Category: Home Birth

Hospital Transfers

5/1/2026

A transfer occurs when we change plans for a home birth and go to the hospital for the birth instead. This can happen during labor, during birth, or after birth. Choosing a home birth is a significant decision, and it is normal to wonder what happens if the plan needs to change.
Why would we transfer?There are many reasons why we may transfer. Sometimes you may request a transfer for pain management, such as an epidural, or I may observe clinical indications that birth will be safer at the hospital. Common reasons for a transfer include:

Fetal heart tones that indicate the baby is not tolerating labor well.
Signs of infection, such as an elevated temperature or amniotic fluid with a strong odor.
Surprise breech birth with a labor pattern that is not reassuring for a home birth.

What does a non-emergency transfer look like?Most of the time, transfers are not due to an emergency situation. I prioritize a client-centered approach, ensuring we have time to discuss what is being observed, the risks of staying home, and what to expect at the hospital.
The protocol for a non-emergency transfer includes:

Selecting the Hospital: We will discuss which hospital to transfer to, usually the closest one with labor and delivery services, or a hospital I have engaged with to establish clear transfer protocols.
Professional Coordination: I will call the hospital as soon as I am aware we will be transferring—even if arrival is several hours away—to provide a report. When I call, I will provide details on your last vaginal exam, if your membranes have ruptured, if you tested for GBS and what the results were, fetal heart tones, and vitals.
Sharing Records: I will fax your prenatal records, labs, and transfer forms so the hospital providers can review them before we arrive.
The Journey: A family member or support person will drive you while I follow behind with my midwifery equipment in case birth occurs en route.
Continuous Support: I will accompany you to the labor and delivery unit and act as a liaison and advisor with hospital staff until your baby is born.

What does an emergency transfer look like?In a rare emergency, the midwifery team may call EMS. If at all possible, I will still alert the hospital that we are coming and what the situation is.
During an emergency transfer, I may ride in the ambulance with you or your newborn. If we take a car, I will bring midwifery equipment in case birth occurs before we arrive. Just like in a non-emergency, I will stay with you to provide support and be a liaison until after the birth.
Our Partnership and Your CareRegardless of where your birth takes place, I will provide postpartum care after you are released from the hospital. Choosing a home birth means having a plan for every scenario, ensuring you and your baby receive evidence-based care every step of the way.
I am driven to do what I can to ensure you are supported well. No matter where birth happens, birth remains a miracle. I find myself in a place of wonder at the miracles of birth that I have the honor to witness, and I continue to be amazed by how strong Moms and babies are.

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The Data on Home Birth Safety

4/15/2026

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When you tell friends or family you’re considering a home birth, the first question is almost always: "But is it safe?" For decades, cultural myths have painted out-of-hospital birth as a risky gamble. However, modern obstetric research tells a very different story. When we look at large-scale clinical data involving hundreds of thousands of births, the evidence shows that for healthy, low-risk pregnancies, planned home birth with a qualified midwife is a safe and statistically sound choice.

The "Gold Standard" Study: 500,000 Births Analyzed
In 2019, a massive meta-analysis was published in The Lancet, one of the world’s most prestigious medical journals. Researchers led by Eileen Hutton analyzed 28 different studies covering approximately 500,000 intended home births across high-income countries.
The goal was simple: compare the safety of planned home births to planned hospital births for low-risk individuals.

The Findings:

No Difference in Mortality: There was no statistically significant difference in the risk of neonatal or perinatal death between the home birth group and the hospital birth group.
Lower Intervention Rates: The home birth group experienced significantly fewer medical interventions, such as C-sections, forceps deliveries, and episiotomies.
Maternal Health: Mothers who planned a home birth were less likely to experience infection or severe perineal trauma.

The "Safety Net" of having a Midwife
Safety isn't just about where you are; it’s about who is with you. Certified Professional Midwives (CPMs) are trained to monitor the safety of both parent and baby throughout the entire process. My assistant and I bring the "hospital" to you in the form of emergency equipment and clinical expertise, but we leave the "hospital environment" behind. This allows your body to produce the natural oxytocin necessary for labor to progress, often avoiding the very complications that lead to emergencies in the first place. By choosing a planned home birth, you are opting out of the "cascade of interventions" while providing for the safety of your baby’s arrival.

It is important to remember that these "safety" statistics apply to planned home births for low-risk individuals. This is why our initial consultation and ongoing prenatal screenings are so vital.

The "Safety Question" is a fair one, but the data has already provided the answer. For healthy women, home birth is not a step away from safety—it is a step toward a personalized, evidence-based, and empowering birth experience.

Sources:
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30119-1/fulltext
https://pmc.ncbi.nlm.nih.gov/articles/PMC9994459/
https://pubmed.ncbi.nlm.nih.gov/32280941/

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Risk Screening and Home Birth

4/1/2026

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In the world of maternity care, "low-risk" isn't just a casual term; it is a specific clinical designation. As a midwife in Kansas, my primary job isn't just to catch babies—it’s to be a diligent gatekeeper of safety.
The safety of out-of-hospital birth depends entirely on the screening process. We don't simply "hope for the best"; we use continuous, rigorous screening from your first prenatal visit until the moment your baby is born to ensure that home birth remains a safe option for you and your baby.

What the Research Says:
The MANA Stats Study:
If you are looking for peace of mind, the data is your best friend. One of the most significant studies in North American midwifery, published by Cheyney et al. (2014) in the Journal of Midwifery & Women’s Health, followed nearly 17,000 planned home births.

The study found that for women who met "low-risk" criteria:

93.6% had spontaneous vaginal births.
The rate of C-sections was significantly lower than the national hospital average.
Neonatal outcomes were excellent, proving that the "community setting" is a safe and viable option for healthy pregnancies.

