Home Birth of My Own
As I reflect back on my own daughter's birth a little over a year ago, I am reminded just how grateful I was for my birth team. My second birth was very different than what I envisioned. I had become suddenly ill kicking my body into full blown labor, lasting less than 3 hours from start to finish. I remember my husband talking with our midwife over the phone about the current situation. We were already talking about transferring to the hospital before she was here. I knew that it was a potential situation when preparing and planning for our home birth, but hearing those words in that moment while in labor was quite upsetting!
I did not end up transferring because baby came like a bat out of hell with my midwife making it to my bedside with one push to spare. It was intense but I recovered quite quickly from the violent laboring that my body had just gone through. I felt very blessed that everything turned out in my favor. I learned a lot from my second delivery, including the glimpse of fear and devastation transferring might have on a woman and delivering in a foreign place with people I did not know.
The Stress and Pressure of Being the Optimal Candidate
It's not just the possibility of transferring to a hospital in the middle of labor. I didn't really consider the steps and requirements for our home birth experience that would need to be taken throughout the pregnancy process to assure I was a safe candidate for having my baby at home. One of the reasons we chose a home birth was for a less stressful pregnancy and birthing experience. I recognize I was very privileged to be a second-time healthy mother in my 20's with no complications or issues with my first birth experience. I had no underlying conditions, generally in excellent health, but I still experienced anxiety and worries of risking out at some point. Would I be the ideal birther, the optimal candidate, the perfect patient? That was quite overwhelming to me at times! This was something I did not expect in the process.
A Birth at Mercy Hospital, Pittsburgh
As a doula I recently had the honor of attending a birth at Mercy Hospital here in Pittsburgh, PA. My clients had been handling their care with The Midwife Center and were planning on an out-of-hospital experience. She voiced concern from some of my first interactions with her risking out from the birth center but I tried to help ease her mind and encouraged her to push that fear aside. Odds were in her favor to deliver at the birth center. We had a short conversation and a rough plan in case of risking out or transferring, but it was something I believed would be a conversation best had if the scenario played out, which I didn't expect to. Time and energy would be better spent elsewhere. Towards the last month of her pregnancy complications occurred and there was no way she would be able to delivery at The Midwife Center. She was frustrated I'm sure, but she showed a lot of resilience and confidence moving forward with the new plan.
An induction date was set in place but baby had much different plans. The baby made his debut one day prior to the induction date. She could not have her baby at the desired location that she had planned for the majority of her pregnancy but she did have her midwives by her side - who still handled and maintained control of her care at the hospital, and she knew that she could count on her husband, and myself to be there for her emotionally and physically. She moved through labor swiftly and delivered a healthy 10 pound baby boy vaginally, with no medication or intervention. It wasn't an easy by any means, but this family really shined in the birth and it was beautiful to observe.
Keeping in Mind: In Case of a Transfer of Care
I asked a local Pittsburgh midwife, Natalie Watson how she handles mother's who may have to transfer their care at any time in the birth process. She told me these important words: "The number one thing I like to instill in my clients is that a home birth to hospital transfer is NOT a failure on their part or a sign of shoddy decision making on the part of the midwife. It's the execution of a successful birth plan."
1) A lot of women may fear that transferring care to a medical facility will derail their birth and that it will lead to a cascade of unwanted interventions. Know that there is a time and place for medical intervention and for the expertise of medical professionals. Also know that it does not mean that any intervention or many interventions will occur.
2) Find comfort in knowing that you have your support team with you by your side during this vulnerable moment. If you have to transfer your care before your birth begins you still have your partner by your side. If you hired a doula or a birth photographer they are also with you every step of the way. Your midwives may even be able to consult in your care and accompany you to your birth! You should never be left out in the cold, dropped off at the front steps of the hospital.
3) Talk about it if it helps you work it out and process the possibility better. Your doula is excellent at listening and helping you with your fears and concerns about pregnancy and birth. Your midwife will also be more than happy to talk with you about fears.
Home births and birth center births for families are beautiful, wonderful choices for our lower risked women. It is often very educational based and more personal. Women who choose hospital births also enjoy and experience low risk, beautiful births too. The people who you surround you in your birth are critical to your well-being no matter if you are birthing in a serene pool of water in your living room, on the side of the road in your car, in an L&D unit at the local hospital, or in the OR during a cesarean birth. It is often emotional to have to transfer your care but it is not a decision that is taken lightly by your midwives. Your health and safety are very important. Know that your midwife respects you and wants you to have a positive experience.
With these things in mind, we hope women will continue to have medical professionals give women more progressive options when delivering at the hospital to make our home birthers and our birth center families feel comfortable when transfers do occur. Fortunately, their are doctors and facilities that strive to make these happen.