re unable to get to the hospital quickly enough, it could mean long term health problems or even death.
The third most common complication of birth is when the baby does not breath after birth (often preceeded by fetal distress). It is not unusual for a baby born at home to begin breathing gradually, or not cry immediately, because midwives do not cut the umbilical cord as soon as the baby is born to ensure the baby receives a much oxygen as possible. However, in the Johnson and Daviss study, about 2.1% of babies needed supplemental oxygen or (less frequently) resuscitation in order to begin breathing. Only .6% of the babies needed to be transferred after birth for respitory complications. Most of the time babies will respond quickly to midwifery treatment, but rarely, treatment is needed that a midwife cannot offer, and brain damage or death is possible.
Other possible, rare, complications from birth at home, and reasons for transfer to the hospital, include but are not limited to: placental abruption, where the placenta separates from the uterine wall; chorionamnionitis, an infection caused by your water being broken too long; uncontrolled hypertension or preeclampsia; and retained placenta, where the placenta does not come out after birth on its own.
Midwives are trained to recognize symptoms of complications before they become emergencies, and if a complication occurs during your preganncy or birth, you are likely to be transferred to the hospital before injury or death is a possibility for you or your baby, but it is important that you speak to your midwife about her experience with complications and their outcomes, the equipment she has available and her experience in using them, and that you also speak up if you have any concerns about symptoms you are having. Make sure she is certified in CPR for adults and newborns, and in neonatal resuscitation or neonatal advanced life support.
Varney’s Midwifery, Fourth Edition, a major textbook for CPMs and CNMS, recommends adherence to the following four principles for a safe home birth:
- The woman must be committed to actively engage in health promotion
- The place of birth must be planned before the onset of labor
- The attendent must be skilled, able to screen appropriately, provide vigilant care, and manage emergency complications should they occur
- There is a system in place for access to medical consultation, hospitalization, and emergency transport
Home birth is very safe, birth can be trusted, and a trained midwife can help you to have a wonderful birth experience, but there are risks, however small they may be. In the end, you must be willing to take an honest look at the risks and benefits associated with both home and hospital birth, and decide which risks you are willing to take. Then, you are ready to sign an informed consent document for your care provider.
For your reference, here are some websites where you can find home birth studies, and read what care providers are saying about them. Be aware that each opinion is biased: