“Risking Out” of Home Birth
While home birth is typically thought of for only "low risk" pregnancies, very little information is available regarding how risk is determined. Here is a handy breakdown of conditions that would require consultation, referral or transfer of care.
Contraindications for Home Birth
I do not assume primary care of clients with the following conditions:
Active TB
Heart or Lung Disease
Liver or Kidney Disease
Cancer
Bleeding disorders
Any other major medical problem or congenital abnormality that affects childbearing.
What if something comes up in the pregnancy?
Some conditions may arise during pregnancy that may lead to a recommended consultation with another practitioner or specialist. With careful monitoring and treatment you can still have a safe and successful home birth.
Midwives recognize the medical factors of risk involved with some situations including breech birth and twin pregnancies. It is my policy to counsel any client with these situations regarding these risk factors for both herself and her baby. I encourage the parents to make a responsible decision in conjunction with their physician, while upholding the right of the consumer to informed consent and self- determination. The intrinsic right of the parents to choose their place of birth is recognized, and within the bounds of my training and my comfort level I am not prohibited from aiding the clients with their choice. If unusual conditions exist an informed consent will be signed. I reserve the right to withdraw care if situations arise that are irreconcilable or are outside my training and/or comfort level.
Prenatal Conditions Requiring Consultation and or Referral: ("REFER" is defined by Webster as: To send or direct for aid, information, etc." Women have the right to decline referral. )
Active syphilis, gonorrhea, or chlamydia.
Unresolved signs of Pregnancy Induced Hypertension
Vaginitis, which doesn’t respond to alternative or OTC meds
UTI, which doesn't respond to alternative or OTC meds.
Anemia which doesn't respond to alternative or OTC meds.
Persistent glucosuria or other signs & symptoms of diabetes.
Third trimester vaginal bleeding.
ROM prior to 36 weeks.
Abnormal PAP (Class III or greater).
Size/dates discrepancy.
Suspected malpresentation.
Suspected twins or breech.
Indications that the baby has died in utero or unexplained decrease in fetal movement.
Rh-negative mother with positive titers.
Signs of preterm labor (before 36 weeks).
Fever of 100.4 degrees for longer than 24 hours.
Herpes: Initial primary outbreak any time during pregnancy.
Abnormal Fetal Heart Tones.
IUGR.
Signs of placental previa or abruption.
Fetus with congenital anomalies that may require immediate medical attention.
Disclaimer: This Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website.
