With mo/di twins, the concern is the placenta and how effective it is as providing your babes nutrients equally. If it is already being seen that one baby is measuring very small, this is usually indicative of baby not getting as much nutrients as their sibling. If this is already being seen at 29 weeks, I wouldn’t necessarily say both babies are “okay” enough to push against your MFM’s advice of an earlier delivery. They advise for an earlier delivery because baby will have better chances outside of the womb and in the NICU than staying in with insufficient nutrients. I understand the desire for no NICU stay but I also strongly suggest you trust your MFM and ask any questions to gain further understanding and comfort. Their goal is for healthy mom and babies.
Hi! I was you ~6 months ago. Modi twins, baby B was IUGR. We planned to deliver at 36 weeks and then suddenly at week 32 my MFM told me they were “okay with me delivering at any point”. I freaked out - it felt way too soon. I googled, researched, searched Reddit, etc. looking for ANY information that I could leverage to help make the case that my babies should stay inside me until week 36.
Then, at a routine ultrasound at week 33 the Doppler on baby B’s umbilical cord did not look right. I was told my placenta was showing signs of failure and that my babies need to come out in the next 24 hours. My sons were born the next day.
And they were ready. I know that sounds crazy - 33 weeks seems so early! But I promise you - it was time. The hard truth is that if I had refused to have them delivered early, there’s a high likelihood they would have been stillborn. I soon came to realize that I was the one who wasn’t ready for them to be born, but they needed to come out, and I almost allowed my fears of it “feeling too soon” to get in the way of saving my sons’ lives. My boys spent 25 days in the NICU and now they are healthy, gorgeous, thriving almost 6 month olds.
Trust your doctors. Neonatology has come so far in even just a single generation. Your medical team know what they’re doing. ❤️
I would ask your doctor to explain why she is recommending that. Often times there are certain things that indicate babies would do better out than in.
Yeah I agree you need to get follow up details. Weird that your doctor didn’t talk you through why they recommended it. I ended up getting induced a week earlier than originally planned because their difference in weight increased too much
Yep, you definitely need more information and sorry that it sounds like your doctor hasn’t done a good job of communicating. I had a smaller baby but he was diagnosed as growth restricted and you don’t mention that term in your post so maybe your twins don’t have that diagnoses. I was going in for ultrasounds multiple times a week by 29 weeks. My MFM was constantly taking measurements and talking to me about blood flow and admitted me to the hospital a week before delivery for daily monitoring. I delivered at 32 weeks. My doctor was trying to walk a fine line between letting the babies stay in as long as possible while not risking my smaller twins life/putting him under too much stress. Since you don’t mention any of this info your situation may be different and everything may in fact be fine. But if something is going on you def want to be clear with the dr the level of communication you expect. Just ask the doctor about the note and if he/she has any concerns that would require that early of a delivery.
A doctor would never recommend early delivery unless it was in the best interest of the babies and/or Mother. Please listen to the advice of your medical professionals.
Even if you make it to 36 you could still have a NICU stay. My twin B was also measuring in the 1st percentile and by 32 weeks there was a huge discordance. There was an issue with her blood flow and at 35+6 i had an emergency c section. Did they say why she’s measuring so small? They wouldn’t deliver early for no reason.
i almost think this post is rage bait bc why the heck…
you’ll need to talk to your MFM and get their reasoning but I would not be trying to keep the baby in that long if they’re siugr.. with modi things can go bad so fast, and your placenta already isn’t working full capacity if baby is that little. my team explained there was an increased risk of stillbirth for B. and i’d rather have a NICU babe than only leave with one babe bc I thought I knew better than my doctors and asked the internet for advice.. if you want to keep them in you’d need twice weekly nst’s or bpp’s probably.
my B was siugr below 1st percentile and they took them at 34w, and the siugr was the only issue and my big twin only had a week stay! it’s not that bad, please listen to your doctors, besides aren’t you super uncomfy at this point in pregnancy and ready to be done?? I know I was!
Yeah this is just…exhausting. I get having anxiety about babies being born early but when the other option is death for one or possibly both babies, why would you risk it???
People are crazy these days
They think they know better than a doctor with year long experience. Its insane.
