Read our 4 part story about long labor scenarios, posted every Wednesday.

Part 4

As a home birth midwife who has also spent many hours on the labor and delivery floor as a hospital midwife, I pride myself in my ability to fully trust birth. I have experienced two unassisted births out of my own six home births and have seen thousands of babies be born. Birth happens, it is physiological. But sometimes it doesn’t and sometimes it isn’t and it’s my JOB to know the difference. I always say that in birth, when things aren’t going along as expected and we’re pushing boundaries, everything is fine until it’s not. I do not want to be at home with a mother and baby who need to be in the hospital. The key is to balance that trust with attentive monitoring and an eagle-eye view of the whole situation to transport in a timely manner – not too quickly and not too late. I admit that I err on the side of transporting more quickly than some of my peers because I could not live with myself if I did not transport when I should have and we have a bad outcome.

I do not consider a hospital delivery a bad outcome if both mommy and baby are whole and healthy. We don’t like some of the things they do there that we feel are unnecessary, but we are happy that they can take over when we have exhausted our efforts at home or have a sign of distress. My client had a beautiful baby with good Apgars and no obvious reason for her slow progress and arrest of descent of the baby.

So we live and learn. We remember the things that worked to get a long labor to move along; we follow the evidence on normal labor and give women every chance to birth; we recommend doulas to help with the stress and exhaustion of early labor scenarios like the story above – maybe having a doula would’ve been the one factor to make a difference for that couple. And we get to fall asleep at night knowing that our client and baby did well and will move on with their lives and have another chance at a beautiful vaginal birth!

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