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Childbirth

Share experiences and get support around labour, birth and recovery.

Natural twin birth

8 replies

Bellbell · 21/05/2010 19:15

I quite recently found out I'm pregnant with twins, and am wondering if some hospitals in London are better than others at assisting women to have positive and natural twin births. Options open to me are UCH, Royal Free, St Mary's Paddington, and Queen Charlotte's and Chelsea.

I am currently at UCH and was told by a midwife there that vaginal birth is possible if babies in right position and no other complications, but that they hook you up to heart-rate monitors etc so you have to be on the bed and can't move around. Birthing pool completely out.

I am somewhat terrified of being flat on my back and have a strong sense that I'd be a lot better off moving around, and ideally wanted to use a birthing pool. I've since read that this is perfectly possible, but that the over-medicalisation of twin births means that few women are given a proper choice.

I was also surprised to learn that they don't assign you a midwife experienced in twin births at UCH for the actual birth, despite the fact you're assigned to a specialist unit all the way through pregnancy...until the most important bit?!?

It just feels that every step of the way is a litany of interference with twin births, from being induced well before mothers of singleton babies are, to being given drugs to speed up the delivery of twin 2, even if you managed to have straightforward delivery of twin 1. As for breech babies, well I just can't imagine anything worse than having a natural birth for the first baby only to be forced to have a c-section for the second. Worst of all worlds and surely not necessary unless the baby in distress.

I'd really welcome any experiences or advice on this. Thanks!

OP posts:
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duckyfuzz · 21/05/2010 19:33

Hi Bellbell, congratulations on your twin pregnancy I can't comment on London hospitals or compare twin to singleton experiences as I only have twins, but I did have a vaginal birth with twin2 a footling breech. I was however flat on my back, epidural given without me really realising it and forceps used for twin 1 who didn't seem to want to put in an appearance (now I know here well, this doesn't surprise me!) twin 2 came 17 mins later. the hardest thing I found was having to let twin 1 go in order to concentrate on delivering twin 2.

I will point marslady your way, she is twin mum, doula and all round expert, and london based too. Good luck!

MarsLady · 21/05/2010 20:18

Well I suppose it depends on where you are based. I have been to twin births at all but Royal Free and St Mary's, so I can't give a twin opinion on them.

I'm not fond of the Royal Free for birth and I don't think you'd get an option for a natural vaginal twin birth there. I am ready to stand corrected.

Haven't been down to St Mary's in years, but I've been told it's improved. Am happy to ask some other Doulas for you.

UCH... hmmm... rather medicalised. I've yet to be at a twin birth or meet a twin mum who's had a "natural" experience there. Of course if the babies come early (very prem) then UCH is the best place to be.

Queen Charlottes disappointed me with the pressure to use epidural and the lower number of vaginal births. Of course the biggest disappointment was the visit from a lady with the Multiples Birth team (the name of them has gone clean out of my mind). Her opening words to my last twin mum there was "don't worry about giving them bottles. It's very hard to breastfeed. I never got on with it". Sigh...

Strangely the best twin birth experience I was at with this choice of hospital was Chelsea and Westminster. Now I sound like a moany Doula, but I wasn't impressed with C&W BUT my client fought to have a natural birth. She refused an epidural, refused continual monitoring and moved around a lot in labour and got to 10cm fairly quickly and was completely relaxed in it all. She compromised and agree to give birth in theatre but specified having the minimum number of attendees and NO students. She couldn't persuade them to let her into water (her subsequent singleton was born there in water and water was definitely her preferred choice). The Consultant and Registrar who were with her for the birth of the boys applauded her for standing her ground and getting a natural birth.

So far the best twin births (apart from the C&W one above) have been at the Homerton and the Whittington. You would still have to put your foot down about the epidural whilst reserving the right to change your mind in labour.

Here's Mary Cronk's website where she talks about twin guidelines.

You can also read the aim's site for more information.

I'm happy for you to email me mars at mammydoula dot co dot uk if you'd like.

It comes down to what you want, the position of the babies and how much of a "fight" you are prepared to put up. Of course the best scenario is an understanding Consultant. Of course Consultants tend to have seen more than Registrars who are incredibly conservative when it comes to birth.

hth

MarsLady · 21/05/2010 20:19

Oh and I forgot....

