Complications in Labor
Hospital Transfers
There are many factors involved in making a decision to go to the hospital. Your midwife will make sure that you understand what those factors are, and she will collaborate with you in the decision-making process.
Transfers are rarely an emergency.
Most transfers are due to a failure of labor to progress. In spite of everyone’s best efforts the labor “stalls out” and that can be tiring for mom and baby.
If I need a doctor, who will that be?
As required by the Medical Board and according to California Standards, we will consult with you and prepare an Emergency Care Plan.
If a transfer is necessary, who will help me on the way to the hospital?
If a mother or baby were to need transfer to hospital, it is normally not emergent.
We activate EMS if an emergency transport is necessary.
We are trained to perform the necessary life-saving techniques in transit to hospital.
We notify the hospital prior to the transport and will receive full records and report as we turn care over to the receiving physician.
Concerns for the Baby
What if the baby doesn’t fit?
Your pelvis and hips are constructed with an amazing ability to stretch and move as your baby descends to the pelvic floor.
Most babies will “fit”.
There are occasions when a pelvis, for a variety of reasons, is difficult for baby to negotiate; or babies can sometimes get in positions that make it challenging to negotiate the birth canal.
Midwives will usually try to correct the problem by helping mom to assume different positions. If that does not provide a solution, your midwife will discuss other options with you and together you will make a decision on how to proceed.
What will you do if the cord is around baby’s neck?
Parents are often surprised to hear that a cord wrapped around a baby’s neck is not an unusual situation.
Most of the time, as the baby’s head is born, the midwife is able to gently slip the cord around the baby’s head and the baby births without any problem.
On the rare occasion that a cord may be too tight to slip over the baby’s head, your midwife to handle these situations.
What if my baby needs help breathing?
Approximately 90% of newborns will not require any help to begin breathing.
For the small number of babies who do need assistance, your midwives are certified in Neonatal Resuscitation and Adult and Infant CPR.
They know how to recognize the need and respond.
Your midwife will bring all necessary equipment to your home, including oxygen, in the unlikely event that resuscitation is required.
What will you do if the baby’s heartbeat stops after it is born?
We frequently assess the fetal well being during the course of the labor. If there are any signs of fetal distress or problems that occur during the labor, our goal is healthy mother and healthy baby. We will transfer to hospital prior to the birth if these conditions develop. If the baby were to be born needing assistance transitioning, both midwives are trained and certified in Neonatal Resuscitation, infant and adult CPR and BLS. The midwives recertify every two years and practice their skills on a regular basis.
Concerns for the Mother
What if there is a hemorrhage?
As midwives licensed by the Medical Board of California, we do carry and use medications as is appropriate.
We take great care in working with low-risk women who are not nutritionally compromised.
We review their labs at least twice in the pregnancy and work with them on optimal nutrition to remedy issues such as iron deficiency, low red blood count, low platelet count and various anemias.
All of these mechanisms reduce the risk of hemorrhage.
If a hemorrhage were to occur immediately postpartum, we have the following medications available and use them judiciously as indicated by the situation: Pitocin – used either IM or IV, misopristol (tablets), hemostatic herbs, methergine.
Consult Your Midwife
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