Emergency Care at Home birth
Sometimes birth doesn’t go perfectly, and as midwives we fully acknowledge that. Prior to last week, I had barely touched 95% of the items in my birth kit. Until I did.
In this case, we used almost everything. An IV cannula was inserted, fluids were given via a pressure bag, three different postpartum bleeding medications were administered, suturing equipment was prepared, and we managed the third stage actively. I hadn’t pulled on a placenta in over a year, but in that moment every intervention was necessary. Only fifteen minutes earlier, everything was perfect.
This is exactly why I believe homebirth is a safe option. Midwives come prepared with supplies and skills to stabilise both mother and baby. And the reality is, these scenarios only happen a very small percentage of the time. Through managing all things at home, I’m reassured that midwives are extremely capable of using their medical training to provide prompt care when it’s needed.
A Safe Outcome
For this mumma, although an ambulance was called, she was stable by the time they arrived. We gained a second opinion, and all agreed she was safe to continue her care at home. No transfer was needed. Despite a “spicy” hour, she still had a beautiful homebirth with timely, appropriate medical care.
Of course, this won’t always be the case. Sometimes transfer is absolutely indicated, and that is a safe and appropriate choice too. There are no failures in homebirth. Only safe, individualised care.
The Difference at Home
Had this experience unfolded in a hospital setting, it would have triggered an emergency response—meaning many extra, unfamiliar faces suddenly filling the birth room. At home, it was just us. The woman knew all three of us and felt safe and supported, even as things became more intense.
Our care was provided immediately and calmly. More hands don’t always mean faster care, but I was grateful to have the backup of emergency services should we have needed them, and the reassurance that hospital care is there as a safety net if required.
I see hospitals as exactly that—a backup. Midwives are more than capable of managing birth safely in the community for most women, with hospital care available if needed.
Why Midwives Prepare
We always talk through and prepare for possible complications, knowing that most of the time everything unfolds beautifully without them. These rare moments are exactly why we’re there.
Emergencies in birth are rare, but they can happen. This is why midwives must be up to date with emergency care—especially in the home setting. That means being skilled in managing shoulder dystocia, neonatal resuscitation, breathing support for baby, or a breech birth.
The Role of the Second Midwife
Another layer of safety at homebirth is the presence of a second midwife. Having two sets of hands means that if both mother and baby need support at the same time, care can be provided immediately and confidently. It also allows for better management of more complex situations.
Your homebirth team’s role, in the rare event of an emergency, is to:
Provide timely medical support
Call ambulance services if needed
Arrange transfer or further assessment
Keep mother and baby stable with equipment and medications available at home
Access to hospitals and distance from care is always part of the planning during pregnancy, so that if transport is required it can be managed quickly and safely.
Individualised Decisions
Not all women should birth at home, and these conversations are an important part of pregnancy care. Decisions about staying home after complications are not one-size-fits-all—they depend on the clinical picture and the woman’s wishes.
For this mumma, IV fluids and support were enough to continue care at home. For another, transfer may have been the safest option. Our role as private midwives is to provide individualised, evidence-based information and make decisions together with women in real time.
Why Home birth is Safe
Most of the time, birth unfolds smoothly with very minimal complications. But in the rare times when it doesn’t, having a private midwife means you have someone equipped, calm, and skilled right there with you.
This is why homebirth, with a trained midwife, is not only a beautiful choice but also a safe one.
Hannah x
