What Happens in Case of an Emergency at The Birth Center? How we evaluate risk factors and handle the unpredictable

Here at The Birth Center, we invite anyone who is interested in receiving care with our team to visit our facility, take a tour, and ask questions. Education is important, and we want you to make the best choice for your family when it comes to your pregnancy and birth.

One of the most common questions we hear at The Birth Center during tours is, “What happens in case of an emergency?” We understand the nature of this question. Birthing parents and their partners are often concerned about safety, especially during labor and birth.

The simple answer is that we rarely have true emergencies at The Birth Center. This is because we screen our clients to make sure they fit our low-risk criteria. In addition, our nurse midwives are trained to identify when a patient needs to transfer before things become more complicated. 

Still, there is always an element of the unpredictable when it comes to birth. And, if routine complications arise, we are prepared to handle them.

How do we determine if you’re low risk during pregnancy?

When we talk with prospective patients, there are some health issues that we consider automatic exclusions from The Birth Center. These include having existing diabetes or high blood pressure, and carrying more than one baby.

When you receive prenatal care with us, we watch for risk factors that can develop. One of the reasons why prenatal care is less frequent in the beginning of pregnancy and increases as the pregnancy progresses is because risk factors often present themselves later. The most common concerns are hypertension, pre-eclampsia, a breech baby who won’t turn, and a low amniotic fluid level.

Statistically, about 95 percent of pregnant women have low-risk pregnancies and could give birth in a birth center if they chose to. If all goes well — and it does the majority of the time — birthing parents can continue their prenatal care at The Birth Center and labor and birth at our facility.

As a birth center, we serve healthy, low-risk pregnant women. When we use our risk criteria properly, we’re not taking care of women we shouldn’t be. This dramatically reduces the possibility of emergencies. However, if risk factors develop and you would need to transfer to OB care, your nurse midwife at TBC will help with that transition of care.

What complications can happen during labor and birth?

It’s important to remember — most labors and births are normal physiological processes. Birth itself is not an emergency or even something that needs to be treated. Problems can arise, but our nurse midwives are highly trained and can handle routine complications.

During labor, we monitor the birthing parent’s vitals and the baby’s heart rate. If a fetal heart rate drops, it can often be corrected by giving the mother oxygen or having her change position.

We do not refer many clients for ultrasounds, but we do see the 20-week scan as a chance to screen for possible issues that would need further follow-up.

What complications can arise after birth?

The two most common complications that can happen immediately after birth are when a baby needs help breathing and when the birthing parent hemorrhages.

All staff members at The Birth Center, including nurse midwives, nurses, and doulas, are neonatal resuscitation providers (NRPs). NRP training is specific to taking care of the newborn with complications at birth or shortly after. We renew our neonatal resuscitation certification every two years, just as hospital staff members do. Additionally, we do drills at least every six months with our life-like newborn resuscitation doll.

At The Birth Center, postpartum hemorrhage is rare. This is largely due to our practice of delayed cord clamping, which allows the cord to continue pulsating and pump blood back to the newborn. After delayed cord clamping, the placenta comes out more readily. In case of a hemorrhage, we have all the medications to stop bleeding that are available in a hospital setting. We are also able to start IVs if needed.

After the placenta is delivered, we inspect it to make sure it’s complete because retained pieces of placenta left in the uterus will cause excess bleeding. It’s rare, but if a placenta is retained, meaning it won’t come out, a hospital transfer will be necessary.

Takeaways on safe birth

In general, we don’t usually have emergencies at The Birth Center. If we have more than one or two patients a year leaving by ambulance, we’re not screening well enough. The most common reason for transfers from TBC is a stalled labor. Sometimes a woman needs medication to improve her labor and/or pain-relieving medications. In that case, it’s not an emergency, and the transfer happens by private car.

There are always unknowns that can arise. That’s why it’s important for you, as the expectant parent, to hire someone who can help you have a baby safely — someone who knows more than you about how to identify when things are deviating from normal.

Are you ready to learn more about safe birth at The Birth Center? Schedule an on-site tour of our center!