At a home birth, midwives monitor both the birthing parent and the baby carefully in order to detect any early complications – just the same as if the birth were to take place in the hospital. Most healthy people have healthy pregnancies and uncomplicated births. However, sometimes birth does not go as planned and midwives are prepared for this.
Midwives have the training and skills to:
- identify when a complication is developing early on
- correct many developing complications
- know when to involve specialists (e.g. obstetrician, pediatrician) to help treat complications and achieve the best health outcomes possible for you and your baby
Although most people who plan to have their baby at home do have their baby at home, there are a number of reasons a planned home birth could end up happening in the hospital.
Non-urgent transfer to hospital
Most people move from home into the hospital for non-urgent reasons. The most common reasons are:
- to access pain relief options only available in hospital (e.g., an epidural)
- to access an IV drip that contains the drug oxytocin to help speed up labour that is progressing very slowly
In these situations, there is no need to rush to the hospital. Travel can occur by car or taxi.
Emergency transport to hospital
Very few people who plan to have their babies at home are transferred urgently to hospital by ambulance. The most common emergencies requiring ambulance transport include:
- heavy bleeding after the birth (post-partum hemorrhage)
- concerns about the baby’s heartbeat during labour or their breathing after the birth
If an urgent transfer to hospital is required, your midwife will call 911. Emergency Medical Services (EMS) will come to your home, and you and/or your baby will be transported to the hospital by ambulance. The hospital will be notified of your and/or your baby’s condition. This allows staff to prepare for your arrival and prevent potential delays in care.
Depending on the situation, your midwife will either accompany you in the ambulance or meet you at the hospital.
Find out more about how midwives are training Ontario paramedics in out-of-hospital birth emergency skills!
Transferring from home to hospital: At the hospital
Midwives work with a wide range of other healthcare providers in hospitals to make sure that you receive safe, excellent care. Sometimes it is recommended that a doctor takes over parts of your or your baby’s clinical care. If this is the case, your midwife will continue to provide supportive care, comfort and information. They will take over clinical care once your or your baby’s condition has improved.