This is about my experience with a twin pregnancy. I think I would have been happy with PSM if I…read morehad a singleton--I was especially happy with my care from Roseanne, Danielle, and Genevra. However, I would NOT recommend this practice for a twin pregnancy. They take so much pride in being a midwife practice that delivers twins that they obfuscate the reality of delivering twins with them.
There are 14 midwives; I met half of them. I got so much conflicting information about their procedures for twin delivery that I cried from frustration multiple times. It's clear to me now that the midwives have vastly different levels of experience with twin deliveries, and your experience will be different depending on who delivers. Rather than being transparent about that, each midwife just told me their version as if it were definite. I eventually just ignored whatever the midwives told me was going to happen and accepted that I had to go into the hospital with zero expectations.
One of the midwives indicated in my chart that I was upset because of the more medicalized process of a twin birth. Subsequent midwives began my next several appointments with a spiel about why twin births have more restrictions, and I had to repeatedly explain that my frustration was actually caused by the conflicting information. It made me feel like no one was actually listening to me and just heard what they expected to hear.
I was told that if both babies were head down, I could attempt a vaginal birth; if Baby A was head down and Baby B was not, the midwives would deliver with support from an OB; if neither were head down, I'd get a C-section. However, the midwives actually have very little power when it comes to a twin delivery at the hospital. There were only three "twin-friendly" OBs at Methodist, and to be able to attempt a vaginal delivery when Baby B is breech, you have to schedule an induction for when one of those OBs is working. I was due during a time when two of those OBs were on vacation, so even though my MFM cleared me for induction any time after 37 weeks, I had to wait until I was 38+4. (My twins were 8 lbs each, I was miserable.) NONE of this was clear to me until the last couple weeks of my pregnancy. During my last appointment, I asked the midwife, "If I go into spontaneous labor before my induction date this week, and the twin-friendly OB is not working, will I likely have a C-section?" She paused and said, "I don't want to give you more anxiety," as if the better outcome would be for me to arrive at the hospital spontaneously in labor and THEN learn that I couldn't attempt a vaginal delivery, despite what I'd been told throughout my entire pregnancy.
On the day of my induction, it was a very busy day and I didn't start my induction until 1p. At 4p I'd barely progressed, and my midwife told me that the "twin-friendly" OB was only working until 6p, and after the next shift started I couldn't attempt a vaginal delivery. I chose to stop my induction, stay in the hospital overnight, and start again the next day, when the twin-friendly OB was working all day. I NEVER would have agreed to start at 1p knowing I only had until 6p to start delivering, and I'm shocked that my midwife thought it was a good idea. The only reason I can think of why she didn't suggest I come back the next day in the first place is that she didn't want to come in on her day off.
I ultimately was able to have a vaginal delivery, with Dr. Leonard (who was amazing) doing a breech extraction for Baby B. However, the only reason I was able to have the birth I wanted was the SHEER LUCK that my pregnancy lasted until my (relatively late) induction date.
The midwife who delivered me was dismissive when I expressed my frustration with the poor communication, saying, "If you were anywhere else, you would've had a C-section automatically." That may be true for other midwife practices, but in hindsight, I would've much rather gone with a twin-friendly OB practice (my doula was able to list several)--and I've only seen midwives for my OBGYN care for the last 12 years.