A Few Words About Safety…
Community births—those taking place outside of hospital settings, at home or in freestanding birth centers—are intended for low-risk clients.
Throughout your prenatal period we will continue to monitor the development of your baby and the health of your pregnancy and general well-being, to ensure that you remain a good candidate for home birth.
Should anything arise indicating something unusual, I will provide appropriate testing, support, and referrals to collect further information and guide decision making.
A primary role I assume in caring for you during labor is to protect the normalcy of your birth experience and watch for any early signs of complications.
If anything unexpected starts to unfold and I cannot use low-tech interventional measures from my skill-set to help correct course, or there are indications we could be traveling away from the realm of low-risk circumstances, I will recommend we transport and include you in decision making.
Usually, signs of complications begin to reveal themselves with enough time to change locations without the need for a 911 call.
Very rarely, ambulance transport is indicated. During your prenatal care, we review potential reasons for a transfer of care, including situations that could require emergency measures, and discuss the ways in which those are handled.
During your labor, if we do realize that moving to the hospital for a higher level of care is the best indicated action, I accompany you and shift my role into that of a doula, so that you can experience continuity with a familiar provider.
In that event, I stay with you through the duration of your labor and birth to provide advocacy, comfort measures, and emotional, physical, and informational support.
Once you return home again, my care resumes for the duration of the postpartum period, as originally planned.
“In Giving Birth to our babies, we may find we give birth to new possibilities within ourselves.”
-Myla and Jon Kabat-Zinn
I will always default to reaching for the least intrusive interventions first. If the need for something like a medication is indicated in your care and an herbal or natural remedy could be substituted safely, I will discuss options with you and respect your choices.
I do carry medicines such as RhoGAM for Rh-negative clients, IV antibiotics for the prophylactic treatment of Group Beta Strep (if chosen), local anesthetic for suturing, as well as emergency drugs to use in labor, should the need arise. These include anti-hemorrhagic drugs, IV fluids, oxygen, and more.
Injectable Vitamin K and erythromycin eye ointment for the infant is also provided, if chosen.
Pharmaceutical pain medications are not available in a home birth setting. Instead, by protecting a calm and nurturing environment and providing comfort measures, physiologically normal labor hormones such as oxytocin and natural endorphins are encouraged to support your process.
Also helpful can be hydrotherapy, touch, herbs, and other means of nourishing, low-tech support.
I maintain current certification in Neonatal Resuscitation- NRP, and Basic Life Support- BLS (advanced CPR for health professionals).
What some other sources say about low-risk pregnancies with skilled/certified attendants experiencing birth outside the hospital setting:
"Research using data from the Midwives Alliance of North America's national database found that low-risk women planning home births had high rates of physiologic birth and low rates of intervention, without an increase in adverse outcomes for mother or baby."
— Journal of Midwifery & Women's Health, 2014 (MANA Stats Project)
"Women who planned home birth were more likely to give birth spontaneously and had fewer medical interventions."
— Cohort study of low-risk pregnancies, Netherlands (BMC Pregnancy and Childbirth)
"Among low-risk women, those intending to birth at home experienced fewer birth interventions and untoward maternal outcomes."
— Systematic review and meta-analysis, eClinicalMedicine (Cochrane-affiliated), 2020
"Pregnant people who are essentially healthy at term with a singleton fetus and choose a planned home birth have positive outcomes and a lower rate of interventions."
— American College of Nurse-Midwives, Clinical Bulletin on Home Birth Services
“Of nearly 17,000 planned home births studied, more than 89% of women gave birth at home successfully, only 11% required transfer, and among those with a prior cesarean, 87% went on to have a successful vaginal birth.”
— Journal of Midwifery & Women's Health, 2014