Delivery in the Operating Room

Definately worth it to me. My first 2 children both came into the world with 2 pushes each. I can't imagine being pushed down the hall just to push: seems like a waste of time and energy to me! Expecially when you have the intense urge to push the babies out so you can finally see them. I want to bring them into the world in a nice calm home-ey delivery room not a cold, bright, sterile-looking operating room. I'm happy to say my new Dr. ensures me if baby A's head is down he will let me deliver in L&D room #1 (which is right next to the OR.) He's worked with lots of twins and is confident in turning little ones in the belly so as long as Baby A is head down he says he should be able to get baby B to move if necessary. The 2 support people was also a big concern of mine so hopefully all will go well so we can have another calm comfortable delivery. I'm glad to see somebody else felt the same way as me; as I got lots of crap from others saying its the best thing for them to be in the OR. I really believe in a women's natural ability to give birth and I've been there and done it. So as time goes along we'll see. Thanks for your support

 

Gee, dozens of people taking time out of their day to answer your question is "lots of crap"? Nice. <_<

 

That's a really good point. Just because you are a few doors down from the OR in a L/D room doesn't mecessarily mean that the OR will be available if it isn't set aside for your delivery.

As far as the OP, you have to decide what is really important to you and then pursue it. I'm much to big of a worrier so it would have never settled well with me to deliver in a L/D room. I had a c-section anyway, so it didn't matter in the end!

 

Since this is a hot discussion, I'll throw my hat it. For those willing and able to have a vaginal or even drug-free twin birth, it really might be preferable to be in a regular room. A skilled doctor will be able to foresee most problems in time to get you to surgery, just like they are for singletons. And pushing? When it's time to push, you want to do it, not wait to get wheeled down the hall. I wouldn't have wanted to deliver on an operating table. I needed to be upright.

Yes, the OR setting is chosen in an abundance of caution. But if you make a vaginal birth harder and harder on the mother, you're setting up failure.

I have no end of respect for those mommas who manage an OR vaginal birth. They fight an uphill battle.

There are lots of things to weigh when making these decisions, and it's a lucky twin mom who has the option of choosing means of delivery. But birthing in a L&D room is right for some, and is a legitimate choice which is getting more and more rare.

 

Eh, "lots of crap?" Tell that to someone who has almost died on the operating table delivering. You just don't get it, until you've been in that situation. I pray you get your easy pushes, like before... and don't ever have to face such a dilemma. Any woman should be so lucky

 

With twins???? It is sooooo much different when there are 2 babies lives at stake. Like I said I labored/delivered in the same room and it wasn't an OR. However the room was so small they had to take my babies to work on them bc of their prematurity and I was left in the small homey L/D room. Horse ****...while I loved my birth (mainly bc it was my babies), had I been in the OR there would have been more room and I could have watched while they worked on them. Not have to get in a wheel chair after not eating for 24hrs+ and vomit into my blanket bc I needed to be with my babies!

 

I haven't given birth yet, but personally think that this is an inaccurate statment. While a skilled OB will be able to predict and make assumptions about baby A before your start pushing, the game changes completely with baby B! This is why there are so many extra precautions. It takes very little time for a baby that looked fine to go into distress or get into a position that is not conducive to a vaginal birth and when there's a situation where that baby needs to come out within a minute or risk disability or death than I think being in the OR is very worthwhile!

Also I think it depends on where you deliver what kind of bed/table you deliver on. I've been told that while I'll be in the OR that I can deliver vaginally in a regular bed or whatever, and then if the c-section was necessary that I'd be just moved over to the operating table.

I think we all need to make sure that we are thinking about our babies and not ourselves when it comes to delivery. I have a friend who very recently had her full term baby die during delivery due to her putting her wishes for her perfect birth above the potential needs of her unborn baby. This is not a situation I'm willing to get into, so if my OB says OR for delivery then I have no issues with it.

 

I can understand where you are coming from in wanting someone out there to share the thoughts you have and to not think your ideas are completely unrealistic. I felt the same way not long ago when I posted asking if anyone had delivered without an IV or Heparin lock (with a singleton this time). Im glad that you & your new doctor see eye to eye. I hope all goes well and you have a smooth delivery!

I could be wrong, but I took her I got "lots of crap" to mean a lot of flack. A hard time. People totally not understanding her feelings or where she is coming from, why she wants what she wants etc. Not that what we were all sharing was crap. I think everyones opnion is valuable even if it isnt the one we like or agree with.

