Monday, March 2, 2009

First OB Visit

I went to meet with my OB as I planned to see him for my first prenatal apt prior to getting a referral to a midwife. I really had a very holistic mindframe for what I wanted my next birthing experience to be like. Not being strapped down on my left side all throughout labor. I wanted to have freedom of movement. Northwestern Memorial Hospital and West Suburban Hospital both offer appealing options in that respect working with midwives. 

My OB is a funny guy. Late 40's, frat like guy. Says, "I can give you a referral to a midwife, but you have to promise me you will come back to me after the birth!" I agree to which he states, "We're square" and offers me his fist to punch back. 

We go through all the basic questions. Urine test confirmed the pregnancy. No planned u/s at this stage. I tell him my last experience, as far as duration of labor. In general he concludes, "Wow, you are really healthy" and pronounces me "low-risk" and is set to deliver the referral. But I really want to see that heartbeat and ask if an u/s is possible to confirm the pregnancy beyond a urine screen.

He agrees and I get set up in a new room pretty quick. I sit there anxiously. Finally I will have a view of what has been happening inside. I am nervous, b/c I had cramps the night before, odd pangs. I want to know if the baby is ok, and in the right place.

He comes in and starts the process. I look at the images confused, there is a weird line making me look like swiss cheese. "Hmm, wow, it is a good thing we did this." I feel dread--the baby is not ok? "You are having twins!" I look at the images, shocked, and cranning for a view of the babies. I felt floored, and yet, I felt like I had known. This pregnancy had been feeling so much more intense and exhausting prompting my husband to say on multiple occasions, "This baby will be harder, it is already giving you a hard time." I asked my OB, "Are they ok? Are there heartbeats?" "Oh yeah, they are measuring small though, at 9 weeks" (I was 9w6 days by my calculations). It is too soon to hear the heartbeat and the images moves to quickly as he scanns around that I don't see flickers, but I ask 2 more times and he confirms they look ok. At this point, we can't tell if they are fraternal or identical.

The remainder was a whirlwind. No longer "low-risk," I changed my mind about my referral for a midwife, despite him offering, and chose instead to work with him. My OB states they take an "aggressive approach" toward twins, inducing by week 38 if the twins have not yet come. He also reiterated that he respected my choices to have a natural childbirth, but that with twins he must "do what it takes" to protect the babies. I felt comforted by the practical approach of modern medicine. Whatever it takes, I want my babies to be ok, and suddenly all my concerns about epidurals or c-sections were out the door. I don't care how they come, I just want them to be ok. 

The follow up for now is a first-trimester screening with a geneticist to evaluate risks for defects such as Downs. I am not anxious about this, as it is only probabilities and it would not change the outcome. It is scary, all the risks, but I am healthy and had a good labor previously, so I will hope to be in the majority that deliver healthy babies as close to term as possible. Hopefully at the next u/s I can hear the heartbeats and both babies will be doing ok. Until then, mums the public word, sometimes twins appear, but don't always stick around.

Meanwhile my husband is convinced there is a third hiding out. Let's hope not for now. Two at once will be enough to work with!

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