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What if Something Goes Wrong?

The most common question I get asked as a home birth midwife, “what if something goes wrong?” I understand the hesitancy given the outlook on pregnancy in our culture. In the United States, childbirth is viewed as a dangerous event where medical management is required to keep women and babies alive. The reality is that this is not true; pregnancy and childbirth are normal events that women’s bodies were made for. Our bodies were created with the intuitive ability to make and birth babies. My first answer when someone asks, “What if something goes wrong” is that rarely does something go wrong, women’s bodies are amazing, and babies are stronger than you think.

Unfortunately, there are instances when things can go sideways, and intervention is necessary. As a home birth midwife, I am an expert in physiological birth. This means I can recognize when there are signs that things are straying from being considered within normal limits. I am trained to recognize a baby in distress and determine the cause so that I may do my best to get baby right back on track. I am trained in monitoring women throughout pregnancy to catch any potential risks to labor. Finally, I am trained to know when birth is no longer safe at home, and it is out of my scope to continue care. I earned a license through the state of Michigan and a national certification that required me to obtain these skills before I received them. My final answer when someone asks, “What if something goes wrong?” is then we will handle it.

Sometimes birth emergencies come up or the situation changes, and home is not the safest place for a birth to happen. I know and respect this as a home birth midwife. It is a vital part of prenatal care in my practice to have an emergency plan. During the visit that we discuss our emergency plan, we will look to see where the closest hospital is with a NICU and where the closest hospital is that keeps an obstetrician on staff so that all our bases are covered. I need my clients to plan to stay home but be prepared to go into the hospital if we need to. Another answer when someone asks, “What if something goes wrong?” is we will go to the hospital, it is not my job to keep you home it is my job to keep you safe.

I am trained in birth emergencies that might come up as a surprise in labor. I curated a birth team that represents my business well and who are also trained in birth emergencies so that when we need to, we work together efficiently. Just over this past weekend my birth assistant, Gretchen, and I visited Tiffin, Ohio to practice and learn new birth emergency skills. We renewed our neonatal resuscitation training as well. While we were down there, we learned new ways to handle familiar situations and practice methods we had already mastered. These trainings are essential because, thankfully, we don’t come across birth emergencies often, so we need to practice keeping our skills up to date. I am grateful for the opportunity to work with a group of women like the one we met while we were there and to have the honor to learn from excellent teachers like Andrea Dixon and her assistant teacher Avril.

I come across many people that are not comfortable with the routine care and pressure to agree to various interventions that so often come with planned hospital birth. At the same time, they aren’t too sure about homebirth with the caveat that something might go wrong. I want to assure them that if they hire a trained midwife with a birth team, birth is safe. Home birth is safe. Something to be consider, why are there countless studies proving home birth is safe and yet there’s not a single study questioning the safety of hospital birth?

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