Homebirth: What If Something Goes Wrong?

Recently I’ve noticed there’s a lot of concern — and even a little hostility — toward home birth. The prevailing thought in many women’s heads is, “But what if something goes wrong?” Many women are, understandably, concerned that if something did go wrong, their life or their baby’s life would be in danger if they were not in a hospital.

Usually we only hear stories from women who were pleased with their home birth experiences, in which everything seemed to go perfectly. It’s why so many of these women hear, “You got lucky.”

But do things go wrong at home? And if so, what types of things? And what happens to those women and babies? I set out to get answers to those questions.

I asked a number of women to share their birth stories with me, specifically women whose home births did not go as planned. I know that this is only anecdotal evidence. But frankly, most of the women who tell me home birth is a bad idea are relying on anecdotal evidence, too. “Well, if I hadn’t been the hospital when…” “I know this one woman who had a home birth, but…” So let’s answer stories with stories.

(Please note that many stories have been shortened due to space. Only non-essential details have been removed. If you have questions, please leave them here, and I can send full stories and/or forward questions to the women.)

“I started having contractions early Wednesday morning around 5:30. I was 5 days post-due date. Becca came by the house to check me around 5 or 6 that evening. I was dilated to 3 and 100% effaced. I had previously had cryosurgery of my cervix when I was 18, and a side effect is for your cervix not to dilate and cause labor to be very drawn out. [No change Wed, tried again on Thurs.] We decided to strip my membranes. I took homeopathics, used pressure points, and ate spicy food. By 4:30 my contractions were in full bloom, hard, and getting closer — less than 5 minutes apart. [Becca] checked me and I was at 7 cm. I got in the tub and labored there for two more hours. When Becca came into the bathroom, Aidalyn’s whole forehead had emerged already. When Becca looked she saw that Aidalyn had her hand next to her face, which explained why it had taken 2 hours in the tub. Becca coached me to raise my leg to give room for her hand. In three pushes, Aidalyn was out at 9:10 PM on Thursday, December the 2nd. Aidalyn was in shock from such a quick labor, so we needed to get out of the tub to get her breathing and make her more responsive. Her APGAR scores were 5 and 6. We moved to the bed where Becca turned Aidalyn on her belly and got her to start crying after several attempts. It could have been a completely different story in the hospital. If her APGAR score had been that low, I’m sure they would have rushed her off, and I would have missed the experience of holding her for so long and nursing her. Thank goodness my midwife was able to react promptly and did just what was needed in that moment. I wouldn’t do it any other way.” —Angela

“Our midwife and two attendants showed up in the wee hours of the morning after I’d been in labor for several hours. About halfway through the day, after many more hours of difficult laboring including lots of throwing up, my water that broke was found to have meconium in it, which my midwife assured me she would be able to handle when the baby came out. But as the hours wore on, the baby’s heart rate kept going down, and my blood pressure continued to rise — both of which were helped by soaking in our warm bathtub. Even though our midwife and the attendants took their turns administering homeopathic tablets, giving me oxygen, and taking their measurements, they pretty much left my husband and me to labor together. And although the pain was more terrible than I ever could have imagined, the experience was more than I could have hoped for. After about two hours of pushing with my blood pressure continuing to rise and baby’s heart rate continuing to fall, our midwife said we’d need to go to the hospital to have either an episiotomy or vacuum our baby out. I had to stop pushing the entire 15-minute drive across town — over and under bridges. The doctor finally had me push, just to see where the baby was at. And wouldn’t you know it: She came right out — no interference necessary! Her poor fist was up against her cheek and the umbilical cord was wrapped around her neck twice. Except for maybe my massive vagina mess — it was described as being “inside out,” with small tears on the inside that they stitched up — there wasn’t anything the hospital did that our midwife couldn’t have handled just fine. They took my baby from me right away, which wasn’t in my birth plan — nothing they did was! It was pretty traumatic, honestly. My husband and I were so overwhelmed by how positive the home part of it had gone that we are definitely planning to do any future births at home!” —Greta

“My first homebirth was pretty fast (2 1/2 hours from the time I realized I was in labor), but I was drinking water the whole time.  Once the baby came, and I’d delivered the placenta, my uterus would not contract. The midwife believed that it was because my bladder was so full. But nursing the baby and manual stimulation weren’t helping the uterus contract down, and I was bleeding pretty profusely. The midwife asked me to try emptying my bladder, and I tried sitting on the toilet then tried in the shower. She was worried about me standing on my own when I was still bleeding heavily, so DH stood with me in the shower while I tried to empty my bladder. That didn’t work, and she didn’t want me standing up, aiding the blood flow with gravity, so I tried sitting in about an inch of warm water in the tub. When that didn’t work, she asked to catheterize me. I hesitantly agreed, and she was able to empty almost 3 quarts from my bladder! After that my uterus immediately contracted down, and the bleeding slowed enough that she was satisfied. The whole time my midwife was keeping a very close eye on how much blood I was losing and had several plans already in place if I’d continued to lose blood [including transfer].” —Jennifer

