October 28- The Battle of my Birth Plan

So the past two days at the hospital have been rather unproductive. Ever since my last contraction on Sunday, I have not had another one. In fact, I feel rather good. The only issue I have had has to do with my OB group and not my actual health. The doctors do rounds on the floors here, so each morning a new one pops in. One from my OB group and later one from Maternal Fetal Medicine along with whichever resident Dr is working. So far I have had nothing but negativity and conflicting information from my OB group, none of which even came directly from my OB! On the first day, the doctor who came in was very short with me and had some sort of a chip on his shoulder. He proceeded to tell me that if he was the doctor on call he would not perform a vaginal birth with preterm twins. Even if they were head down! This was the very problem I thought I might have with this group, but had gotten it straightened out. This doctor was telling me that it wasn't safe for preterm babies to be born vaginally, which was a direct contradiction to what MFM says. MFM feels that vaginal is safer because there are less instances of death from Respiratory failure, as going through the vaginal canal squeezes the excess fluid out of the baby's lungs on the way out. He was very snippy and told me he would speak with MFM on the matter and get back with me. Later on when MFM came in, they reiterated what they originally told me, that going the vaginal route is perfectly safe especially if they are both head down. The only hesitation he said the group doctors may have is if one is breech, they don't want to pull out a preterm baby by the feet as the cervix could close on the baby's head. I am totally okay with that. And make no bones about it, if there is some kind of danger or complication to me or the babies I am all for a c-section. All I am asking for is the chance to try vaginal. The MFM doc told me he spoke with the group doctor who talked to me earlier and that they were on the same page as long as Baby B wasn't breech and so I thought everything was set.

The next morning I was visited by another doctor from my OB group. This time it was a woman and the first thing she did was immediately tell me I should just go for a C-section because it is easier. Well I am not going for "easy," I am going for safe and less invasive. She again mentioned that their group was not comfortable doing a breech extraction, which is really aggravating that they keep bringing up because neither baby is breech! This is all a "just in case" kind of scenario so I don't even know why they are harping on it! She reiterated that if one came out vaginal and the other was breech they would have to do a c-section on that one. I get it. Totally understand. I still want to try for vaginal as Baby A is practically dangling out of me he is so low and is head first. She said she would speak with MFM and that her impression was that they were all on the same page, but they most certainly were not. Apparently later in the day the group would be having a meeting and one of the items on the agenda was to discuss my situation, so they would be getting back to me. I knew right then and there how the meeting would go. It would be an "all in favor of a c-section" discussion and I can take a lucky guess as to what the answer would be...

Later in the day my doctor from MFM was doing rounds so he came to visit. I explained what was going on with the OB group and he said they just had an issue with doing a breech extraction but thought they would be on board with a vaginal delivery otherwise. Good because I was tired of having this conversation. I told my doc what the group doctors were saying and he once again solidified my decision by telling me there was NO danger in having a vaginal birth and that the babies would be safe and it was a lot more risky to cut me open. He said from what he understood, the only issue the group had was if the babies were breech and I agreed that if that was the case I would go with whatever was best for the twins. It appeared (once again) that we were all on the same page.

But then this morning the head of my OB group (I still hadn't seen or heard from my OB in the group as of yet) came in and was a total dick. He matter-of-factly told me that his group had a meeting to discuss my situation and the final decision was that none of them would allow for me to try a vaginal delivery unless the babies were at least 37 weeks. 37 weeks??? That is 9 weeks from now! The odds of them staying in that long are slim to none so he was basically telling me they weren't going to do it, period. And he wasn't very nice about it. I mentioned that MFM was telling me something different and he quickly snapped, "then MFM can take over your delivery." Hell, I'd prefer that! But I was worried they were leaving me stranded. He took off with a huff and I was left feeling stressed.

A little while later my MFM doc came in and right away told me he spoke with the head of the OB group. I expressed to him that I was not trying to be difficult, nor do I think I know more than the doctors, but I was just going by what MFM was telling me and all the research I've done and just wanted the chance to deliver vaginally, if and only if, the babies and I were safe. My doctor told me the group said they won't do it, that it is their "group policy," but that there was no medical reasoning behind it and they would gladly take over delivery. YES!!!!! Hell yeah! That is what I wanted all along anyway so I am totally okay with that. And to be honest, I used to feel like I wanted the same doctor to be in the delivery with me but as I have been experiencing all this pre-term labor stuff I am realizing that when it comes time to have the babies the odds of having the ONE doctor I want are slim to none. Everyone here is so nice and are on board with my plan so I feel comfortable with whoever is going to deliver the twins. And with as much pain as labor brings by that point I don't care if the janitor is the one to do it, anything to get them out of me!

So I feel much better about the situation. My OB finally called to check in on me and let me know she was aware of all that was going on and brought up what I already knew about their decision of not being willing to deliver the twins vaginally unless they were 37 weeks. She explained that it was just their group policy, that there was no right or wrong answer and I would be in good hands here. And I couldn't agree more. Now if only I knew when I would actually be having the babies!


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