This page has been compiled based on my years of research on the subject of homebirth. It was created for your information, as a compilation of many of the questions homebirthers hear, so you can have some quick answers all in one place. It is not, however, to be construed as medical advice. My recommendation is that you do the research yourself, decide for yourself what the true facts are and what’s really fiction, and draw your own conclusions. But please be informed – don’t be a blind consumer of the medical industry.
What if the cord is wrapped around the baby’s neck?
This is fairly common and generally not a medical emergency. Usually the cord can be gently lifted over the baby’s head. Occasionally, the cord is too short for that, in which case there are two options. The first option is to clamp and cut the cord. This is easier, but probably not the best option in most cases, as it will deprive the baby of some blood and oxygen. The other option is to hold the baby snugly against the mom’s thigh and allow the newborn to “somersault” out as he’s born.
What about placenta previa?
A full placenta previa requires medical intervention, but should be a known factor prior to the birth. With a partial placenta previa, the baby can sometimes still be delivered vaginally, but with very careful monitoring, and a little help to keep it out of the way. (Because this would be a known factor prior to the birth, seeking medical help would, of course, be an option at that point, even if you had otherwise intended none.)
What if the baby is breech?
Breech babies can almost always be born vaginally, if mom is in an upright position. The standing squat is generally considered to be an ideal position for birthing a breech baby. (If you know your baby is breech and are intending
to have a hospital birth, make sure your doctor or midwife is experienced and/or comfortable with vaginal breech births, unless you really want a cesarean.)
What if the baby is transverse (sideways)?
To the best of my knowledge at this time, this is an instance requiring medical intervention, although some believe that, as baby cannot come out transverse, he will turn himself. This (the baby’s being transverse) is something you would know going into the birth, giving you the opportunity to go to the hospital as needed.
What if there are twins?
If the mother has been eating well and staying healthy, there is usually no reason twins can’t be birthed naturally. See “What if the baby is breech?”
What about Rh incompatibility?
If there is no amniocentesis done during pregnancy, cutting the cord is delayed until it stops pulsing, and the placenta is allowed to deliver naturally, there is very, very little chance of the baby’s blood mixing with the mother’s. (Although if you have had a miscarriage or abortion, that baby’s blood may have had opportunity to mix with yours.)
A woman who has a home birth still has opportunity to get Rhogam, though, if she chooses to. (Although Rhogam IS a blood product, and therefore carries it’s own risks. Much of it also contains mercury. Be sure to make an informed decision here, as well.) You can be tested for antibodies. You can also be tested for an additional blood factor which, if present, negates the Rh issue. I don’t have much information on this at this time, though, as I’m Rh+.
What if the baby goes into distress?
This is pretty rare in a birth with no interventions. Most fetal distress is caused by drugs, fetal monitoring, or poor positioning of the mother (flat on one’s back). Many doctors will tell you that long labors cause fetal distress, but this is usually not the case. A long labor that results in fetal distress was probably long because of interventions, not because it was naturally long. (Occasionally, if there is an underlying problem, it will cause both a lengthened labor and fetal distress.) Often, it is assumed a baby is in distress because the monitor shows that his heart momentarily stopped beating or slowed. This is normal, however, shortly before birth.
What if the baby has trouble breathing after birth?
In an at-term birth, this is not likely to be a problem. Most initial breathing problems are a result of immediate cord-cutting. The birth process is such that the baby should not need to immediately breathe completely on his own, but has a period of transition while he’s starting to breathe, but blood (containing oxygen) is still being pumped through the cord.
Learning infant CPR might be a wise precaution if you’re planning a birth with no medical assistance. Newborns don’t generally need to be suctioned, either. Turning baby facedown will allow him to cough up any mucus and fluid on his own. Suctioning can actually sometimes force fluids farther into his lungs.
What if the mother hemorrhages?
True maternal hemorrhage is serious, but is pretty rare if the placenta is left alone and allowed to deliver naturally. Hemorrhaging is most often caused by forcing the placenta to separate before the uterus is ready, by tugging on the cord and/or pushing on the uterus.
If there is a lot of blood, nursing the baby will have much the same effect as the pitocin the hospital administers, without the negative effects of drugs. There are herbal remedies for this as well, and placenta can be placed under the tongue (a piece; not the whole thing!) if necessary. And, of course, there is nothing to keep mom from visiting the hospital following the birth if she feels it’s necessary or prudent.
