due to low fluids and were still inducing on Sunday when I finall gave in to a c- section. Glad things are going so well

Gurlee said...

It is so important to trust your instincts and what makes you feel good. My RE was a bit arrogant but I felt similarly, she was that way because she wanted to be the best and in my experience so far so good :)

Mags said...

While I'm no expert, I think preparing for your ideal scenario and keeping an open mind for things to unfold as they will is the BEST birth plan. I know you, and know that you will be present and focused and you will do what is right for you in the moment. I'm so glad your OB is a good fit for you, because I think in all likelihood you will ultimately be happy with your birth no matter what the circumstances.

And I love that we're to the point of discussing birth plans!

Heather said...

I am so glad you have a good doctor that you like, and I hope everything just falls into place, however babies come out that they are healthy and happy!

Kristin said...

Hello! I'm here fro ICLW. I'm so glad that you have an OB that will deliver vaginally. After the trauma of ALI you deserve a good birth! Best of luck!