CONGRATULATIONS Twins are WONDERFUL (and exhausting, and rewarding, and double the love etc etc etc)

Bellbell · 21/05/2010 20:43

Thanks so much to you both for all these thoughts and information, I just didn't know where to look, so it's a great help! MarsLady I will drop you a line at some point on your email so thanks very much. On the choice of hospitals I'm in West London at the moment, but in the process of moving to North London hence the confusion, so the Whittington might well be an option for me...not sure how transfers work and if I'll have moved in time though it's good to know (and I used to live in Archway so not unfamiliar!)

Thanks again, and looking forward to life with twins!

OP posts:
e3chick · 22/05/2010 15:14

Hi Bellbell, I can't give specifics about the hospitals you mention but I wanted to comment here anyway as my experience may be able to help you out.

I am in East London, and was choosing between Homerton and the Royal London. Ideally my heart was with a home birth but I just didn't have the strength for that in the end.
I went to see the consultant midwife at the Homerton and have a guided tour of the unit and the room I would be in. I got the hospital protocols and looked at what they would want me to do if they completely had their way. I did the same for the Royal London where I was booked in anyway, and after much deliberation I decided to stay there.

The starting point for both hospitals was very similar. (Epidural, CFM, slightly different time limits for 2nd baby, etc. Very interventionist). At a fairly early stage I went through the protocols with a consultant to get an idea of what they were flexible on, as at the RLH the protocols were written a good few years ago so were out of date. And then I researched the rest and decided on what I wanted and what I was flexible on in order to make my birth plan.

At the Royal London I did NOT have to be in the theatre, but at both hospitals I found the larger rooms required for twin births to be very institutional and, frankly, GRIM.

To cut a long story short I negotiated use of the pool at the RLH. They agreed to me having intermittent CFM, meaning that I would have a 20 minute trace done every 2hours, so I would have had to get out out of the pool every 2 hours (but I knew it wouldn't take that long). Then I think I agreed to get out of the pool for delivery of t1 when I got the urge to push.
I was VERY firm about only having the lead midwife and another midwife in there and for all updates and discussions about my progress to the consultant to be done outside of the room.
What else? Oh, yes, T2 was breech. Initially frank breech but after t1 was delivered her feet came down and I think she was flexed. At the RLH they are a lot happier about breeches for second twins and they will not section, but different consultants have a different level of jitteryness with regards to them. The first consultant with me was quite nervous, but thankfully she went and another took over who was very hands off. Before t2's birth he said to the midwife "in these situations we find the breech births itself" so he was remarkably hands off. And my little T2 did come out very easily all on her own.
I researched the time interval between twins and found that there were different guidelines all over the place. Which lead me to believe that noone really knew what was best. I got them to let me try for 30 minutes before starting with the syntocinon, but we actually left it 50 minutes, and then I waited another hour before having my waters broken. The gap was nearly 3 hours - but I wouldn't recommend that. The separation from t1 was not nice.

I don't want to go on and on about my own labour, as that is not what you have asked for, but what I am telling you this for is so that you know that you CAN get them to compromise, don't take the first no for an answer. And as different hospitals will do different things then surely that means the risks are not proven adequately?

I found the paucity of research and information for my particular situation very frustrating and the fact that so few people seemed to have done it naturally it made my battle feel like quite a lonely one.

As well as the information Mars has given, google a woman called Karen Gromada. Link here. She has a draft birth plan which is good for helping you think about the issues in the articles page. She also has some photos with breastfeeding positions for 2, but I found that a bit scary antenatally!

Congratulations, there are plenty of healthy normal twin pregnancies so try to enjoy yours and not let the worry mongers get in the way.

MumNWLondon · 23/05/2010 17:28

I know nothing about twins but I transferred my care to the whittington at 34 weeks and they didn't seem to care that i was out of area... you could probably transfer there without waiting to move. if you are in west london i doubt its that much further than the RFH.

i would recommend calling them to discuss before you transfer your care - i did this as i wasn't happy at the RFH and they were happy to have detailed conversation on phone about what was realistic etc before i committed.

Bellbell · 26/05/2010 08:59

Thanks to all for all this helpful advice and for sharing your own birth experiences of twins. It's very helpful and reassuring.

OP posts:
SelinaDoula · 27/05/2010 12:05

Hi Bluebell,
I was a Doula at a twin birth. She had the babies in a MLU, used the pool for the first stage and did not have continuous monitoring, or an epidurao.
Info here-
www.magicalbirth.co.uk/6.html
Selina

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