In a message dated 7/19/0 6:20:04 AM, [log in to unmask] writes:

<< It looks like docs who are "shepherding" the babies carefully in their
intrauterine environments,with the help of more sophisticated prenatal
testing, are more confident that the twins are strong enough to "make it"
safely with the NICU improvements now available.

Obstetricians are then more confident they can control predictable
gambles of premature delivery by elective C. Section under regional
anesthetic.

The alternative is the unpredictable gamble of  complications that are
historically more common in labor and vaginal birth of twins (such as
prolonged, inefficient labor, cord prolapse, entrapment of the
aftercoming head of the second twin etc.)

Those often require an emergency C. Section under general anesthetic for
the second twin. Few doctors now have ever had the experience of
performing either an chancy incision of the cervix, or an internal
version.

(This means using one hand inside the uterus and the other outside the
uterus to try to turn and extract the second baby, hoping it did not
suffer oxygen deprivation or worse.)

This is what U.S.doctors did 4 or 5 decades ago when there was often no
other choice. Many babies were lost or suffered permanent damage, and
many mothers sustained severe gynecological injury during such
procedures.

"I know. I was there" as the saying goes. I worked L&D full time during
the U.S. "baby boom" and watched it many times. Can anyone comment from
countries with less medical technology available?
 >>

This is similar to the excuse for doing breech births by surgical removal of
the baby. As so many doctors have lost the skills basic to providing good
care of birthing women--communication skills, broad experience of normal
birth, patience and humility, they have been replaced w/ lofty sounding words
which sound fear-based and heroic. The truth about breech births is that the
safest way to birth is vaginally, but doctors don't know how anymore. The
safest way to feed a baby is at the breast, but doctors are so used to seeing
artificially-fed-induced pathology, they don't recognize normal. The safest
place to birth a baby is generally where there is a midwife and no OB. There
is nothing in life or science which has convinced me that twin births are
"safer" when medicalized. Besides, I am always extremely leary of anything to
do w/ birth that puts the emphasis on safety as if it were separate from the
overall well-being of the mother. Safety is far less a matter of mere science
than medical doctors would like us to believe. Life itself is an
unpredictable gamble, no matter how much we want to believe medicalization
will save us from it. What I have seen for many years are the wounded mothers
whose pregnancies were "shepherded" right into pathology and have only been
able to heal their birth traumas once they have birthed w/o medical
intervention (including w/ twins). The same is true of breastfeeding--the
many mothers who have lost breastfeeding b/c their doctors and/or family
members believed (or pressured them) to take the "safe" route and give a
supplement or switch to bottles or whatever other way the distrust in
mothers' bodies can be communicated.
Jennifer Tow, IBCLC, CT, USA

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