Tuesday, May 4, 2010

Doctor Visit - 21 Weeks

It's only been two weeks and a day since I was seen my a midwife & had the ultrasound, but I haven't talked to any professionals (besides nurse friends and neonatologists at work) since I found out I was having twins (because my ultrasound was after my midwife appointment). I was getting tired of not having a practitioner and not knowing what the plan was going to be for the rest of my pregnancy! So today I felt like I finally got to discuss the twin situation with my new doctor. I actually went with a different doctor than I originally intended, because the other doctor couldn't see me for another 3 weeks, and I thought that was too long. Maybe I am just impatient.

So... here's the update :)

The medical assistant was able to hear both heartbeats right away. They were both strong, although I didn't get the exact bpm. The medical assistant is actually the mom of 6 year old identical twin boys! So I told her... "I guess it is possible" ;) Weight gain so far: 13 pounds.

The doctor did a full physical exam on me because I am a new patient. My fundal height is 25cm. (For a singleton delivery, the fundal height approximately matches the gestational age in cm's.. give or take a few cm's... so I think 25 cm is good for twins). And she didn't mention anything else so I guess everything else is fine :)

I am going to be seen every two weeks from now until 32 weeks. Then, I will be seen weekly. And I will be having monthly ultrasounds to check the growth of the babies. So lots of monitoring! My next ultrasound is two weeks from now. They said they are sending me to the best ultrasound tech at the clinic, because they want to get really good shots, and see if they can tell one more time if they babies are in separate placentas. (This would be the best situation as far as the level of risk). They are definitely in their own sacs within the placenta though.. so that is good. Also at 26 weeks I am getting two steroid shots, 24 hours apart, to help develop the babies' lungs in case they are delivered early. Since twins are more likely to be delivered.

Also my doctor talked to me a little about the actual delivery. (Which is exactly what I wanted to discuss!) And let me just say... my goal has always been a natural, epidural-free birth.. but that was before the twins & before I heard about my birthing options with twins. Now I'm thinking the epidural sounds preettty good, but we'll see what happens.

So, the doctor said she has never had to deliver twins with a combination of vaginal & c-section. This was music to my ears, because the recovery for that sounds pretty intense. She said if there is no medical necessity/emergency and twin A is vertex (head down), she usually tries a vag delivery. Then twin B usually is floating around in a strange position, so usually a little manipualation is needed (as in the practioner grabs the feet), and twin B is usually delivered breech. This is safe since the cervix has already dilated and delivered one baby. I asked if both babies are ever delivered vertex.. and she said it does happen if twin B rotates into that position after the first birth, but it's much more common for the second to be breech. So it sounds like I will only get a C-section if I really need it.. which is good.. but the whole manipulating the baby while he's still inside scares me a little! She said all the doctors in the practice have the same philosophy too, just in case I am delivered by an on-call doctor.

Also, she said she's only had a couple of twins that had to stay for any length of time in the NICU, but she said it was very common for one or both twins to either transition in the NICU or stay for 3 or 4 days. She said most of her twins are born between 36-39 weeks. She doesn't like them to go much further due to growth problems. If my babies do have to go to the NICU... at least I will know the staff taking care of them :)

Soo... I think that is about my entire doctor update. Kudos to you if you got through it all! :)

**On a personal note... I am exhausted today. Working the last 2 days in a row (12 hour shifts, mainly on my feet) without a lot of sleep before either shift has not been good for this mommy. I had to drag myself just to get up and take a shower today at 11:00am so I could make it to my doctor appt. Now that is sad!**


thewelchblog said...

So glad to hear an update, Krystal! I'm happy to hear you found a good doctor ;) I wouldn't have wanted to wait around either. You look great, by the way, just perfect! I know it's hard to take all of the stares and comments. I'm so excited to follow your progress as you look forward to becoming the mommy of two!

Elesha said...

awesome to read your update : )

Anonymous said...

I'm reading this years after the fact, but I'm very impressed by your doctor's philosophy regarding twin delivery. I'm a mom of g/b twins, and due to the size discrepancy (Baby B was bigger), I was told I would have to have a section unless both were head down. Fortunately, they both cooperated, and I got my best case scenario.