Hospitals

[quesadillas]

Hi,

Yet another question I'm afraid! 13 weeks with twins. I'm booked in at a hospital, but are some hospitals better equipped to deal with twin births than others? I'm going to a twin clinic in a couple of weeks, so clearly they know something. They have a special care unit, is that all I need? I just want to make sure I'm booked in at the best place possible. I'll be requesting a c-section (already requested before I knew there were two) and I've had a section at this hospital before, so I know they're OK on that score.

So confused, so many questions......

[2015isgoingtobeBIG]

You will be consultant led rather than midwife which will mean you can't necessarily use the facilities in any local midwife led units. My antenatal has been under the high risk pregnancy team which has a multiples clinic. I've never met the consultant, only a registrar, but the midwives and scan appointments are all geared towards more than one. I'd be asking whether your own hospital has similar orat the very least a names consultant for multiples and what their experience is with birthing twins. I've just moved antenatal as we have moved and it seems the new hospital does things a little differently up I've found their policies online for twin births so know they are set up to deal with them. In terms of facilities for after the birth, different NICUs are equipped to deal with babies born at different gestation. A level 3 unit can take babies born before 27 weeks but a level 2 can on,y take them from 27 weeks. What this means in practise is if your local unit is level two and worse case scenario your twins come at 26w5d you will get transferred to the nearest level 3 unit which may not be that close (these re highly specialist units and if there's no cot free in your nearest they will send you to the next nearest that has a bed). Obviously nobody wants to meet their babies this early so hopefully this won't matter to you but worth knowing th diffence just in case.

Hope that helps

[quesadillas]

Thanks, that's really helpful. I didn't know abou tthe different levels of NICU, so that's something to ask about, see what level it is and where the nearest higher dependency unit is. I'm in a big city, so hopefully distances shouldn't be huge.

I have a consultant appointment in a couple of weeks in the multiples clinic. I believe he's the head of the department, so hopefully he's got plenty of experience. I'd have been consultant led anyway due to issues around last pregnancy and birth, so seeing doctors rather than midwives doesn't feel too scary as I was expecting it anyway. And I had lots of scans last time, so I'm well used to them too.

I've not looked in detail at the hospital's website, maybe there's information on there. I was too in shock when I found out yesterday to think about asking actual questions!

[2015isgoingtobeBIG]

Depending on your twin type you should be given the protocol for how often you'll be seen and by whom and when you'll get scans. There wasn't much info on my old antenatal hospitals website (Central London teaching hospital) but my new one has a lot of their policies under the GP section. Some of them are a bit medical but I am a health professional who likes to be informed so I stuck with them and managed to make sense of most of them.

I frequently forget to ask most of my questions when I get to the appointment even though I tell my patients to write everything down beforehand....finally started taking my own advice and went armed with a written list to my new GP and it does work!

[quesadillas]

I've already started my list of questions! Some of them will probably be really stupid.

[2015isgoingtobeBIG]

No such thing. It's a whole new world and if you don't ask you'll only be on here asking and hearing "ask your midwife!"

[JemFinch]

Mine were delivered at 31 weeks (TTTS and placental abruption), I had to be transferred out as my local hospital didn't have NICU and only took over 32 weekers into SCBU. I ended up nearly two hours away as they had to find a hospital that had room for me and two NICU spaces.

In reality though this didn't change the hospital I was under though as I didn't know I would deliver that early.

I guess what I'm saying is it can all the best laid plans can go out the window depending on the situation.

I would def want there to be a unit that could deal with +32 weekers but unless you are near a very big regional hospital or in London then you won't have the NICU units anyway if that makes sense

[JemFinch]

Meant to add that we were all transferred back to my local hospital after 6 days as they had hit the 32 week mark and were well enough to be transported so it wasn't that bad in the grand scheme of things:)

[Ratfinkandbobo]

Hi (waves) I have twins DDS 7. My local hospital advised I had the option of birthing at a larger city hospital 50 miles away. As it was I went into labour at 32 and requested I stay at local hospital for family support (invaluable after emcs and prem babies IMO!). As they had 2 high dependency incubators available at that time, I had my emcs there.
When I had mine, patients had a choice, but I'm not sure if that is the case now.
If your local hospital has the appropriate facilities, and you are satisfied with the care you have received, I would advise you stay put.
Obviously mine were prem, the last thing I needed was to be separated from them and the stress of travelling.
See how your pregnancy progresses. I knew that mine were likely to be prem. Some twin mums carry to 37/38 and have babies that don't need medical intervention.
When you have a prem, where they will be is dependant on where the special cots are available. I was told that mine might have to be transported to another hospital, luckily for me that didn't happen
Best of luck, I will be following with interest, also congratulations

[quesadillas]

Thanks for all the replies, it's really useful to hear from people who have been through it. I'm in London so hopefully plenty of facilities available.

I suppose for now all I can do is go and see the consultant armed with my list of questions and go from there. As long as I continue to feel comfortable with the care there, I'll stay under their care. A friend had a (single) prem baby there a couple of years ago, so I'll chat to her about her experiences.

Scary stuff, but lots of people get through it, so I'm sure I will as well!

[2015isgoingtobeBIG]

Not sure where you are in London but I think UCH, homerton and Kings are all level 3 units. Not sure about out West.

[JemFinch]

You're in the right place! St Thomas' and even Lewisham I think. I was at PRUH (SE London) but ended up in Ashford!

[Ratfinkandbobo]

As your in London there sounds like lots of good hospitals, so don't worry. Plus you'll have good transport links