“Gave birth to my daughter at home with a midwife. Everything went well ’til 1 hour postpartum. The placenta delivered incomplete. I suffered PPH. My midwife had my sister call 911 immediately while she administered pitocin and oxygen. The bleeding was under control before the paramedics arrived. My midwife acted quickly and correctly. I still transfered to the hospital to get a D&C and ended up with a blood transfusion 2 days later. Sometimes it makes me sad that I missed my blissful postpartum at home, but I have been able to separate that experience from the actual birth, which was the most wonderful, empowering thing that’s ever happened to me and my new family. And yes, all our other babies will be born at home, too.” —Robin

“I had my second daughter at home and am very confident that if I had been seeing an ob and planning on a hospital delivery, I would have ended up with a C-section. My water “broke” on a Monday, and she was born Friday of that week. I didn’t progress very quickly, and after many hours of a.c.t.i.v.e. labor, we discovered she needed to be rotated. My awesome midwife and her students were able to move the baby, and my next contraction was different! She was born almost an hour later, in our birth pool. I had four tears, which presented a cool learning opportunity for my midwife’s students.” —Ashley

“Around 9 a.m. I called my midwife and told her I was having too much pain in my ribs to keep the baby much longer.  She came over at 10 a.m. and, after seeing that I was not dilated at all, stripped my membranes. I was 3-cm dilated by 10:30. She went home after that. I called her around 5 p.m. saying that I was having contractions 5 minutes apart. Labor progressed really nicely throughout the whole labor. I was in the labor pool we had for a while, then wanted to get out for a little bit. Just as I wanted to get back in the pool, I felt the urge to push. After 2 pushes, my beautiful, albeit red, baby girl was born. Now, before labor, we thought my child would be quite large due to my large belly size. However, she was only 7 lbs., 7 oz. The reasons for the large size were 1) I had an extremely large placenta, and 2) there was about a gallon of fluid in the womb with her. My midwife left an hour or so later — after seeing that I could walk to the bathroom without passing out. Then about 2 hours or so after she left, I called her saying I couldn’t get out of bed for the bathroom . I was extremely lightheaded when moving at all.  My midwife came back and found that there were still more blood clots inside me. After getting them out, she hooked me up to an IV bag [of pitocin, likely], which she hung from the ceiling fan. All in all, it went very well. But there were various unexpected points along the journey.” —DeDe

“On the morning of December 19th, 2009, around 5:30 or so, I was awakened by some strange hip pain. I concluded I must be having some false labor. False because it was still four weeks until my due date. I headed back to bed, hoping that the contractions would stop. Marilyn [midwife] came over at around 11:30 to check me. I was already dilated five centimeters. She finished checking me, looked at me, and said, “You’re going to have your baby tonight!” I was able to get into [the pool] when I was around eight centimeters or so. I started feeling the urge to push, but even though I was almost completely dilated, there was still a lip of cervix in the way. It wasn’t moving, but then Marilyn held it out of the way while I pushed a couple times — pretty much the most uncomfortable thing ever! — and we were good to go. Marilyn kept monitoring the baby’s heartbeat every other contraction and at one point, when the baby was almost out, it dropped. Since she felt my pushes weren’t going to get the baby out fast enough, she helped by easing his head out. Once his head was out, one more push got the rest of him out — the strangest feeling! Marilyn kept monitoring him, and after a couple minutes was concerned that he didn’t seem to be breathing very well. Marilyn called the doctor she works with, asked his opinion, and they decided our little boy needed to be taken to the local children’s hospital. The ambulance was on its way. We spent the day at the hospital, mostly in the NICU waiting room. He was doing better than they originally thought he would, and he continued to improve all day. But … there was grace. Grace for both of us to being able to sleep soundly that night and awoken to hear that Cedar was doing much better in the morning. Grace for the next four days (much less time than the doctors had originally told us) that we spent in a room in the NICU.  And it constantly amazes me to think how far our loving Father has brought him … and will continue to.” —Jessica

These women faced labors that didn’t progress, babies in difficult positions (posterior, hands up by face), hemorrhage, and so on … and there were ultimately no adverse outcomes. All mothers and babies are fine. All mothers are ultimately satisfied with their experiences. All midwives were well-trained and able to handle the complications, including knowing when a transfer was needed and doing so in a timely manner.

Tomorrow I’ll be sharing an interview with a midwife who shares how she has handled some of the more difficult situations she has encountered in her 40+ year career. Don’t miss it!

Have you had or considered a home birth?

Top image by mbaylor

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Related links on Babble:

Babble’s Best Birth Stories, from a 55-hour labor to a home birth gone awry

Maternal Health Care in America: Ina May Gaskin’s vision for the future

• My Illegal Home Birth: It was weird, magical and a felony

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