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Recommendations for twin delivery?

Do you have some recommendations for obstetricians, birthing centers, or hospitals for a twin delivery?  An urbanMama emails:

I am 21 weeks and just found out we have having twins!  Originally we were working with excellent midwives at Andaluz Waterbirth Center when we thought we were only having one baby.  Now that there is two and more risk factors we are reconsidering our birthing options.  We are exploring options right now and would love any advice.  We still prefer to work with a doctor who would be supportive of a natural twin pregnancy or with as minimal intervention as possible.  Also, looking for doctors who have low ceasaren rates for twin births.  I think Providence and Legacy are in network for us so if anyone knows of good doctors at either place we would love to hear your input.

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I gave birth to my twins at OHSU. The facility wasn't that impressive, but I had a ton of support in having a vaginal delivery. They still required (maybe you could push on this though; I didn't) an epidural and delivery in the OR but were great. I cannot recommend Meg O'Reilly enough; she never pushed any testing on me or talked about c-sections, stress tests or extra monitoring. I have heard that Providence Portland does not do many vaginal deliveries of twins.

If you want more info, let me know! Congratulations, by the way! It's a crazy thing to find out, huh?

My recommendation would be to choose a facility with a good NICU, just in case. We had planned to have our twins at Good Sam with as little intervention as possible but ended up at Emanuel when they came early--the staff at Emanuel is great and I'm sure you could find lots of people supportive of your birthing preferences there as well, but getting babies home safely should be the main priority. Twins are not as low-risk as some providers would have you believe. We had all the rest of our kids at Emanuel after our experience with the twins--I'd never choose a hospital without a NICU again just for the peace of mind. I know a few people who delivered at hospitals without them and ended up recovering in one hospital while their baby was transferred to another--not an ideal situation!

Congratulations! What an exciting time for you!

My sister-in-law just had twins. Hers was not a low-risk pregnancy as she'd had preeclampsia with her first and then some bleeding in the first trimester with the twins. Hopefully you will breeze through your pregnancy and delivery, but if it ends up being more complex . . . she used the perinatal clinic at St. Vincent's and the twins spent a week in the NICU there. I know she loved her perinatalogist and had good care in the hospital.

i would highly recommend Dr. Lisa Johnson. she is found at the Womens Clinic, which has an office and can deliver at both Legacy Emanuel and Providence Portland.

503-249-5454

I had my twins a Legacy Emmanual this past summer. Although I had a great pregnancy,m y girls had to be in the NICU for a few weeks and I highly recommend LE. Ended up having to have a c-section because twin A was head down, but my Dr. was open to all options. Her name is Lara Williams and she is with everywomens health. I was happy with her. Definitely plan on deliverying at a hospital with a good NICU. Hopefully you won't need it, but alot of twins do.

I had my twins at Legacy Emanuel and also spent 8 weeks on bed rest there from week 24 to 32. The staff is amazing and the NICU is the best there is in the area. I had a host of doctors that I saw at Legacy Center for Maternal-Fetal Medicine: http://www.legacyhealth.org/body.cfm?id=522. I highly recommend Merrill and Coleman. Although many twin pregnancies are free of any complications, others are not... I credit the above mentioned doctors for saving my twins, which were almost delivered at 24 weeks, and enabling me to make it to 35.5 weeks and deliver near-full-term healthy babies. I did deliver c-section, as baby A was much smaller than baby B and they thought it would result in a vaginal birth for A and c-section for B. Point being, how you deliver will come down to what's best for the health of you and the twins. Congrats and good luck! Twins are the best and you will be awe struck by their amazing bond.

I had a natural VBAC birth at St. Vincent's using a midwife (they are ALL awesome there, my favorite 2 are Christine Barlow & Helen Welch) Here is their website: http://www.whallc.com/staff/index.htm
This was a nice combo for me because I was given midwifery care (never rushed or made to feel like I was crazy to want to have an all natural birth following a C-Section, I'm sure with twins you will be pressured to have a section with an obgyn) and I was also in a setting where if I had needed medical intervention, it was available to me. I know that they will do a new patient interview and it is certainly worth checking out! The hospital isn't the nicest in the area, but my treatment was great, the food decent enough (and you can order up as much as you'd like, whenever you'd like) and the midwives and nurses helped to make my experience wonderful. I also had a doula who played a tremendous part in my experience. Her name is Jill Fransen. She has a website: http://www.webroots.com/doula/
Best of luck to you and congratulations!

