What if something goes wrong?
Certified Professional Midwives are qualified to manage a variety of medical complications, and part of their training includes knowing when to transport safely to the hospital should it become necessary. Safety is a very important issue with us. At ABC, we are concerned with both your safety and the safety of your baby. We will never take unnecessary risks just to have a baby at home. As much as we love home birth, it is much more important to have a healthy baby and mother than it is to keep you at home in a high risk situation. Our transport rate is still low, even though we are conservative and transport sooner than later. If there are early warning signs that the birth might need medical assistance, we seriously consider transporting. We will consider your input and wishes in this decision as long as it is not a true emergency. True 911 emergencies are extremely rare but even if they do happen, we are equipped to keep both mother and baby safe and stable during any true emergency transport.
At ABC we are equipped to stop hemorrhaging if needed. We carry emergency medication for hemorrhage. This requires standing orders from a physician and we have standing orders. We also carry oxygen and resuscitation equipment. We are also trained in infant and adult CPR and neonatal resuscitation.
We are often asked about cord around the neck. Midwives can unwrap umbilical cords from around necks and torsos. Rarely does a cord cause a real problem and when it does, there are also little warning signs long before it becomes a serious problem. Occasionally, a cord will prevent a baby from being born vaginally, but when this happens there are early indicators that give us plenty of time to transport before it becomes a real emergency.
In 15 years of practice, we’ve only once had to actually cut the cord to get it loose from around the baby’s neck as it was being born. And that baby was perfectly fine, although we did need to give her a few puffs of oxygen right after birth. We handled the complication exactly the same as it would have been handled in a hospital setting.
We monitor the baby’s heart beat regularly and are able to assess the position of the baby and the contractions. The main difference between monitoring at home and in the hospital is what we do requires us to be present, rather than down the hall watching on a monitor. We are more “hands on” when we take heart tones, but this also allows you much more freedom to move around. You can even be in water because our Doppler is water-proof.
According to a study published in the British Medical Journal comparing planned home births with CPMs to planned hospital births, the intrapartum and neonatal mortality rate among women considered at low risk at start of labor was 1.7 deaths per 1000 planned home births. This is similar to the risks in other studies of low risk home and hospital births in North America.
In other words, the risk of fetal death, whether at home or in a hospital, is about the same. If you are low risk (and we limit our practice to low risk) you are just as safe to deliver at home as you are in the hospital. But just as important to consider is the fact that this same study shows that if you choose home birth, you greatly lower your risk of unnecessary interventions, including caesarean section.
Our culture has instilled in us a fear of the natural experience of birth and a fear of our bodies. In countries where women are supported in their desire and ability for a natural birth (Northern Europe leads this charge), babies and mothers have the lowest mortality rates. When it comes to safely, natural birth is safe birth, and midwives are the experts in natural birth.