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How Safe is a Home Birth?

QUESTION

My first child was born at home with a midwife. He was healthy and the labor was a normal first labor. I am pregnant again six years later and I am doing medical research concerning birth.

My main concern about having another home birth is having a birth in which the chord begins to come out first. I have been told by my doctor that this is a life threatening situation which needs immediate ceasarian intervention. What is the midwife's approach to this situation?

Thanks.

ANSWER

Of course a "prolapsed cord" is a rare event, but there are many rare events that a midwife is prepared to handle. The short answer is that we do the same thing at home that we would do at the hospital: put you in knee-chest position, hold the baby's head out of the vagina, and stay that way until you are in an operating room. I have personally held the baby who was just fine using this approach; the mom didn't get her home birth and did get a cesarean, but everyone did well.

There are risks and benefits to each place you might choose for delivery. There are risks that are less likely (or basically non-existent) at the hospital and risks that are less likely (or basically non-existent) at home or a birth center.

As a good mom who is trying to evaluate her options (good for you!), you need to weigh the risks of your alternatives and then make an informed decision.

Good luck!
Cynthia

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.