I don't have any experience with twins, but with my second pregnancy my water broke at 32 weeks so I was in the hospital on bedrest, then had an induction. I delivered at Legacy Emanuel and my girl spent a week or so in the NICU.

I highly recommend my ob-gyn practice, Everywoman's Health, and most especially my doctor, Dr. Ribbink. Despite the stressful situation and uncertainty, she was great about including me in decisions and giving me information and recommendations without forcing a particular course of action on me. It was a much more medical birth than my first, and more medical than I liked, but at least I never felt it was out of my hands. And despite my daughter's early birth, she was delivered onto my tummy and all that good stuff. The NICU there is a good one though never an easy experience, I suppose.

Another great experience at Emanuel and with Everywoman's Health. I primarily interacted with Drs. Holzman, Kehoe and Suriano who were all great. My babies were both breech, so a c-section was required for me (done by Dr Holzman, who was awesome!), but my doctors were supportive of letting me wait on the c-section as long as possible.

My only negative at Emanuel is that the hospital was not terribly supportive of my doula. I had hired her before I realize a c-section would be required, but I still really wanted her to help with breastfeeding early on. However, she was not allowed to visit me post-op until I was in recovery - 4 or 5 hours later - by which time I'd already initiating breastfeeding on my own.

It sounds like OHSU is not on your health plan, but I just wanted to put in a plug for them overall. I had both my children there. The OHSU perinatologists were the most kind, warm, supportive group of doctors I have ever dealt with throughout my somewhat complicated (singleton) second pregnancy. With pregnancy #1 I ended up with an emergency C-section after a long labor with the midwives, and I could bring any one person into the OR that I wanted--I chose spouse over doula, but my doula was there with me after I came out of recovery, which was very quick, and my midwife, who was also in the OR, initiated breastfeeding with me immediately in the recovery area. Also, the mother-baby rooms have a beautiful view!

I delivered at St. Vincent's. Not twins, but it was a high risk pregnancy so I was seeing their perinatal department constantly. My after care was fabulous, the nurses were awesome, my perinatologist (who wasn't there for my delivery) was fabulous, but my delivery experience was barely OK. I think the doctor that delivered my son was a newby, and actually made me WAIT for over an hour between being fully dilated and pushing (I had an epidural, thank GOD, but unfortunately didn't know enough to speak the hell up for myself to get things moving again). He also instantly wanted to do a C-section as soon as he heard about a semi-rare uterine anomaly I have... I could see the medical student curiosity light up in his eyes and the nurse actually told him to hush. Oh, and he didn't offer my husband the opportunity to cut the cord he just did it himself before we even knew it was happening, even though we had said previously that he wanted to. Um, anyway. I doubt that's the usual and have heard great things about their L & D. Having the peri dept. plus their NICU was a huge deciding factor for us.

I delivered vaginally and had a c-section at Emanuel. Highly recommend the hospital. I also recommend Lisa Johnson. Great doc, great organized office! I liked all the partners, as well.
Every Women's health....some good doc's in the practice, but they have communication problems...I experienced it 1st hand. The office is very disorganized.
Good luck and have a happy and healthy pregnancy and delivery!

Someone already recommended Women's Healthcare Associates and I have to second that. Specifically Christine Barlow and Kate Pelosi. While I didn't have twins they were incredibly supportive of all my decisions. Appointments were AWESOME and I never felt rushed. I delivered at St. V's which has great L and D rooms but pretty meager post partum rooms. However, the staff is great and I would definitely deliver there again. Good luck with your babies!

Philippa Ribbink is great. She posts her philosophies on her webpage. She was recommended by my Internist and I think she delivers at Emanuel Children's Hospital and possibly Providence Portland.

http://www.everywomanshealth.org/Practice-Philippa.html

First congratulations! I will be much better positioned to speak to your concerns in just a couple weeks as I'm 35+ weeks pregnant with twins. But wanted to counter some of the above assumptions that OBs will pressure you to have a c-section with twins. I originally planned to work with the midwives at Providence but once they found out I had twins I was advised to go elsewhere. I asked for a reference for an OB with twin experience and have thus far been happy with my Dr's (Dr. Brendan Carroll) attitude towards delivery and have felt no pressure towards having a C-section. While the last stages of delivery will be in the OR (at Providence) as a precaution...my Dr. currently treats a C-section as an afterthought and the default setting is for a vaginal birth (fortunately both babes are heads down). So we'll see what happens at the time of delivery. You may want to join the local multiples club (http://www.fullhousemoms.com/), I'm sure you will get all kinds of advise about doctors if you post your inquiry there. Good luck!