Thanks for this repost. My first baby is due at the beginning of February and I’ve worried about some of these complications.
Thanks for this well-stated post. I am due in May with my tenth baby. The first 7 were born in a hospital with an ob attending, number 8 was a precipitous birth (dr didn’t make it so the nurse caught the baby–best birth of all of mine!) and number 9 was born in a hospital under the care of a midwife. There were so many disappointing things that happened during the birth of that baby because hospital policy over-ruled nearly everything we had spoken with our midwife about. I was “overdue”, so this had the hospital staff all in a tizzy and I don’t do the routine screens/tests during pregnancy. All of my other pregnancies and births have been completely free of problems so I am “low risk” by every count, yet they treated me like a time-bomb waiting to self-destruct. Our daughter had trouble transitioning which I feel was completely due to the midwife cutting her cord the instant she was out (my jaw just dropped, as we had *specifically* spoken to the midwife about delaying–baby was out, and she just clamped and sliced in one swift motion before I knew what was happening). Baby was up on my chest and we were all rubbing her but I watched her turning dusky and told them to help her. I was so disheartened. I was sad to watch her need this help that I believe was available to her through the placenta had she not been severed before she was ready. I was shocked (again) as the midwife began tugging on the cord to “help” me deliver the placenta. We were on a bit of a timeframe as she had to get home to her kids because her sitter had to leave. I know she was trying to hurry and get done so that I wouldn’t have to be under the care of the nurses on duty (whom she told me the next day are VERY anti-midwife), but the whole thing was just NOT what we had specifically discussed during our visits with her prior to the birth.
From start to finish, my labor was 2.5 hours. Her difficulty transitioning to life outside the womb led to a cascade of ridiculous interventions and hospital-policy-directed interventions. Because we hadn’t done all the screens/test during pregnancy, we were suddenly looked at with even MORE suspicion and contempt for taking such “risks”. Over and over I’ve thought to myself “there was no reason for all of that to have happened the way it did.” I am an experienced mother, experienced pregnant lady, experienced natural birther–all of my children have been born with NO drugs, epidurals, etc. I know what I am doing and it was incredibly disheartening to have been so disrespected in that regard. If they had just let me be and let me proceed as my instincts and experience were leading me, I believe so much of that could have been avoided.
And when we wanted to leave “early”???? Well, we just put the icing on the proverbial cake! One struggle after another, just to leave a hospital building roughly 16 hours after the birth of my ninth baby. HELLO! We lived 45 minutes away (we’d gone to that hospital specifically because they have midwives there; there are none closer to where we live), our other children were at home with my mom but there was snowstorm approaching and we dairy farm so we were anxious to beat the weather, and besides all of that, me and baby were FINE. She had been born the evening before and we wanted to head for home in the morning. They thought we were CRAZY to leave “so soon.” It was so hard to have to encounter so much opposition to our every decision at a time when mom feels quite vulnerable and tender.
Though we’d been wanting to have the babies at home for the last few, paying the $3000 out of pocket made that impossible. Thankfully, the crop was good this year and this 10th baby will be born at home, Lord willing, with the assistance of a (dfferent) midwife. She lives 90 minutes away and is the closest homebirth midwife to us
I have pored over midwifery texts, natural birth books, blogs, etc. and have found words to so many of the things that I instinctively knew were “not right” with everything we’ve experienced with our hospital births. Maternity care in America is a tarnished, broken system and I’m so sad for all the women who have come through the process changed–and not for the better. I’m sad for the women who go through pregnancy and childbirth and don’t know more than they did before, about themselves, their babies, or pregnancy in general.
I’m passionate about letting women know that our bodies were made to do this and we have to trust that creation process. I believe women can trust their intuition and instincts and those of a skilled midwife to safely birth their babies and NOT be made to feel as if they are a veritable crisis waiting to happen.
Blessings to you this day,
Melissa
I’m so sorry, Melissa! What a terrible experience. 🙁 You’re right – it’s so sad that things are “set up” now in such a way that it’s like this for so many mamas. And this should be one of the most amazing experiences, meeting our babies for the first time!