It is the role of a midwife to evaluate every situation and determine if each situation resides inside a “normal” box. Even variations from the norm must be thought about in terms of risk vs benefit and considered in the light of the midwife’s level of experience and expertise and ability to help. Sometimes you have to seek a referral for a problem and sometimes, reluctantly you have to let go so they can receive high risk care.
I have a current client who has a previous history of preterm labor. Several natural things can resolve some of those issues. The Brewer Diet is a great resource and solution for many pregnancy complications, including premature birth, placental abruption, pre-eclampsia and toxemia. Then a fellow midwifery friend, Kristi Zittle, has formulated an herbal product that has shown great success in getting women with preterm labor issues to carry their babies full term (it’s not on the website, you have to inquire about it currently). It beats the heck out of the medical alternatives (mag sulfate, procardia and the dreaded terbutaline). My client was the recipient of terbutaline with her three previous pregnancies. One of the possible side effects of this drug is heart damage/heart attack. Right now we are wrestling with some heart symptoms she is having and trying to determine the cause of her symptoms. Did she have long term damage from the terbutaline use previously? Is it hormonally related or a viral condition of the pericardium? I have a friendly doc who is helping to run labs and sort through the medical mystery.
I want her to have her dream of a homebirth, but mostly I want her to live. That involves drawing on any resource that can help that to happen. That’s my job. Defining what falls into the normal box and what does not. Most women could easily birth their babies at home. A good midwife is skilled at handling even a few of the emergencies, but sometimes you have to call in the big guns. I’m not opposed to that. It just grieves me when it happens.