Editor's note: This article was sponsored by Overlake Medical Center and Clinics.
As Kelsey Mooseker and her husband, Andrew, of Lake Stevens prepared for the birth of their twin girls in early 2019, they expected the delivery would be via C-section. Mooseker had had a previous C-section in 2008, and with this latest pregnancy, one of the twins was breech, positioned head up in the womb. Under the circumstances, Mooseker says, a vaginal birth seemed out of reach.
“I’d come to terms emotionally with having another C-section. I wanted a vaginal birth, but I thought the stars would have to align perfectly,” says Mooseker.
In a way, the stars did align. The weeks leading up to the twins’ birth coincided with the launch of the Team Birth Project, a new initiative promoting safe, informed birth practices. Currently piloted at just four hospitals in the United States, the project aims to improve communication between parents and their providers, improve outcomes for moms and babies, and reduce the rate of C-sections, which are currently performed in about 30 percent of births nationally.
The Northwest is home to two of the project’s pilot hospitals, Overlake Medical Center and EvergreenHealth. “We want Overlake Medical Center to be an environment that supports normal vaginal birth, which tends to lead to an easier recovery for mothers,” says Dr. Kristin Graham, a practicing OB-GYN and medical director of Women’s and Infants’ Services at Overlake.
With just weeks to go before the birth of her twins, Mooseker learned that she’d be able to try for a vaginal birth if her one twin moved into a head-down position. Mooseker readily agreed to the safeguards recommended by her provider, EvergreenHealth’s Dr. Bettina Paek: She’d give birth in an operating room, instead of a traditional birthing suite, and the babies would be monitored for signs of distress during labor.
“Everyone listened to what I wanted and took me seriously,” Mooseker says. The twins were born vaginally on Feb. 7, 2019, after 33 weeks of gestation.
Mooseker credits the Team Birth Project with helping create a supportive, empowering environment for the birth of her babies. One of the project’s key components is a “labor and planning board,” a large whiteboard that faces the patient in the delivery room and acts as a clearly visible birth plan. The whiteboard keeps hospital staff, the laboring mother and family members informed and up-to-date. The board also facilitates regular staff “huddles” so doctors and nurses can confer as the birth progresses.
Overlake providers have adopted other practices shown to reduce unnecessary C-sections, says Graham. These include allowing mothers enough time to move through the stages of labor, and encouraging mothers to allow labor to become established at home before coming to the hospital.
Compared to her first delivery 10 years ago, Mooseker says the difference in her second was remarkable. “In 2008, I wrote a birth plan, and I didn’t feel heard or listened to,” she says. “My doctor actually used a black Sharpie to cross out sections of my birth plan! There wasn’t a discussion about what I wanted. The whiteboard is there to push communication both ways.”
While surgical births can be lifesaving in certain circumstances, families should understand the risks involved in any surgery, including C-sections, says Graham. Along with risks involving scar tissue and bleeding, there can be complications for future pregnancies.
“Once somebody has a C-section, they tend to have repeat C-sections, which increases risk for problems in the way the placenta attaches,” she says.
For the Moosekers, a vaginal delivery made for an easier transition into life with four children. “Having been through a C-section, I couldn’t imagine recovering from a major surgery while caring for twins, along with two other children,” says Kelsey Mooseker. “This time, I’ve had a great postpartum experience and recovery. We’re thrilled.”