Generally pregnancy is a state of wellness and birth is a normal, healthy event. The great majority of women that choose to have midwifery care and birth at home will do so without complication or the need for medical assistance. The best homebirth is a safe homebirth. Nothing can guarantee a perfect outcome. Critical situations can arise during pregnancy, labor, or postpartum which necessitates specialized care not provided in the home. It will be necessary to transfer care prenatally or transport to a hospital during birth if you are in need of care that cannot be safely provided at home. Sometimes babies will require follow-up or transport to the care of a pediatrician.
In the event that you transport to the hospital during labor, your primary midwife will transfer with you. Records, labs, and a transport record will be provided to the hospital team caring for you or your baby. The midwife’s role will switch to that of a doula/support person. If your labor is long, it may be necessary to switch out support people. If you choose pain medication and rest, your birth team may temporarily leave to allow you privacy and so they can rest as well.
Typically we do not need to use the EMS system unless Mom or Baby is too unstable to transport by private vehicle. If an emergency situation arises (ex: hemorrhage) and you are unable to reach me immediately, call 911 or go straight to the hospital. Call the hospital to let them know you are on the way and why. Call me back and be sure to leave a message. Some of my clients live in rural areas and reception can fade in and out. Sometimes text messages or pages will come through when phone calls do not.
Transports typically happen fairly quickly. Once the decision is made, we will usually be on our way within 15 minutes. Situations that can slow the process include EMS response time, traffic, weather, gathering items desired to accompany you to the hospital, getting to the car with frequent contractions, stairs, arrangements for children/pets, etc. As part of informed consent, you should know the traffic times and local EMS response times in case of emergency. Many clients have found it helpful to pack a transport bag, write birth/newborn plans, arrange back-up care, arrange child/pet care plans, and/or tour local hospitals in advance in case of transfer during labor. If you transport, it is likely because you need/desire intervention or your birth is no longer low-risk. Therefore, your birth plans may not be the same as if you were planning a natural hospital birth. Please keep in mind that under these circumstances, we are very fortunate for the intervention that the hospital can provide and their willingness to support us. Examine the transport and cesarean statistics to get an idea of the most common reasons for transport and how often women planning homebirth transport to physician care or require cesarean birth.