 

i am not fishing for details as i agree that i don't think it's a conversation that needs to be had and i am sorry to hear about your friend's loss, but i think it's deeply unfair to make such a vague, fear-inducing statement like the one you did above without any explanation. those sorts of statements do not help anyone make informed decisions about their pre-natal care. they only cause fear & uncertainty.

as for thinking about our babies & not ourselves when it comes to delivery, that's exactly what i was doing when i pushed for an unmedicated vaginal delivery. without a doubt there are times & situations in which medical interventions mean the difference between life & death in L&D, but unless otherwise indicated, unmedicated vaginal deliveries are best for babies. that was the biggest factor in my decision.

 

Oh I totally agree with you! Personally I am also gunning for a vaginal as close to natural as I can delivery for my babies as I do believe that is best for them if there is no reason for any interventions. I will likely have an epidural prior to delivery as I personally feel that will be safest in the case that an internal version or emergency c-section is necessary, but I don't feel that whether or not I'm in the OR or a regular L&D room will make or break my experience and it certainly doesn't have any effect on the babies.

As for my friend I was being respectuful by not going into specific details, but it is just an example of a time when a Mother's desire for a natural/unmedicated/non-interventionist birth was made more important than listening to the medical professionals who have loads of experience, and how it can end badly. Somehow a lot of women nowadays think that birth is so simple and safe (and it certainly can be!) but it can also be complicated and many women and babies have paid the price over time (I'm talking about before hospital births here) and we need to be able to consider all sides and make concessions where concessions need to be made for the safety of babies and Mom. Especially in the case of higher risk birth scenarios (ie. twins) I think that the OR "rule" that most hospitals seem to have are there for a reason. Now I will say that no one should be pushed into a c-section if they do not want one, or any other interventions if they are not actually necessary...but I personally think it's a bit selfish to be so picky as to what room you deliver in if most OBs seem to agree that the risk is high enough to warrant delivering in an OR.

 

She asked if it was necessary, and most of the ladies here who have BTDT responded with their opinions.

If you want whatever is best for your babies, then it might not hurt to stop assuming so much, and take into consideration what everyone has said. The few people who say "Fine, do it, it's not a problem" are in the minority for a reason. Whether they had the world's most skilled doctors or not, they were as lucky as the rest of us.

You asked if it is common with twins, people said yes, you asked if it was necessary, and got an answer, you mentioned wanting more agreement, but I'm sorry to say that no mother of twins in her right mind, will agree with someone regarding something as important and risky as a twin delivery just because its what they want to hear.

There is a lot of risk during the delivery of twins, anything can happen, and it can be too late to do much within the few seconds it takes to rush a baby to the room next door. And, it's just as likely that nothing will go wrong. Erring on the side of caution is not a bad thing, and I think your babies will forgive you for not delivering them in a pretty room.

Think it over, and make your decision. I wish you a safe delivery.

 

Wow...some interesting posts here. My thoughts on this have already been well covered by some of the ladies.

I'm just curious to hear the end story to all this...see what happens and thoughts about it.

Of course the only thing I DO care about is those lil ones come into this world safe, and am thankful that Hospitals have policies that take the decision making away from those who are not doctors for the safety of the children.

 

Birth in America is an industry, not a skilled craft anymore. Lots of the procedures and policies OBs and hospitals enforce are done so for reasons other than the health of the mother and the babies. Like continual fetal monitoring. No study shows that it improves outcomes. It doesn't. It just increases surgical delivery.

Now, I'm not saying that doctors and hospitals are malicious. Far from it; I know many wonderful OBs and believe most doctors give what they believe and are taught is the best care. But the desire to control the birthing process and to make an inherently unpredictable event predictable comes with some side effects not all of us are comfortable with. And lots of skills are lost: physical maneuvers that better position a mother and her baby / babies but cannot be done on a supine patient, and safe use of forceps are a couple of examples.

Now, scheduling a c/s before labor starts changes the risks from the unknown to the known. Which is a personal choice. But some mothers are in the enviable position of being able to try for a birth that is ideal for our babies - a drug-free, spontaneous, and vaginal. There are scientifically known benefits if other risk factors are not present. These mothers should be supported. Maybe birthing in the OR vs. a L&D makes no difference. But it seems like one more hurtle. I'd like to see a study that shows better outcomes, not just higher surgery rates.

I'd be very surprised to meet any mother who put her birthing "experience" over the safety of her child.

And a more important final note: NO ONE, especially fellow twin moms, but including doctors, should threaten pregnant ladies with fetal death. It's the worst kind of manipulation. These choices should be made on a case by case basis, and based on science and evaluation of risk. Not emotional blackmail.

 

Well I'll assume that the last one was aimed at me...and I'd like to apologize if anyone feels like I was threatening them with the death of their baby or babies. I certainly don't wish that experience on anyone, nor do I think that it happens often with proper care prenatally and during delivery whether with a midwife or OB or peri or whoever! I just felt that it needed to be pointed out that it does indeed still happen. And it can happen in a situation where all things seemed to be going well five minutes ago...so you never know.

Totally agree with the PP about the birthing "business" and how things have really gone downhill...but I don't think that the issue we were discussing was planned c-sections, inductions, and other interventions that I do truly believe healthy care providers sometimes use more to cover their own butts than to help Mothers and babies.

The discussion was purely about whether or not it's reasonable to deliver in an L&D room vs an OR given the inherent higher risk of a multiple birth. As you said yourself delivering in an OR or L&D room really makes no difference, and you can certainly still get your spontaneous, unmedicated, vaginal birth!!! No one is saying that you or the OP or anyone else can't have that experience. But as it's often said, sometimes it's best to hope for the best but be prepared for the worst.

Anyways, I respect everyone's decision and wish us all luck in making them. There are no easy decisions and especially with all of the things we learn these days it's even harder to know what do sometimes. Personally I went through an "I think it's easier to just have a c-section phase" because I was scared to give birth to twins and scared for baby B to go into distress, but after lots of research and thinking I know that I want to have a vaginal birth and I also know that the necessary precautions are in place to make sure that everything goes just fine even if it doesn't go as I am planning.

 

"Birth in America is an industry, not a skilled craft anymore. Lots of the procedures and policies OBs and hospitals enforce are done so for reasons other than the health of the mother and the babies. Like continual fetal monitoring. No study shows that it improves outcomes. It doesn't. It just increases surgical delivery."

I could not have said this better!! A thinking womans guide to pregnancy is a great book that outlines some of these so called policies and the research behind them. I think that the medical field likes to use scare tactics alot to get things done as well as to cover their own assess. Don't get me wrong I know that their are risks as I am a nurse but I have seen alot of risks with both medical interventions and deliverying naturally.

I think that it is fine to give your personal experience but don't let your feelings on the matter get the better of you. I don't think it is fair to harshly judge this woman for wanting a natural birth in a calm environment and instead of voicing all the negativity we could respectfully respond to her decisions. Their is research that supports giving birth in a clam peaceful environment coresponds with a good birthing outcome. It is my personal practice to support peoples wishes and try to make their birthing experience as pleasant and calm as possible and I feel that staying positive really helps.

I also know from a medical point of view that sometimes things are done because it is easier or more convientent and not always because it is what is best even though that might be what the professionals say. People have the right to their feelings and we should all respect them no matter what they are without trying to use scare tactics.

Don't get me wrong I think there is definately nothing wrong with airing on the side of caution if thats what you want but the same thing does not always work for everybody. Their are still lots of women who choose a home birth and do well with it even with multiples.

I had a C section because of placenta previa and although I am very glad that my boys had a safe delivery I am very sad about how they came into this world. All I am trying to say is that this lady is just looking for some support and it is okay if you don't agree with her but we don't have to try to scare her into it either.
This is a great website with wonderful people on it and I am sure that no one intentionally tried to be rude but the thing about messages is that everyone interprets them differently so it may not come across to some the way it was meant to. Anwya sorry about the disjointed message but the kids are kinda hairy carry this morning so it has taken me a while to write it.

 

k2daho - didn't mean to direct my pissiness at you. Really, I wasn't singling any one out. I stayed away from this discussion for a while since I thought I had nothing really to add. But the general tone seemed to me to be getting scary - "listen to your doctors or else" - and I'm still furious at my OBs for threatening me with fetal death as a response to every question.

Right, as for the original point - OR or L&D - until I see the research showing improved outcomes I'm going to assume this rule is for hospital administration. When I'm in a cynical mood I'd guess it's easier to encourage MoMs to go for a surgical delivery once in the OR. My hospital has an 80% twin c/s rate, well above what's needed to be safe.

FWIW - That 80% number had me fleeing. I feel fortunate to have had a wonderful twin homebirth in my bedroom with one of the most experienced midwives in the country. Where I delivered did matter to me.

 

I think it's unfair to interpret dozens of posts sharing people's stories as giving her "flack." It's not a matter of understanding feelings. I think most of us understand wanting a birth to go one way and having it go another. Personally, I hope that the OP is able to get a birth experience that she can be comfortable with, but I do think it's rude to call all the opinions that weren't what she wanted to hear "lots of crap." She can certainly say otherwise if she wants, but that's how I take it.

