Home Birth Complications: 8 things to Reassure You

How prepared will your midwife be? How fast could you get to hospital? Get the lowdown on what happens if things aren’t so straightforward…

by midwife P. Kayti Buehler

Home Birth Complications: 8 things to reassure you

1. Hospital transfers aren’t normally emergencies.
Actually, the most common reason (90% of transfers to hospital) home birth plans don’t work out is because you’re tired and things are progressing really slowly. Part of this is that you might decide you want an epidural. So if you hear about people deciding to go to hospital after planning a home birth, you’ll understand why.

2. Transfers to hospital happen quickly. Transfers to hospital usually take less than an hour from making the decision to arriving. Ask your midwife how long it takes in her experience. If you do need to change your home birth plans, it will all be sorted quickly.

3. If there is an emergency, the hospital will know. If you or your baby is showing signs of distress, your midwife will call an ambulance. They’ll tell the hospital it’s an emergency so staff will be ready and waiting for you. That means you and your baby will get the treatment you both need quickly. Your midwife will call the hospital and give them a report and fax records immediately.

4. A home birth doesn’t mean you can’t have interventions when necessary. If your midwife is concerned about you or your baby during labor, she will arrange your transfer to a hospital for assessment. Sometimes, that assessment will lead to a decision to have an epidural, Pitocin, or a cesarean birth. This will remain your choice. You always have the right to choose interventions in your birth.

5. If the baby has the cord wrapped around its neck, the process is the same as in hospital. Just as if you were in hospital, your midwife will be monitoring your baby’s heartbeat throughout labor. If there are signs that your baby needs help, you’ll be transferred to a hospital. Over a third of babies are born with the umbilical cord around their necks so it’s a perfectly normal part of labour. The cord’s usually loose enough to be unlooped and your birth plan will progress normally. If your baby isn’t coping well after the birth, the midwife will arrange transfer for both of you to hospital.

6. Midwives can deal with blood loss/postpartum hemorrhage. Midwives are trained to deal with complications that come up wherever you are. They’ll have the same equipment at home or birth center as they would have on a midwife-based hospital birth center. So if you do hemorrhage, the midwife will give you a drug to contract your uterus, and will massage your tummy to stem bleeding. Your midwife can also start an IV to replenish lost fluids if necessary.

7. For the rare occasion it’s needed, midwives bring resuscitation equipment for babies. Most babies who are showing signs of distress will already be in the hospital. Otherwise, it will become clear during labor that the woman and baby need to go to the hospital. So it’s unusual for babies born at home to need resuscitation, although some newborns do need to be encouraged to breathe. Your midwife gets annual training in these techniques, and will follow the same process as she would use in hospital: keeping the umbilical cord intact so the baby gets oxygen from the placenta keeping the baby warm and dry making sure the airway is open giving the baby five or more puffs of air chest compressions The midwives can also call an ambulance to bring the baby to the hospital in the rare case that this is needed. Your midwife is trained to keep your baby oxygenated the entire way to the hospital if needed.

8. Some women and babies go to hospital after the birth. A few women have a complication after they give birth that means it’s a good idea to go to hospital. Complications might include a retained placenta, needing a lot of stitches, or concerns about the baby. If there are complications, the midwife will arrange a transfer to hospital. This article was adapted from the British site: NCT, which is a BRILLIANT resource from a country where women have total choice in maternity care between home, birth center or hospital - attended by midwives NO MATTER where they choose to birth. Their midwives are continuous care - so you get your midwife team and they stay your midwives throughout your visits, birth and postpartum in whatever setting the parent(s) choose! Follow Up: Why do other developed countries such as the UK recommend mothers birth in the location of their choice, and pay for this fully?