The midwife at a home birth will have all her instruments laid out, readily accessible, and the oxygen tank turned on, so that what might be an emergency becomes a matter of routine. Many couples worry that the umbilical cord may be wrapped around the baby's neck, a very common occurrence that can be easily handled by a midwife in a home birth.
Some babies "get stuck," a situation called shoulder dystocia. They are gently eased out with position changes of the mother, manipulations of the baby and sometimes episiotomies.
When a situation needs more than the midwife can offer, she has the mother transported to the hospital. Most transports are for labors that progress slowly. If the midwife has good rapport with the backup doctor and the hospital, the birth can often proceed as if the mother and midwife were still at home.
Bio: Barbara Harper, R.N., is the founder of Global Maternal/Child Health Association, a nonprofit organization dedicated to education and research about natural childbirth, including the use of water to ease labor and birth. She lectures internationally on maternity care reform. This article is an excerpt from her book, Gentle Birth Choices, published by Healing Arts Press in Rochester, VT.