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Complications and Homebirth Midwifery

Updated: Jun 26, 2023

As you are laboring and working towards meeting your baby - we enter your house and set up our equipment. You are already aware of what these items are and what they may be used for. We talk prenatally about what types of complications are most common and what we most commonly do to rectify them. Neonatal resuscitation, shoulder dystocia, postpartum hemorrhage- these can feel like big, scary words. But, in all honesty, I would prefer for them to be resolved by a skilled midwife than any other care provider. The skills are important, vitally important, but so are the skills of keeping mom and baby as connected as possible, and communication throughout the process.

While I can't walk you through every single complication and what we do for them, taking one and discussing it actually helps you see how we handle the things that birth can throw our way. You'll see a theme here: we have the skills engrained in our minds and muscle memory in our bodies, we have the awareness of the experience for both parents and baby and the importance of how that is handled, and we have the ability to communicate calmly what is happening, why it's happening, and what we are doing to resolve it. Midwifery care is always midwifery care.

Here is an example of some resuscitation equipment we keep on hand at births so that we can easily grab them should they be needed. Most of the time this equipment isn’t needed. Babies come out, lock eyes with their exhausted, relieved, oxytocin-high joy-filled mama and we all ohh and ahh over their precious rolls and sweet features. But, that’s not the reality all of the time.

Sometimes we put out this vision that homebirth is always straightforward, that everyone is blinded by all the rainbows and butterflies that are shooting out from everywhere as we care for mom and baby. It can be. It often is. More often than not, Tiffany and I find ourselves holding the space and keeping a watchful eye, keeping our skills in the forefront of our minds, but not actually needing them. As midwives, do we love those births? Of course! It all oozes oxytocin so thick that we float around your home on a high of our own. But, as midwives we are really there for the births that go a bit…sideways.

Birth doesn’t always go the way we envision it. There are a lot of variables, and a lot of complications and variations that we are trained to deal with. One that we are asked about often is: What if baby needs help breathing when they are born?

Statistics tell us that 1 in 10 babies need assistance in breathing, in one way shape or form, after they are born. That may sound scary, but as midwives- this is one of our specialties. We are certified in Neonatal Resuscitation, a training that we take at least every 2 years, and to be honest, we don’t mind having to utilize these skills. We know what to do, how to do it, and how to communicate the process with our clients. The majority of the time when these skills are needed, babies need some help inflating their lungs for the first time and encouragement to push out fluid, and our skillset and equipment helps them do that quite efficiently.

Contrary to how resuscitations are done in hospital, we are highly aware of the respect that babies, parents, and situations deserve. As often as we can we keep baby connected to their placenta, recognizing what a lifeline it is and the purpose it serves especially in this particularly important moment. Pulsing all of this oxygen rich blood into baby when, let's be honest, baby needs it the most. Instead of a warmer, we keep baby on your chest as often as possible. As we utilize our skillset quickly and efficiently, we encourage you to be a part of the process. Talking to your baby, rubbing your baby’s feet, encouraging your baby to take a deep breath.

As midwives we are constantly reminded of the importance of breath. For your baby, for you, for us as care providers.

As these skills are needed, I sense the world slow down in front of me and I walk through each step confidently and purposefully, trusting in these research-backed skills. More often than not, these resuscitations are straightforward and not traumatic for baby or parents, because of the reverent nature with which we treat them.

While you may not have planned for these types of complications, we as midwives are always prepared for them. Yes, sometimes things don't go as you planned, and that is when you are particularly thankful you have a care team that is present and ready to help you and baby be as healthy, safe, and honored as possible.

Want to learn more about the most common complications we encounter at homebirths and how we respond to them? Check out this post!


We love educating parents about the behind-the-scenes of homebirth midwifery care and often share resources and information about how midwives prepare for these types of situations. Be sure to follow us on Instagram @beautifulonemidwifery.

Although we are licensed midwives by profession, we are not YOUR midwives. All content and information on this website is for informational and educational purposes only, and does not constitute medical advice. Although we strive to provide accurate general information, the information presented here is not a substitute for any kind of professional advice. For more information, click here.

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