Delivery in the Operating Room

My doctor mentioned having me try for a vaginal delivery, as he knows that is what we want.. But he seems to think that we should deliver in the OR in case something were to go wrong. I want whatever is best for the babies but it just seems a little ridiculous. I would assume it wouldn't take much longer to get me to the OR if it were absolutely necessary. I guess I am just wondering if this is common for twins??

 

My hospital has a new L&D wing, and actually it is their policy that if you are having multiples, you must deliver in the OR, regardless of delivery method. This allows them to quickly respond in case you must switch over to C/S.

 

It's common for twins. The regular delivery rooms are not set up for 2 babies. I delivered vaginally in the OR with no problem.

 

It is standard procedure to deliver in the OR for twins.

 

Here you delivery twins in a regular birthing room, but there are two teams in there with you. The OR is "ready" for you if something were to happen. I think it is because the birthing rooms are so much more relaxed and less "hospital like" :lazy:

 

Same as my hospital. :good:

 

It's policy at our hospital too but since it was late at night and the OR was ready, I delivered in a (bigger) regular delivery room. They had 2 teams ready for the babies

 

Same in my hospital. Had a very uncomplicated pregnancy and birth (though with breech baby B) but delivered in an OR just in case ...

BTW, they didn't move me there until I was 9 1/2 - 10 cm dialated so it's only for the actual birth not the birthing process.

 

That was the rule at the hospital that I delivered my girls.

 

Yep, standard delivery for twins (and mandatory) at my hospital as well.

 

It was policy for me and I was glad to be in there. Doctors can not predict if something will go wrong, especially in twin deliveries, and they have you in there in case of an emergency c-section. From what I was told, problems usually occur with the second baby because after the delivery of the first there is a chance that the second could fall over and become transverse making it impossible to delivery without c-section. Also if cords become compressed, etc, and fetal heart rate declines, then emergency c-section is necessary..so being in an OR is just to facilitate quick delivery in case something goes wrong. Twins are high risk, even though everything seems perfectly normal, no one can predict what may need to be done.

 

Yeah, that was the standard where I delivered as well. My OB almost let me do it all in the birthing suite, but we found out that Baby B had flipped to breech at 38 weeks. But, he mentioned the possibilty of staying in the same room as I was being induced and he started the u/s to see their positions. Like some of the other pp's, I labored in my room until I was fully dilated and then I was taken back to the OR. I can say it was a much different experience back there delivering than it was with my oldest, but I was willing to do whatever was needed for a safe delivery.

 

I'm not sure if it is the hospital's policy or if that was just what my doctor wanted. I will have to ask about that. We really wanted a home birth, but being that they're two of them now we decided they should be delivered in the hospital. I still really feel that is unnecessary to deliver them in the OR, even if they do wait until you are fully dialated. I was hoping to hear a lot more people telling me that they were allowed to give birth in the labor and delivery room.

 

I think if you think about the risks though if your babies or even just baby B goes into distress then the few minutes it would take to get to the OR and get prepped could mean the difference between your baby (or babies) living or dying. I don't think it would be such a common policy if there wasn't a good reason for it.

 

This is the policy at the hospital that I delivered at too. We ended up with a c-section for multiple reasons, but after being in the room for all 3 of my SIL's deliveries at the same hospital, there is no way that the number of people who were there for my delivery could have fit in one of the regular suites even though they are fairly large. FWIW the regular rooms are probably at least a minute run from the OR where my boys were born and that would be not pushing a bed with a woman in labor and baby or babies in distress. Sometimes that minute counts a LOT.

Once we were in the regular room after delivery, it was difficult for everyone to fit even when they were checking the babies etc. since there were always med students or residents with the doctors. (I also think this is becasue I delivered on the first day of their rotations so we were quite the celebrities and for all 3 of the residents we saw, we were their first twins)

You will have to do what feels right for you, but know that what your doctor is suggesting is a very common practice.

 

I also delivered - vaginally - in the OR. I was fine with it.
In an emergency situation, the doctor may literally only have a few minutes to get the baby (especially B) out safely. And like others have said, between the doc, nurses for me and nurses for the babies, there is no way we would have fit in a regular delivery room.

