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June 13th, 2007, 05:57 PM
CharmieCM CharmieCM is offline
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I've actually never seen a homebirth transport that was the mother's request, except in the case where everyone is talking about what the next step is and the logical next step is the hospital.

Most transports that occur in labor ARE, however, non-emergent. Things like positioning of baby, maternal exhaustion, a tear that's beyond the midwife's suturing skills (or that requires antibiotics), concerns about baby's heart rate (yes, even THAT is usually a non-emergent transport).

But you're asking for the "worst case scenario." Okay, so lets say that you have a cord prolapse (about 1/1000 chance, and it would be much more likely with a baby who is in an odd position than with a head-down, engaged baby). A cord prolapse means that baby's life supply is possibly going to be cut off by the pressure of baby's head on the cord, which would cause the baby to suffocate, in effect. If one knows how to deal with this circumstance (put your chest on the ground, your butt up in the air and have someone stuff their hand inside of you to push baby up off of the cord, and drink about 2 liters of water immediately so that your bladder will provide some cushoin for the cord as well and DO NOT MOVE FROM THIS POSITION UNTIL YOUR BABY IS SAFE AND SOUND ON THE OUTSIDE OF YOU), and how to have the hospital ready to do a "splash and gash" c-section the minute you are rolled through the door (call ahead, tell them you're on the way, that there was a cord prolapse and that they MUST MUST MUST be ready to GET THIS BABY OUT immediately), 45 mintues will not be the difference in life and death for your baby. Now, if no one knows how to handle the situaiton and the hospital dilly-dallys around, then yes, it will mean life or death. In any case, most hospitals have a 30 minute response time for c-sections, even if you're in a labor room down the hall and they determine that you need one.

Other circumstances, like hemmorhage or retained placenta, can be emergencies but are usually much less dramatic. In the case of bleeding, your midwife has drugs to get it under control and the EMTs will also know how to deal with bleeding (whereas they sometimes don't really understand why you've got your butt in the air in the case of a cord prolapse). The retained placenta, as long as you're not bleeding, is not an emergency. I've heard of women waiting 6 hours (after transport) for a d&c to remove their placenta.
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Charlotte, midwife mama to Samuel and Atley, mourning the loss of our "March Baby"
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