 

Gena 22 - Wow 80% is an incredible rate! That would scare me too. I have been so lucky that I've found an OB who is totally gung ho for a vaginal twin birth, and has barely uttered the words c-section to me the entire pregnancy. Basically for him I can tell that surgery is really a last resort, and he's very skilled and confident in his ability to deliver both babies vaginally even if B end up breech during the delivery. I have heard that lots of twin/multiple Moms do get pressure from the very beginning for a c-section, and I find it incredible how many random people just assume that I'll be having one since it's twins. It's like it's a shock that I'd choose a vaginal delivery! Luckily for me my babies are both head down and similar in size so the vaginal delivery has as good a chance of going smoothly as any other. That being said I will be delivering in the OR and really have no issue with that. As much as I want to have the vaginal delivery, I also have NO issue having a c-section if the babies are in distress or some other major complication arises. I never thought of it either, but I really doubt that my OB would try to pressure me into a c-section once we're in the OR if there wasn't a valid reason for it.

I think part of this whole deal is really finding the right OB or midwife for you and making sure that you're on the same page from the start And yep definitely everyone is entitled to their own decisions and their own birth experience.

Ugh and I also wanted to say that I think it would be horrible to have your OB basically threatening you with fetal death...that's another one that I have thankfully not encountered during my pregnancy.

Good luck to everyone!!!

 

Oh...for sure. I agree that Hospitals find cc's easier and less complicated.

I feel that choice should be left up to the parents vs. the doctors unless the is a medical reason for the safety of the birth.

No way do I feel that a doctor should TELL you how to deliver. I just think it is a smart move having twins born in an OR...just to ba a bit safer. I commend those types of policies.

Whatever can be done to accomodate the wishes of the parents should be done I feel, but wether it is natural birth in a nice comfy room, or in an OR...I don't see the big difference. Not sure being in a nice comfy room would make the process anymore fun of comfy.

I know our OR shares a door to the NICU, and honestly...a 5 second trip to the NICU from the OR, or having stuff right there in the OR so they can work on your babies if need be can make a HUGE difference from being about 45 seconds to a minute away from a place or tools that can help save a babie's life should complecations arrive.

If I have learned anything through my exp., is always expect the unexpected. We had a ZERO issue pregnany until she thought she just had a cramp but was 10cm dialated at under 25 weeks once she just got "a check up" when she got to the Hospital.

All thoughts OR cares about how we wished, or planned for it to go went out the window.

We never once had thoughts, or felt cheated by a "normal birthing exp"(whatever that is...ha), we were too focused on the lil ones fighting. We didn't have time to feel "cheated"...and even now don't. We had a unique exp. and some great stories for years to come.

 

To me, being cheated from a birth experience was when I was knocking on death's door with my first, and didn't get to see or hold my DS until he was already two days old. Perhaps this is why I have such a different outlook on the OP's original question. To me, I know what it's like to be "cheated" from a real birth experience, and being in an OR just didn't factor into that experience for me. An experience is what you make of it, not the four walls that surround you. Just my humble opinion

 

I wasn't referring to everyone's responses as crap. I actually was referring to one individual who gave me alot of crap about not caring about my babies, putting them at increased risks, making me feel guilty for others losing their children, and being selfish with my wishes for my birthing experience rather than doing as my first doctor wanted. So I am sorry to anyone who thought that was aimed at them. When I found TS I thought it was a great site with lots of supportive people (which I still believe it is) but when one person in particular PM'ed me seemingly enraged about my birthing plan it really pissed me off. I guess I was just looking for more support. I am glad I got a lot of responses. It was nice that so many people shared their experiences with me. I was pretty surprised that so many people did deliver in the operating room but the way we over-medicalize things nowadays I don't know why it surprised me. I don't have a problem with people who share opposing opinions. Just threatening with the loss of a child is obviously something you shouldn't bring up to a pregnant woman. I am a paramedic, and I'm going to school to get my RN right now. I am aware of the risks with twins just like most twin parents are. For everyone else that thinks it's not possible to deliver in L&D with twins statistics show that babies born in L&D rather than in the OR do better. I personally believe the statistics are in part due to the "high risk" pregnancies being OR mandatory in most places now, but there is also furthur research that indicates babies bond more readily with their parents when brought into a calm environment. There are also increased risks to both baby and mom when preforming a C-Section. The only time a c-section should really be done is when the benefits outweigh the risks (ex:when saving a life depends on it) In my opinion it is crazy how people are allowed to opt for c-section way in advance now and not opt to deliver in a normal delivery room.

 

Can I ask a silly question - what makes a L&D room a more calm environment? The lighting? My experience in the OR with my first delivery couldn't have been more calm. Soft music, soft speaking, no drama at all -- it was very calm.