I am having twins in a couple of months and though I am in Kaiser (and thus my options for docs and hospitals are more limited) I suggest you definitely advocate for what you want.

I have talked a lot to my doc (herself a mother of twins who delivered vaginally) about options - especially if the second twin is breech. Some docs won't (or don't know how) to help turn a baby and will just want to do a c-section. You can (ahead of time, but also in labor) ask for the back up doc if the first doc won't help you try for a vaginal birth.

Also - most hospitals require that twins are delivered in the OR "just in case". The general rule is you only get one person in with you, but once I asked I got the okay to have my husband and doula with me.

The big thing is: talk about and ask for what you want BEFORE you go into labor. This is definitely one of those times when pushy is good.

I HIGHLY recommend Dr. Jenna Murray. She's a part of the Bridgeview Practice out of Good Sam. She is amazing. She is very supportive of mother - and father's - wishes and has incredible bed side manner.

I have worked at Emanuel and would recommend it to someone who wants a twin birth. Giving birth in the OR is something that may not be negotiable, even the most supportive physician of vaginal twin births may have had a scary enough experience with a seemingly normal delivery to feel safest in the OR just in case the second baby needs extra help coming out. Make sure your provider feels very comfortable with breech extractions. There are definitely some out there and they will tell you their thoughts. Its yucky giving birth vaginally to one and having a cesarean with the second- sometimes the safest thing to do but twins are often small enough that a vaginal breech extraction is safe.

I had twins in March 2008, difficult pregnancy, best rest from week 16 on,,,Dr Phillipa Ribbink is awesome,,,I trust her with my life and the lives of my boy and girl,,,excellent Doctor with vast knowledge and a most superb bedside manner. Treats you as a member of your own health care team,including your opinions and preferences while keeping you completely informed at all times. I can not recommend Dr. Ribbink enough,,,,,

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I had a singleton, but Dr. Desiree Bley at Women's Health Today delivered our daughter after a long labor; most docs probably would have "called it" rather than letting me deliver naturally. And Dr Bley has twins herself, so not only is Dr Bley open to supporting someone who doesn't want interventions, she would likely have lots of good advice for mamas of twins.

I highly recommend that you stay with the midwives at Andaluz. I had my twin babies with some midwives from Andaluz Waterbirth Center and the experience - from prenatal care through labor and well into post-partum - was on the whole extremely good. I believe that I and my babies were both safest and best treated by my midwives. When I discovered my twin pregnancy, I was at first inclined towards finding an hospital that would allow me an untethered (by IV or anything else)and un"managed" labor. I was not able to find a single birth ward willing to allow this. In the process, I found that the usual response to either baby being breech at the beginning of labor is to deliver via major abdominal surgery (affectionally called a "cesarian"). In fact, very very few doctors here have any experience with vaginal delivery of breech babies and very few insurance companies or hospitals are willing to allow it. My midwives at Andaluz have experience with vaginal or "normal, physiological" birthing of breech babies, and I believe their experience and competence to exceed that I would have been able to acquire in any of the hospitals in this area. Once I had done my research on outcomes and interventions in hospital, and considered that I was mere minutes from the hospital should a real medical emergency arise that could not be completely handled by my midwives, it was clear to me that it would not increase my safety level to give up birthing naturally at my own home, rather I and my babies would be much better off. And, to boot, we would be treated with gentleness and respect, which is something I was not finding in the hospital community.

oops! Sorry, I must ammend my post and add one thing - I was told at my hospital than if either baby is breech then I would have a cesarian, but I did find that some other hospitals (e.g. OHSU and Legacy Emanuel) will allow a vaginal breech birth of the second baby, if the first was vertex, but only for some few cases, and only in the Operating Room - probably with an epidural in place.

If anyone has had an experience to the contrary, please let us know!

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