----- Original Message -----
Sent: Thursday, October 04, 2001 10:36
PM
Subject: Re: twins
Hi Jan
Your comments in regard to twins
is a dilema I am faced with in a very personal way. My very precious niece
had just joined our local team midwifery program and her excitement was
great. Much to her delight she now finds she is having twins, unfortunately
I practice in a low risk unit that excludes her from midwifery care. I
am so loath to advise her to attend the mainstream clinic for fear of the
fear that seems to be generated from various medical officers. I purchased a
video from the multiple birth association at the acmi conference in
brisbane, imagine my horror that the first birth is a c/section and the so
called "normal' birth is a ventouse delivery in a private hospital with
midwifery care being alluded to in a very minor way. Can you suggest
any reading material or videos related to twins, to support this beautiful
young couple in deciding what the best options are for them. I am
really trying to give them a realistic picture of what is possible with each
option. I have floated the home birth idea but would also like to
think the "system' could meet their needs if they chose that
option.
Does anyone else have an
ideas? Thanks Marian
Hi Marian
There is a great up-to-date book (probably available through libraries if
your niece does not want to purchase) called MOTHERING MULTIPLES -
Breastfeeding & Caring for Twins (or more!!!) by Karen Kerkhoff Gromada -
La Leche Leage International Revised Edition. This is a good book to help your
niece focus on her future life with twins.
Provide your niece and her husband with as much information as they can
digest.
Current evidence will help empower them when negotiating their birth
plans with any health professionals involved in their care.
Make sure your niece understands the necessity for additional rest
towards the third trimester and that she makes arrangements to get it! Can
other family members or friends pitch in and take over some of the household
chores for her after she gets to thirty weeks? She increases her chances of
getting the babies to term if she can achieve a rest period every day.
Establish the whereabouts of the local multiples group and give your
niece the contact details.
Drag out your midwifery textbooks usually and all the 'twins' articles
you can find in Midwifery Today, MIDIRS current journals, etc. All the
twin birth stories (thoses with great outcomes along with the not so
great outcomes) should be discussed and understood.
Help the couple write their birth plans and make a copy to present to the
consulting obstetrician.
If your niece does not want to use drugs during labour and wants to stay
upright she should put it in writing and discuss this with the attending
obstetrician during pregnancy.
Having a written birth plan will help negotiate the type of labour and
birth care she desires. She will also be better equiped to decline offers of
unecessary intervention as well as accept and understand the reasons for any
necessary ones.
The couple will do better if they have a midwifery advocate during visits
to any attending medical officers. Perhaps that person could be you and you
could follow them through and be their support person during labour as
well.
If this does not sit well with you there must be some local midwife who
you would trust to provide advocacy for them in a similar fashion. Continuity
of care (apart from any others involved) will do wonders for the birth
outcome. I am looking forward to hear of your niece's progress.
Jan
--
__________________________________________________________________________
Jan
Robinson
Phone/fax: 011+ 61+ 2+ 9546
4350
Independent Midwife
Practitioner
e-mail:
<[EMAIL PROTECTED]>
8 Robin
Crescent
www:
midwiferyeducation.com.au
South Hurstville NSW
2221
National Coordinator,
ASIM
__________________________________________________________________________
