good luck shazza, although I am sure it will be fine and you won't need it!
I met up with the King's MW (wife of my colleague) last night ... I left shell shocked to be perfectly honest. It is good to be well informed (well, that's my opinion anyway), and it was really good to speak to her, but my goodness, I am still processing all the stuff she told me ...
We started off with talking about twin births and I told her about the awful description in Lesley Regan's book. She then said that they were a bit more relaxed at King's (re the 30 minute deadline on getting no 2 out), but then we started going thru the process of giving birth and we ended up with 'well, not really that much different then ...'. She said that with twins you are more likely to have 'uneven' contractions. With a singleton the uterus has a nicely shaped baby to contract aroudn, with twins it is a bit more of a mixed bag and the uterus often struggles to contract properly. This means that labour is not progressing properly and you will be put on a syntocin drip. She said, not as a MW but as a person, 'get an epidural in place before you go on the synto'. The contractions on a synto drip are god awfully painful. Then, research has shown that as soon as you have an epidural your chances of an assisted delivery (that means forceps/ventouse to you and me) increase. An assisted delivery also means increased chances of episiotomy (cut). So that's twin one done. ;-) Second twin, she said generally comes down on its own, it takes a while for the uterus to take on its smaller size and get contracting properly, so they don't have a 30 min cut off, but you should sort of get it out in 2hrs, max. What happens from here depends a bit on whether the waters break immediately or later, when baby is more engaged. If waters break and baby gets cord wrapped around its neck then obviously this is a risk and they will want to take it out asap. She said that this is not specific to twins but a risk for singletons too. She said it is likely to need synto for no 2 too, but that it is not that bad for no 2 because you are already well underway IYKWIM.
Pool birth not possible, some consultants will allow you to, but you'd have to get out of the water to get monitored every 50 mins for 20 mins, so sounds more trouble than it's worth.
The constant monitoring doesn't mean you're stuck on a bed, but you are restricted in moving around, you can move aroudn the bed, different positions etc, but you can't take the machine for a walk ;-).
Then she also told me about other risks of c-section that I didn't konw about, such as that it is often difficutl to get twin 2 out, resulting in dislocated shoulders etc.We talked a bit about that for preemie babies vaginal delivery is best and why.
She said that in the end I need to be happy and comfortable with my choice of birth. She also told me, which was nice, that I should believe in my body, being able to do this, and that I would not have fallen pregnant with twins and carried them this far if I wasn't able to do this. I didn't tell her a woman got me pregnant, but i guess it is still true that I did carry them this far.
Then she told me to start expressing already, when pregnant, in wk 36 and get a couple of sweeps booked in! What?! The expressing bit made sense, get the system up and running so that it is all ready to go for the twins. She also said that twins often have low blood sugar so to have a batch of colostrum in the freezer is not a bad idea. Turns out you keep on producing colostrum until you give birth, you don't 'run out'. On the sweeps thing she said 'you really have got quite a small window of opportunity to get in to labour unaided'. Me: 'Panic. I thought week 38 ...' She then went: Ah, no, they will want to INDUCE you in week 38. So you would want to give birth in week 37. Which means expressing / sweeps in week 36. Bloody hell, I just lost 2 weeks of my pregnancy there! I don't know why but that bit shocked me the most. (they want twins out in wk 38 because of space issues and deteriorating placenta)
Another good bit of advice was to stay at home as long as possible. You don't need to go in the hospital at 3 cms dilated, you can stay at home as long as you like. She said that often the adrenaline of coming in to hospital slows down contractions and it takes a good while before they are back to where they were. I asked whether it was not dangerous to not go in to hospital immediately. She said that the advice is to start monitoring from 3 cms (I think it was 3 I can't remember now, but there's this 'formula' so many contractions per minute lasting a particular time) but lots of women come in not knowing they are already 7 cm dilated and they are not monitored, and are fine.
She also told me that 9 out of 10 women have trouble breast feeding, and that is not painless, despite what NCT tries to tell you. Another reason to get expressing sooner rather than later. I didn't realise it was so many though! Blimey! Read up on anything BF beforehand!
I feel more confused now then I did before! But it is still good to have the info and practical tips on the expressing and sweeps. I need to process this all and let it sink in.
Ah, I also asked her her opinion on hypno birthing. She definitely thinks it helps, for the right person (ie control freaks - that's my interpretation anyway!;-). It requires quite a lot of prep antenatally to get the techniques down. She did say to (despite what the hypno people say) is to learn all the techniques etc, but then to completely leave it alone for 2 weeks before giving birth. She said that some women stress themselves out trying to apply all the right techniques etc, and then panic when it doesnt work.
Sorry for the long post. And apologies if I scared the shit out of you now for giving birth. Remember it doesn't have to be this way, this is just the twin thing.
My mother gave birth (obviously) and always said she never understood what the fuss was about. She didn't think it was particularly painful or dreadful. Hopefully this is hereditary!