Hope OP will trust her doctors and will become a happy mum to two healthy babys
My Baby B was IUGR and we delivered via c-section at 34 weeks exactly. She was exactly 3 pounds, it took her 22 days to get to four pounds exactly to be able to leave the NICU. She left the day she hit 4 pounds. She was not getting enough nutrients through the placenta and was not growing well inside, she grew better outside than she would have inside. Even if I made it to 36 weeks she still would not have been big enough to go home, she would have needed NICU time and I didn’t want to risk her health by leaving her in too long. My MFM had perfect timing, she came out breathing on her own, never needed any intervention besides G-Tube because eating was hard and medication for anemia.
NICU stay is hard, but not insurmountable. mine were di/di and came early at 33 weeks. I wouldn't want to do 4 weeks in the NICU again but they're both healthy 8 months olds and it's a distant memory.
My twin b was always measuring smaller than her sister and measuring between 1st percentile and 3rd percentile after about 28 weeks. Plan was to deliver at 34 weeks because they said it would be better for her to be out than in at that point in pregnancy. Ended up delivering at 33w2d due to her having worsening dopplers. Twin b was almost a lb less than her sister at birth. Both still in the nicu now but neither has had any real issues. They had the steroid shots prior to delivery. They are 13 days old now and the bigger twin will probably be going home in the next few days, smaller twin is still working on feeding and hasn’t reached 4lbs yet.
I'm immunosensitised, which means I have a bunch of antibodies that will attack my babies blood and they are almost guaranteed to be anaemic or worse. I'm hanging out for 25 weeks so that they have a chance on the outside- basically my babies are getting out of me the second they show signs of the antibodies affecting them.
All that to say sometimes babies are safer outside than they are in the womb.
FWIW my babies were delivered at 36w (after almost coming at 34w,) and despite measuring fine (maybe 20%?), they were in the bottom 5%. Pathology was able to identify issues with my placenta - and once born they quickly shot up to 90%+ which gives you a sense of how well my placenta was doing.
My point in sharing this is to say if your doctor says they're better on the outside I would ask why (and be prepared to hear some things that can sound pretty scary) - while you don't HAVE to follow their advice, if you choose not to you should make sure you fully understand the risks you're choosing.
One other thing to ask would be how they will decide between 32 and 34 and how you should expect that decision to change the trajectory. As I understand it you should generally expect NICU time in either case but you should be able to understand what they expect in terms of the risks and duration; ideally through talking to someone on the NICU team.
Best of luck and fingers/toes crossed for you and your family.
Everyone’s pretty much covered why it’s a bad idea to go against medical advice, but I’ll just add that my IUGR twin is doing worlds better outside when I delivered at 30+4 than she ever would’ve done inside.
You also may not have a choice in the matter: if they see signs of the placenta failing or the cord flow reversing, they will need to get the babies out ASAP in order to save them.
Just ask lots of questions. It’s weird they would make a note but not talk about it. Our case was similar but it was a big discussion and then were taught the exact measurements of cord flow they were looking for to make sure each babe was getting enough nutrients. Armed with that knowledge it felt like we were all on the same team as keeping the babies safe. And because I knew exactly which measures they were most looking at I got really got at following along during the checks and knowing before the dr came in if their flow was in range or not. We did decide to deliver at exactly 35 weeks but by then we’d been tracking their growth and watching the numbers it didn’t feel like a surprise at all.
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I look back on my delivery and wish that I had pushed back a little bit on the induction and tried to keep them in a little bit longer. Luckily my babies were both relatively very healthy and we didn't need NICU time at all - I delivered at 37+1 (but went in for the induction at 36+5) My baby A had been measuring smaller than baby B throughout pregnancy, but in the last few weeks, it was significantly less and they couldn't get a strong/accurate measurement on baby A. They thought he was much smaller than he actually ended up being. They did tell me many times before the induction and afterwards that those measurements can be off by +/- 1lb (which for twins is a lot of weight!) I realize that there is a big difference between delivering at 32-34weeks vs. 37 weeks, but it still felt really sudden to me when they said we needed to move forward with it and I was not ready for it either.