The "Risk-Out" Reality
A common misconception is that midwives will take any client who wants a home birth. In reality, we are always screening for risk. We look for "green lights" like:

A single baby in a head-down position.
Absence of chronic conditions like Type 1 diabetes or heart disease.
Labor that begins naturally between 37 and 42 weeks.

If a "red flag" appears—such as the development of preeclampsia or gestational diabetes that requires insulin—we "risk out." This means we transition your care to a clinical setting where higher-level interventions are available. This isn't a failure; it’s responsible clinical management.

Safety in the "What Ifs"
Even in a low risk pregnancy, we prepare for the unexpected. Your home birth "kit" isn't just blankets and birth pools; the midwife brings:

Neonatal resuscitation equipment
Resources to manage postpartum bleeding
Equipment for regular monitoring of fetal heart tones throughout labor

Furthermore, a hallmark of a safe home birth is a seamless transfer plan. Research shows that roughly 10-12% of home births move to a hospital, but the vast majority of these are for non-emergencies like maternal exhaustion. Having a plan in place ensures that if the "low-risk" status changes, your safety remains the priority.

Choosing a home birth in Kansas isn't about rejecting modern medicine; it’s about choosing the appropriate level of care for a healthy, physiological process. When we respect the science of risk screening, we create a birth environment that is not only beautiful and intimate but clinically sound.

Sources:
https://pubmed.ncbi.nlm.nih.gov/24479690/
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30119-1/fulltext
https://www.ksrevisor.gov/statutes/chapters/ch65/065_028b_0003.html

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Placenta Previa

9/15/2025

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What Exactly Is Placenta previa?
Placenta previa is when the placenta implants low in the uterus, covering all or part of the cervix, which is the opening of the uterus. Normally, the placenta attaches to the top or side of the inner uterine wall.

The way the placenta covers the cervix can vary, leading to different classifications:

• Placenta previa: This refers to when the placenta completely or partially covers the cervical opening. The placenta implants over or near the internal os of the cervix.
• Marginal placenta previa: This means the placenta is near the cervix (specifically, within 2 centimeters) but doesn't cover it.
• Low-lying placenta: Here, the placental edge does not cover the internal opening but is within 2 cm of it, or sometimes defined as 2 to 3.5 cm away from it.

Placenta previa is estimated to affect around 1 in 200 pregnant women at some point during pregnancy. In the majority of cases, approximately 90%, especially with low-lying placentas, the condition resolves on its own by the third trimester. As your uterus grows and changes, the placenta appears to "migrate"—it doesn't actually move, but rather grows towards the richer blood supply at the top of the uterus, while the lower uterine segment grows, increasing the distance from the cervix. This means that only about 1 in 800 pregnant women continue to have placenta previa at the time of delivery.

What are the symptoms of placenta previa?
Placenta previa may not cause any noticeable symptoms and may be discovered incidentally during a routine second-trimester ultrasound, such as your anatomy scan. However, the primary sign, if it does occur, is sudden, painless vaginal bleeding. This bleeding is typically bright red and usually happens after 20 weeks of pregnancy, often in the second or third trimester. The bleeding can sometimes be accompanied by uterine contractions.

How is suspected placenta previa confirmed?
A transvaginal ultrasound is considered the best way to confirm the exact location of the placenta.

Is home birth an option for someone with placenta previa?
For most cases where placenta previa persists until delivery, a cesarean delivery is the safest for both Mom and baby. However, there are specific circumstances where home birth might be an option. If the placenta is classified as a low-lying placenta, homebirth may be an option. Careful monitoring of the position of the placenta is an important tool in deciding what type of birth will be best for Mom and baby.

Sources:
https://www.mayoclinic.org/diseases-conditions/placenta-previa/symptoms-causes/syc-20352768
https://www.ncbi.nlm.nih.gov/sites/books/NBK539818/
https://www.yalemedicine.org/conditions/placenta-previa
https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/placenta-previa

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Helping Siblings Get Ready

2/15/2025

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Birith not only creates parents, it can also create big brothers and big sisters. As you are preparing for the arrival of baby, you can help your children to prepare to be a big brother or sister too.

Even the youngest future big brother or sister can do things to be ready to welcome baby. Here are a few suggestions:

Putting diapers into a basket, or a drawer at the changing table
Picking out an outfit for baby to wear in the first few days after birth, or choosing a new outfit for baby at the store.
Picking out the first book to be read to baby after baby arrives.
Drawing pictures for baby
Picking out a toy or toys to give baby.
Helping set up the nursery
Making a "baby is here" freezer meal

Other suggestions for things you can do to help a future big brother or sister include:

Have a big brother/ big sister gift to give after baby is here. My son was delighted with his Worlds Best Big Brother balloon bouquet and Tonka dump truck
Read some books together that talk about becoming a big brother or sister. I have a few recomendations:
- Little Critter; The New Baby by Mercer Mayer
- The Berenstain Bears and Baby Makes Five
- My New Baby by Rachel Fuller
- The New Baby by Mr. Rogers
- The Berenstain Bears New Baby by Stan and Jan Berenstain
- Babies Don't Eat Pizza by Diana Danzig
- Socks by Beverly Cleary (this one is my personal favorite)
Talk about how wonderful it will be to have a new baby brother or sister and what things siblings can do to connect with baby like reading them stories, singing to them, etc.

Helping siblings get ready for baby can go a long way towards a smooth transition once baby is here.

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Hospital Transfers

The Data on Home Birth Safety

Risk Screening and Home Birth

Placenta Previa

Helping Siblings Get Ready

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