Midwives are medical professionals who are specialists in normal pregnancy, birth, and newborn care. We provide comprehensive prenatal care including referral for laboratory tests, ultrasound and genetic screening and are trained to screen for and manage common complications of pregnancy and childbirth. When necessary, we work collaboratively and refer to alternative health care modalities as well as obstetricians, pediatricians and neonatologists. Our relationship with hospital-based providers is one of the components of home birth safety, since rapid transfer and smooth arrival is optimal for safety.
SAFETY & EQUIPMENT
Midwives are the only health-care providers trained and equipped to provide all the necessary care that you and your baby will need at your home birth. The equipment midwives bring along with them to home births is equivalent to what would be found in a community hospital, including oxygen, medications to stop bleeding and sterile instruments.
Midwives carefully monitor the baby throughout labor, using intermittent auscultation by doppler, (as recommended for low-risk labors by many midwifery and obstetric organizations in the ‘first’ world). Mother’s vital signs, urinalysis, progress, etc are also monitored regularly. We are trained in and re-certified regularly in emergency newborn resuscitation and adult CPR.
Midwives continually evaluate and assess the mother, baby and the overall situation to confirm all is normal and do not wait for a crisis to consider moving from home to hospital. Research shows transfer to hospital is far more common for an exhausted mother and a slow labor rather than an emergency. During a home birth, if you and your midwife determine that it would be best for you to move to a hospital, she will accompany you to hospital and continue to care for you in a supportive role. If there is a need to transfer in an emergency, your midwife will keep you and/or your baby medically stable, arrange the transfer and stay with you until your baby is born and/or until the situation has been resolved.
SAFETY & RESEARCH
Global research shows that home birth is a safe option for healthy women experiencing low risk pregnancies who have chosen skilled care providers. Research demonstrates that home birth is at least as safe as hospital birth, in large part because of the skills and education midwives bring with them.
In a comprehensive US study of almost 17,000 American women planning home birth with midwives between 2004-2009, the results are excellent. Low-risk women in this study experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes. The majority of transfers were for failure to progress. The rate of spontaneous vaginal birth was 93.6%, 87% of VBACs were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. Excluding lethal anomalies, the neonatal mortality rates were 0.35-1.30.