 

Wow, I am shocked to see that most places require even vaginally in the OR. My hospital has 2 different delivery rooms. Several regular and several HR ( high risk). I was in the HR room but its identical to the regular ones just maybe a little bigger and its down the hall further and closer to teh OR. I had the nurses and dr and 2 NICU teams in there with 2 heaters ( one was brought in once I was in full labor) We all fit tightly but it was done

 

It sounds like your hospital was designed for this. In a lot of hospitals, the birthing rooms are NOT really close to the OR and not big enough for the necessary teams of people. My DH actually does a lot of architecture work for hospitals, and I think that this sort of thing is becoming more current in the designing.

At our hospital, they had just built a new tower with GORGEOUS, HUGE L&D rooms, but no go. All high risk patients (which means all twins) had to labor in the old L&D rooms because they were much closer to the OR, and I would have had to deliver in the OR (as it ended up, I had a c-section for failure to progress, so I was definitely in the OR!). It doesn't really matter, I don't think. It's hard/impossible to talk them out of monitoring with twins (I had two heart monitors for them and a contraction monitor, and if I moved they lost a heart beat. Plus, my blood pressure shot up to 190 over 120 during labor, so they were monitoring that. Plus, I had an IV for antiobiotics (group B strep) and pitocin. SOOO, it's not like you are laboring on a birthing ball anyway.)

 

The other posters posted great comments, but I just wanted to add 2 more:

1. You will likely labor in a regular room, but move into the OR (or C-section room) when you're 9-10 cm dilated. They don't want to tie the OR room up with a patient sitting in labor for 8-9 hrs, when there may be emergency Cs that need to be done.

2. The C-section room is larger to accomodate 2 teams of nurses for the babies. I see some ladies said they had larger L&D rooms to birth in. Not many places have those, so it just makes sense to have it in a larger room.

 

Great point. There were so many people in the OR with me there would have been no way they would have all fit in the regular L&D room. I had 11 people in the OR counting my DH..no way they would have all fit in that little room.

 

I also delivered vaginally in the OR, but as it was a planned double breech vaginal (breech/transverse presentation) I was really glad to be ready to move into high gear if needed. In fact they put the epidural in when I was fully dilated, just to have that line in place (rather than general anasthesia), so while in the hospital I labored in triage and the recovery room and then delivered in the OR (things moved REALLY fast for me though Good luck with your delivery!!

 

You might want to get details of what the birth will be like.

I had a completely drug-free birth with my DD, no IVs, nuthin' and loved it! I expected to do the same thing this time around but after talking to my Doc, I realized that I will need an Epi and that the birth experience could be much different. She explained that I could do drug free but if something were to happen, I would be knocked out for a quick delivery. I am not willing to miss the birth of my babies for a medfree birth.

She also explained that I will labor in a room and be moved to an OR for delivery and that it will be like a "three ring circus" compared to my DD's birth. There will probably be about 15-20 people in the room because each baby requires their own set of nurses and then there is my Doc, a midwife and other staff around as well.

I admit, I was bummed out that it was going to be so different because it was not what I intended when I found out I was pregnant but luckily, just like prepping for my DD's birth, I have months and months to prep for the birth of my boys too and I have embraced it because I know it is what is best for them. I really love the hospital and the Dr's in the practice, they are well prepared for a twin birth and are very supportive of my wanting a low-grade epi so I can feel the pushing.

 

I was sent to Seattle from AK to deliver and they said it was policy that multiples be delivered in the OR just in case. My twin A was delivered quickly and smoothly vaginally but my twin B was up really high and presenting hand first so she had to be delivered by emergency c-section. I'm glad they had that policy because it allowed them to get her out quicker.

 

I also delivered my twins vaginally in the OR with no problems.
I labored in a regular room until I was fully dialted and then off we went. We were there long enough to have the babies and then back to the regular room we went again
If I can remember everyone that was there we had:
me
dh
the doc
a med student
2 L & D nurses
2 nurses for each baby
2 pedis (1 for each baby)
anesthiologist just in case

so about 13 people? To me the OR was just another room only it had mirrors so I could see 'down there' the whole time!

 

Totally a safety precaution for you and your twins. This is in case you have to have an emergency csect

 

My hospital does all multiple deliveries in the O.R., just to be safe.

 

It's also just the number of people that need to be in the room for twins vs singleton delivery. I had two OB's (my regular one, plus another dr from the practice) a couple of nurses, the ped was standing by, probably some pediatric nurses, I don't remember. But there needs to be a "team" for each baby. What if Baby A came out fine, but Baby B got stuck and the OR wasn't available? I don't know why it's so objectionable to deliver in the OR.

