The health of the mother, in depth visits, risk screening, referral and/or transfer to the hospital when appropriate, continuous support and care during labor/birth is what makes having a delivery out of the hospital safe.
We cannot accept clients who have conditions such as insulin-dependent diabetes, high blood pressure, epilepsy, drug use, HIV, hepatitis, heart, renal and kidney diseases requiring ongoing treatment or medications, lupus, MS, a BMI greater than 35%, other conditions are considered on a case by case basis.
Low-risk criteria in pregnancy include not having:
Conditions occurring during pregnancy such as anemia (Hgb < 10.0) that does not respond to supplementation, gestational diabetes not controlled by diet, cholestasis, oligohydramnios, pre-eclampsia or baby in a breech position (bottom or feet first) could also cause you to ‘risk-out,’ although these conditions can often be prevented or even reversed with proper prenatal care and/or nutrition. The State of CA also limits birth services for midwifery clients ranging from 37 to 42 weeks gestation.
Some conditions may resolve on their own but not always, placenta previa (the placenta is over the cervix), or a medical problem with the baby (such as heart defect, etc) that will require special care.
The focus of midwifery is preventative care and to identify the little things before they become complications that would risk you out of care. If a situation requiring medical attention arises, we will refer you to one of several qualified physicians we work with or you may visit a doctor of your choice.
In working within the 2014 regulations regarding Licensed Midwifery, all clients must have a care plan in place indicating where they would transfer to if the need arose. Our clients can schedule a visit with one of our consulting OBs to establish a relationship and preregister at the hospital. This way, in the event of transport you have an OB to accept you into care.
If you have a question about your “risk status”, please contact us.
For more research on the safety of out-of-hospital birth:
Evidence Based Birth on Birthing Centers
Citizens for Midwifery