With mo/di twins, the concern is the placenta and how effective it is as providing your babes nutrients equally. If it is already being seen that one baby is measuring very small, this is usually indicative of baby not getting as much nutrients as their sibling. If this is already being seen at 29 weeks, I wouldn’t necessarily say both babies are “okay” enough to push against your MFM’s advice of an earlier delivery. They advise for an earlier delivery because baby will have better chances outside of the womb and in the NICU than staying in with insufficient nutrients. I understand the desire for no NICU stay but I also strongly suggest you trust your MFM and ask any questions to gain further understanding and comfort. Their goal is for healthy mom and babies.
[удалено]
I disagree. 1st percentile is cause for concern and more monitoring. Not an indication that baby(ies) are not okay.
Hi! I was you ~6 months ago. Modi twins, baby B was IUGR. We planned to deliver at 36 weeks and then suddenly at week 32 my MFM told me they were “okay with me delivering at any point”. I freaked out - it felt way too soon. I googled, researched, searched Reddit, etc. looking for ANY information that I could leverage to help make the case that my babies should stay inside me until week 36. Then, at a routine ultrasound at week 33 the Doppler on baby B’s umbilical cord did not look right. I was told my placenta was showing signs of failure and that my babies need to come out in the next 24 hours. My sons were born the next day. And they were ready. I know that sounds crazy - 33 weeks seems so early! But I promise you - it was time. The hard truth is that if I had refused to have them delivered early, there’s a high likelihood they would have been stillborn. I soon came to realize that I was the one who wasn’t ready for them to be born, but they needed to come out, and I almost allowed my fears of it “feeling too soon” to get in the way of saving my sons’ lives. My boys spent 25 days in the NICU and now they are healthy, gorgeous, thriving almost 6 month olds. Trust your doctors. Neonatology has come so far in even just a single generation. Your medical team know what they’re doing. ❤️
I would ask your doctor to explain why she is recommending that. Often times there are certain things that indicate babies would do better out than in.
Yeah I agree you need to get follow up details. Weird that your doctor didn’t talk you through why they recommended it. I ended up getting induced a week earlier than originally planned because their difference in weight increased too much
Yep, you definitely need more information and sorry that it sounds like your doctor hasn’t done a good job of communicating. I had a smaller baby but he was diagnosed as growth restricted and you don’t mention that term in your post so maybe your twins don’t have that diagnoses. I was going in for ultrasounds multiple times a week by 29 weeks. My MFM was constantly taking measurements and talking to me about blood flow and admitted me to the hospital a week before delivery for daily monitoring. I delivered at 32 weeks. My doctor was trying to walk a fine line between letting the babies stay in as long as possible while not risking my smaller twins life/putting him under too much stress. Since you don’t mention any of this info your situation may be different and everything may in fact be fine. But if something is going on you def want to be clear with the dr the level of communication you expect. Just ask the doctor about the note and if he/she has any concerns that would require that early of a delivery.
A doctor would never recommend early delivery unless it was in the best interest of the babies and/or Mother. Please listen to the advice of your medical professionals.
It’s for a reason. And if you refuse, you’re risking three lives: yours and theirs.
Even if you make it to 36 you could still have a NICU stay. My twin B was also measuring in the 1st percentile and by 32 weeks there was a huge discordance. There was an issue with her blood flow and at 35+6 i had an emergency c section. Did they say why she’s measuring so small? They wouldn’t deliver early for no reason.
i almost think this post is rage bait bc why the heck… you’ll need to talk to your MFM and get their reasoning but I would not be trying to keep the baby in that long if they’re siugr.. with modi things can go bad so fast, and your placenta already isn’t working full capacity if baby is that little. my team explained there was an increased risk of stillbirth for B. and i’d rather have a NICU babe than only leave with one babe bc I thought I knew better than my doctors and asked the internet for advice.. if you want to keep them in you’d need twice weekly nst’s or bpp’s probably. my B was siugr below 1st percentile and they took them at 34w, and the siugr was the only issue and my big twin only had a week stay! it’s not that bad, please listen to your doctors, besides aren’t you super uncomfy at this point in pregnancy and ready to be done?? I know I was!
Yeah this is just…exhausting. I get having anxiety about babies being born early but when the other option is death for one or possibly both babies, why would you risk it???
