When A Home Birth Doesn’t Go As Planned – Part 1 – My Radiant Beginnings

When A Home Birth Doesn’t Go As Planned – Part 1

Sometime the best laid plans don’t actually materialize.  What then?

You had good prenatal care, took care of yourself and the baby, participated in childbirth prep classes, followed the advice of your healthcare provider, had a birth plan and seemingly did everything in your control “right,” but something (could be a variety of things) causes you to need to transport to the hospital for the delivery of your baby.

Let me pause here to reiterate that there are no guarantees with birth.  You can only control so much.  I have journeyed with moms who have fit the above picture of being the model client and did everything within their power to have the birth they desired, only to have a different outcome.  And, I have met women who on paper seem to have lots of room for improvement, and whom I encourage one way but choose another, have the picture-perfect outcomes that dreams are made of. It’s not fair. It is frustrating.

Those who are against out-of-hospital birth would run rampant here and argue their point that birth is scary and needs to be in the hospital. That is not my impression or what I want your take-away to be. Midwifery is safe for low-risk women. While I have had to transport, I have not personally had an emergency transport situation.

So why would a low-risk, healthy mom need to be transported in labor and it not be considered an emergency?

Remember, there’s only so much you can control. You are in control of your nutrition, your exercise and your response to labor. You are not in control of your contractions or the response of the baby.

Ideally, with all the factors working together, a mom who is set up for success in her birth approach who has effective contractions and a baby who is tolerating labor well should be able to expect an uneventful birth without complications. However, if the latter two factors aren’t cooperating then something needs to change.

While there are some techniques a midwife can use to help regulate or strengthen contractions, there is a limit to that. We do NOT use Pitocin to stimulate or augment labor. When the natural remedies and holistic tips & tricks run out, we need to transport for back-up and support so that you and baby are monitored while your labor is augmented medically.

Perhaps the baby isn’t tolerating labor well and his/her heart rate has low or otherwise unfavorable decelerations. If a change in position doesn’t immediately resolve the issue, it is time to transport mom and baby. This is no one’s fault. You cannot control how your baby will respond to labor. Typically this doesn’t happen at the very beginning of labor. It may be a result of a longer labor or when other factors are present.

Finally, another reason for non-emergency transportation in labor would be for pain relief, or an epidural at the request of the mother. This is nothing to be disappointed by. The point is, you are listened to and heard and your voice matters throughout. You are in charge and call the shots. When you say go, it is not my place to talk you out of it. Please hear me, I have had women say “I can’t do this anymore” who are 9-10 cm and just need to hear that they can make it through, and they get a second wind and work through it and I support them every way imaginable. I have also supported women who say “I’m done, I want an epidural” and based on where their labor is at, it would be inappropriate to talk them out of it and stay. This is when it is invaluable to have had a close working relationship throughout the prenatal and early labor period. If a healthcare provider was just walking in, for shift change or on rounds to check on you and there was not an established history or positive rapport, it is more likely to get judgment calls based on reaction versus relationship.

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