 

Yes the amount of people in the room is phenomenal. Esp if you deliver early and the hospital doesn't have a NICU like in my situation. So we had Nurse, med student, Dr, hubby, 2 respiratory therapist per baby, 1 pediatric hospitalist per baby, 2 or 3 nurses per baby (cant remember), but honestly I delivered in a regular room and they had to move the babies to a different room in the nursery to have enough room to work with them.
So long story short, I gave birth, they took my babies, family went to see babies and I was left alone bawling my eyes out til DH came back. Then not even 20 mins after delivering I was up in a wheelchair so I could go be with them....after not eating for over 24 hours I was exhausted and ended up throwing up into my blanket. NOT the delivery I expected although I was very happy that day
I'm sure if you end up delivering in the OR you will wonder what the big deal was afterwards

 

here it depended on which doctor was on call. my OB had told us we had to deliver in the OR but when we got to the hospital the doc on call said he was fine having us deliver in the L&D room (that being said, my labour went so fast i started pushing in triage & i ended up getting run down the hall as if i were being rushed to the OR anyway ). he said that it would be a matter of seconds to move to the OR if necessary. for me, it was a really big deal to deliver in an L&D room because i wanted to have an unmedicated birth & to help with that we had hired a doula. at my hospital, if you are in the OR, you are only allowed one support person where as in the L&D room you are allowed two. so if we had been forced to deliver in the OR i wouldn't have been able to have my doula with me & that would have sucked. had we been allowed two support people in the OR, i don't think i would have been as upset about delivering in there.

you can fight the policy if you really want to - but you'll need to do some soul searching and decide how worth it it truly is to you.

 

Our hospital is brand new (just opened last year) and was built for high risk c-sections. On each floor the OR's are in the middle and the labor rooms go around it in a circle. It would take less then 20sec to get to an OR at my hospital.

However the HOSPITAL's policy is that twins (either vaginal or c-section) must be born in the OR. As everyone has said its for different reasons. I know the L&D rooms are big enough for a whole team but what my Dr. explained was you never know how many people need an OR at once. They have 4-5 per floor and she has said many times they have had to wait for one to open or go to a different floor. That is why you have to deliver in an OR at my hospital b/c those few mins it takes for an OR to open or to change floors means the difference between life and death.

You have to remember that a twin birth is not the same as a singleton. There are way to many things that can go wrong with Baby B during delivery. You may also want to prepare yourself for the fact that many hospitals ask you to have an Epi in place for delivery of twins as well.

My DD was born at 35w5d and the amount of people in that room was crazy. I had about 5 just for myself (2 nurses, my Dr., a secound Dr. helping and the anesthesiologist) plus another 6 people for the baby and that was a regular low risk c-section with no problems.

As much as I wanted a natural VBAC this time my thought is "Whatever is best for the babies". So if I have to have a c-section or deliver in an OR I will b/c that is what is best for them and me.

 

It's standard here too. I was in a very nice birthing room while they were attempting to stop my labor, but even if it hadn't been preterm labor they would have moved me to OR for delivery (vaginal or c-section).

I wouldn't be so upset that you have to deliver in the OR. Personally, I'd be thinking about what's best for the babies. Things can literally happen in the matter of seconds and I'd want to move as quickly as possible to insure the babies would be okay.

 

Having been set to have a vaginal delivery (both babies head down) and ending up with a prolapsed cord with Baby A and immediate emergency c-section (under general anesthesia), I highly recommend delivering in the OR. Nothing is more important than the safety of those babies - I am continually thankful I was in a hospital for delivery/water breaking. I refuse to imagine what could/would have happened if we had been anywhere else.

 

i delivered my twins vag in my room at the hospital.

 

I hope that you are able to deliver in a regular room. In my hospital I could have delivered in a regular room on the high risk wing but I had to have a c section so I didn't get anything I wanted and was very disappointed about it. If everyone is healthy and things are going well I don't see why it would be a big deal and I hope that everything works out for you. Best wishes

 

I had a c section but I just wanted to chime in and say that you will not care what room you are in when those babies are being born. Honestly looking back I fixated on so many things that I never thought about when the time came. Your focus will be those wonderful babies no matter where you are so I would probably say not to waste too much energy on this one - especially as it is just a reasonable precaution to safeguard your health and that of the babies.

Good luck mama!!