One of the biggest lies of the many lies told by homebirth advocates is that unexpected childbirth complications can be managed by immediate transfer to the hospital.
Some can, but the worst emergencies cannot. Why? Because in the case of a serious emergency, the baby is often left without oxygen. Think about it: could you hold your breath until you got from your living room to the closest hospital — even by ambulance? If not, why would you imagine that a baby could do it and survive?
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Could you hold your breath from your living room to the closest hospital?[/pullquote]
Umbilical cord prolapse is just such an emergency. If the umbilical cord falls out of the uterus into the vagina or even out of the vagina, the blood vessels in the cord constrict in response to the change in temperature, just as they are supposed to do after a baby is born. The baby’s blood supply, and therefore its oxygen, is cut off.
Even if the blood vessels don’t constrict, the cord can get compressed between the baby’s head and the mother’s pelvis. That’s why in the event of a cord prolapse the attendant is supposed to reach into the vagina and exert upward pressure on the baby’s head to keep it from squeezing the cord. Emergency C-section is needed to save the baby’s life and the attendant must keep her hand in the vagina until the baby is delivered.
In childbirth emergencies, “time is brain.” Brain cells begin to die within 5 minutes of being deprived of oxygen. It almost always take more time to get to a hospital, no matter how close, than it takes to injure a baby’s brain.
The latest homebirth death is a perfect example.
A reader sent me this story:
“I wanted to share with you the horrific experience I had that I know will never leave my heart or my mind.
Working at a big hospital we get a lot of home birth transfers and we always take care of them the same way we would a person who chose to deliver in a hospital.
However recently we got a call from our charge nurse that we were getting a home birth transfer via ambulance with a cord prolapse and to get the OR set up.
When the mom arrived in the hospital she was on hands and knees on the gurney with a student midwife behind her with a hand in her vagina. We moved quickly and got the mother onto the OR tables and many people worked together to get an IV started and get her prepped and ready for surgery.
One of our labor nurses took the place of the student midwife and put her hand on the baby’s head to relieve the pressure and she felt absolutely no pulse from the umbilical cord. She knew sitting under that drape that this baby was already gone.
We got a very sketchy and incomplete history of this mom. We found out the student midwife had told the mother that she was fully dilated, but when the on call doctor checked her she was 8 centimeters.
This mother was over 40 weeks pregnant and had ruptured hours before at home with thick green meconium. Tell my why at that point would you not immediately transfer your patient to the hospital to give her baby the best chance of survival. Instead they did nothing.
We still don’t know what exactly happened at home that day. The midwife stated that she had performed an episiotomy and I guess at that point they realized this baby had a cord prolapse and she shoved her ungloved hand up the woman’s vagina in a panicked state.
We had initially thought we heard the baby’s heartbeat in the 110’s, but that was more likely the pulse of the mother. When we finally got this baby out, which took several minutes due to the position of the baby and the size, she was covered and stained in thick green meconium.
This precious baby was gone before she got to us yet we rushed around frantically trying to get this baby out ASAP to give her the best chance of being resuscitated. The baby scored apgars if 0-0-0. They coded the baby for 15-20 min before calling it.
We at the hospital did not have a fighting chance to save this baby despite all of our best efforts. It’s not fair to blame the hospital staff for causing traumatic birth experiences when they are the homebirth midwives are the ones who screwed up. Where does their accountability lie?
This delivery could have 100% been a successful delivery and saved this woman the pain of burying her child and explaining to her 3 year old why her baby sister she had been excited to meet was gone. As we heard the NICU team frantically trying to get any signs of life from this baby and finally called it, it was heartbreaking for everyone in that room. The on call doctor who inherited this disaster was so distraught that she almost could not finish the case.
This poor mother had delivered her first child in our hospital with a highly skilled ob fairly quickly and uneventfully, so I’m sure she was assured by her LAY midwife and accompanying student that she was low risk and could absolutely deliver in the comfort of her own home. She was most likely told that hospitals only want to strap you down to a bed and deliver how the doctor feels most comfortable. That is not at all the case! She was sold on this romanticized fantasy of channeling her inner goddess and doing what her body was created to do with the prying gloved hands and irritating monitoring.
The fact remains that this perfect baby did not have to die. Had this mother been transferred as soon as she ruptured thick meconium she would have been taking her baby home in her arms instead of making funeral arrangements. The hands off approach is a complete gamble and you have no idea what hand you will be dealt. Tragically this mom learned this the hard way. Homebirth mothers only worry about their experience and what they want and they don’t take the health of their baby in to account when they have these reckless disasters.”
Rest In peace, Baby.
And for those thinking about homebirth, think again.