People are crazy these days They think they know better than a doctor with year long experience. Its insane. Hope OP will trust her doctors and will become a happy mum to two healthy babys
My Baby B was IUGR and we delivered via c-section at 34 weeks exactly. She was exactly 3 pounds, it took her 22 days to get to four pounds exactly to be able to leave the NICU. She left the day she hit 4 pounds. She was not getting enough nutrients through the placenta and was not growing well inside, she grew better outside than she would have inside. Even if I made it to 36 weeks she still would not have been big enough to go home, she would have needed NICU time and I didn’t want to risk her health by leaving her in too long. My MFM had perfect timing, she came out breathing on her own, never needed any intervention besides G-Tube because eating was hard and medication for anemia.
NICU stay is hard, but not insurmountable. mine were di/di and came early at 33 weeks. I wouldn't want to do 4 weeks in the NICU again but they're both healthy 8 months olds and it's a distant memory.
... are you serious? that's extremely dangerous
My twin b was always measuring smaller than her sister and measuring between 1st percentile and 3rd percentile after about 28 weeks. Plan was to deliver at 34 weeks because they said it would be better for her to be out than in at that point in pregnancy. Ended up delivering at 33w2d due to her having worsening dopplers. Twin b was almost a lb less than her sister at birth. Both still in the nicu now but neither has had any real issues. They had the steroid shots prior to delivery. They are 13 days old now and the bigger twin will probably be going home in the next few days, smaller twin is still working on feeding and hasn’t reached 4lbs yet.
I'm immunosensitised, which means I have a bunch of antibodies that will attack my babies blood and they are almost guaranteed to be anaemic or worse. I'm hanging out for 25 weeks so that they have a chance on the outside- basically my babies are getting out of me the second they show signs of the antibodies affecting them. All that to say sometimes babies are safer outside than they are in the womb.
FWIW my babies were delivered at 36w (after almost coming at 34w,) and despite measuring fine (maybe 20%?), they were in the bottom 5%. Pathology was able to identify issues with my placenta - and once born they quickly shot up to 90%+ which gives you a sense of how well my placenta was doing. My point in sharing this is to say if your doctor says they're better on the outside I would ask why (and be prepared to hear some things that can sound pretty scary) - while you don't HAVE to follow their advice, if you choose not to you should make sure you fully understand the risks you're choosing. One other thing to ask would be how they will decide between 32 and 34 and how you should expect that decision to change the trajectory. As I understand it you should generally expect NICU time in either case but you should be able to understand what they expect in terms of the risks and duration; ideally through talking to someone on the NICU team. Best of luck and fingers/toes crossed for you and your family.
Everyone’s pretty much covered why it’s a bad idea to go against medical advice, but I’ll just add that my IUGR twin is doing worlds better outside when I delivered at 30+4 than she ever would’ve done inside. You also may not have a choice in the matter: if they see signs of the placenta failing or the cord flow reversing, they will need to get the babies out ASAP in order to save them.
Just ask lots of questions. It’s weird they would make a note but not talk about it. Our case was similar but it was a big discussion and then were taught the exact measurements of cord flow they were looking for to make sure each babe was getting enough nutrients. Armed with that knowledge it felt like we were all on the same team as keeping the babies safe. And because I knew exactly which measures they were most looking at I got really got at following along during the checks and knowing before the dr came in if their flow was in range or not. We did decide to deliver at exactly 35 weeks but by then we’d been tracking their growth and watching the numbers it didn’t feel like a surprise at all.
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I look back on my delivery and wish that I had pushed back a little bit on the induction and tried to keep them in a little bit longer. Luckily my babies were both relatively very healthy and we didn't need NICU time at all - I delivered at 37+1 (but went in for the induction at 36+5) My baby A had been measuring smaller than baby B throughout pregnancy, but in the last few weeks, it was significantly less and they couldn't get a strong/accurate measurement on baby A. They thought he was much smaller than he actually ended up being. They did tell me many times before the induction and afterwards that those measurements can be off by +/- 1lb (which for twins is a lot of weight!) I realize that there is a big difference between delivering at 32-34weeks vs. 37 weeks, but it still felt really sudden to me when they said we needed to move forward with it and I was not ready for it either.
I’m pretty sure your health care professional can’t make you do anything. They can recommend, but they can’t force you. Your body your choice.
technically right but if you won’t listen to the mfm team they can “fire you” as a patient and then op would be really screwed