Can I continue to see a midwife if I'm having twins?

Can I continue to see a midwife if I'm having twins?

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Maybe. If you've been seeing a midwife for your early prenatal care, the discovery that you're carrying twins will mean taking another look at your plans. Some certified nurse-midwives will continue to work with women carrying twins, but many will not.

Even if you're young and in perfect health, a multiple pregnancy is considered "high-risk." Carrying more than one baby makes having a premature birth (delivery before 37 weeks) as well as other complications more likely.

That means you'll probably need to see an obstetrician or perinatologist (an obstetrician who specializes in high-risk pregnancies), but your midwife may be able to stay involved in your care and may even be able to deliver your babies.

Some midwives who work in hospitals have collaborative agreements with obstetricians who support and consult on midwife-managed twin pregnancies. However, some hospitals have guidelines that don't allow midwives to care for women pregnant with twins or deliver them.

If your midwife delivers exclusively at a birthing center, she won't be able to continue your prenatal care because a multiple pregnancy is considered too high-risk for a birth center delivery.

Some home birth midwives do care for twin pregnancies, but delivering twins at home is risky. A certified nurse-midwife is likely to recommend giving birth at a hospital.

If the twins share an amniotic sac or aren't growing properly, or if you or they develop other complications, you'll be advised to be under the sole care of a perinatologist for the duration of your pregnancy.

If you see both a midwife and an obstetrician or perinatologist, the three of you will need to discuss how the collaboration will work. Your midwife may be able to continue directing your care, with your obstetrician available as needed. Or your obstetrician may take the lead, with your midwife playing a supporting role.

Assuming you haven't developed any complications and you've continued to see your midwife, she may end up delivering your babies as long as they're both in the optimal head-down position and your labor goes smoothly. The birth would take place in a hospital delivery room – or possibly a birthing room – with an obstetrician in attendance, as well as the rest of the medical team that would typically be present for twins.

Even if both babies are head-down during labor, there's no guarantee that the second twin will stay in that position after the delivery of the first (although your medical team will do what they can to enhance the probability). The obstetrician will very likely take over immediately if the second twin is not head-down or you end up needing a c-section. In that case, your midwife would probably stay and provide supportive care for you and your partner.

If you decide to see a midwife, be sure to choose someone who is experienced with twins and has admitting privileges at a hospital with a level III neonatal nursery, in case of preterm delivery or other complications. Use our printable midwife interview sheet to help you make your decision.

Watch the video: 5 Signs Youre Pregnant with Twins (February 2023).

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