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Birth: Expect The Unexpected

Certified Nurse Midwife Anne Margolis discussed what happens when labor does not go as planned. She talked about the importance of understanding what a cesarean section is and why it's important to know what happens in case of an emergency.

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When it comes to birth, oftentimes things don’t go as planned. Sometimes this means a woman never makes it to the birthing tub she prepared, filled up and dreamt about birthing in, because in the moment of giving birth, she found her groove and prefers to stay on the squatting stool or her labor progresses quickly, and she needs to push before the tub is filled with water. Sometimes this means certain family members or friends aren’t present for the birth like originally intended because for example a mama is not laboring well with her kids present, they want to leave, or her best friend is sick and could not come to help.

Other times, when things don’t go as planned, this means a woman might need medical or surgical intervention. A common example: a mama is experiencing a hard back labor at home or free standing birth center, her baby persists in the posterior position, she is not progressing for hours despite trying everything and is exhausted; she is transferred to the hospital for Pitocin to augment her labor and the compassionate use of an epidural. A less common example is baby is not tolerating the labor, and is showing signs of worsening distress in any birth setting, and a cesarean is needed to save baby’s life.

Photo by Mary Elliott O'Haire

Photo by Mary Elliott O'Haire

Overall, we must surrender to the process of labor and birth and know that we are being guided and well cared for. To avoid needless suffering, we must embrace what comes our way that is not in our control, as what is meant to happen – because it is happening or did happen; and we can raise to the level of being grateful that we were given exactly what we needed for our benefit, what we each needed on our own journey as a soul temporarily living in a body, even if we do not understand the whys. I am not apologetic about my spiritual perspective and my firm belief that the infinite all powerful being, Spirit or G-d of our own understanding is pure goodness and love for each and everyone one of us.

I’d like to address a question I get asked frequently.

Art by Catie Atkinson @spiritysol

Art by Catie Atkinson @spiritysol

Why do I mention cesareans in my online posts?

Cesareans can be both planned and unplanned for serious complications or illness. In both cases, they are indeed a birth. They are a birth for baby, a birth for mom, a birth for dad, and a birth of a new family unit.

I want all women to feel lovingly supported and cared for however they birthed and that includes a cesarean.

Art by Catie Atkinson of @spiritysol.

Art by Catie Atkinson of @spiritysol.

I like to post information on what I refer to as a gentle cesarean. It’s still using a home birth model of care, with the principle of restoring humanity to maternity and newborn care – especially in the operating room. A gentle cesarean would include possibly pulling the curtain down, allowing the baby to birth itself gently through the incision, encouraging mom to receive her baby directly from the surgeon, hold her baby skin to skin, delayed cord clamping and early breastfeeding; it can also include allowing her partner, doula and anyone else she needs in the OR by her side.

I want to offer support to all women, and especially women who feel their birth did not go as planned. Although it’s rare for normal births to lead to complications or emergencies requiring life saving medical and surgical interventions, most births don’t go as initially planned.

Photo Credit: @albanydoula

What do I do when things don’t go as planned?

In general, healthy mamas with healthy pregnancies have healthy births. The stats on homebirth  and free standing birth center outcomes are excellent when there is a trained experienced midwife in attendance.

My transfer rate from home to hospital in labor is 7% and that is comparable to those of my colleagues. The vast majority of transfers are non-urgent. In most cases, it’s usually first time vaginal birthers whose labor stops progressing with exhaustion despite us trying every one of our "tricks" to remedy the situation. The need to call 911 and have an urgent ambulance transfer has been a handful of times in 20 years.

The midwife is of course there as a lifeguard - as rarely emergencies do occur. I bring the same emergency equipment and medications that any free-standing birth center has. Most of the time I don't use it and all is well. But when I need it, I have saved lives, as any seasoned midwife can say.

I saw much more catastrophic events when I was an OB nurse in the hospital. I have never lost a mother, but our country's maternal mortality rates are among the highest compared to most modernized countries, and this is largely from risky hospital interventions, which are not happening at home.

I have had to resuscitate significantly less babies at home – we have a screened healthy low risk population, are watching closely and WITH the mama in active labor. We do not intervene unless medically necessary and do not cut the umbilical cord until it stops pulsing or placenta is birthed, unless there is a problem or a request for lotus birth.

In 20 plus years of homebirth midwifery practice I have had to transfer 3 babies to the hospital who did not respond to resuscitation and needed intensive care due to unrelated complications, and this is significantly less than our country's high newborn morbidity and mortality rates.

Yes, we need to be prepared for and have to manage a rare shoulder dystocia (stuck shoulders) but it happens less as our mamas are laboring and birthing in positions that use gravity and maximize the diameter of the pelvis. Yes we have had to treat postpartum hemorrhage not responsive to natural remedies, with medication and IV fluids.

Not to offend animal lovers and vegans, but this moose provided a perfect home "IV pole" for a mama who needed intravenous fluids during her homebirth. Homebirth midwives must be creative.

Not to offend animal lovers and vegans, but this moose provided a perfect home "IV pole" for a mama who needed intravenous fluids during her homebirth. Homebirth midwives must be creative.

I do not convince anyone to have a homebirth as it needs to be each mama's decision. I do provide information so she can make an informed one. She needs to birth where she feels safe or she won't labor well. 

It is one of my passions and areas of expertise to help mama's with these sorts of questions. I offer online consulting for mama's just like you, whether a one hour discussion or a package of consultations and email access from pregnancy through postpartum – which is great for mamas who want and need more personal attention and guidance to a holistic midwife as they have no access to one in their area.

To really best help a mama make a decision unique to her situation - I recommend a conversation. This is not something simply answered on social media, without discussion.

If you want to schedule an online consultation, please go to my website:  - I look forward to connecting more and answering your personal questions.

Photo by Megan Hancock Photography

Photo by Megan Hancock Photography

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma,

Or a midwife, doula, or birth professional guiding mommas..

Regardless if you are planning a birth at home, a hospital, a birth center or need a cesarean section, or if you are taking another childbirth education class…

You Really Can Create The Delivery Of Your Dreams.

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

  • Understand the sensations of your body and connect your intuition with how your body is communicating and leading you towards what to do during labor

  • Tap into your inner calm to deeply relax yourself,letting go of busy, stressful and fearful thoughts on demand for the health of baby

  • Speak your truth from your heart in a way that deepens your relationships, sets clear boundaries, and has people listen to you and support you before, during and after pregnancy

  • Trust yourself, connect with your body wisdom andcommunicate with baby in belly

  • Connect with natural time and sync your body and mind up with your unique biological clock for ease from pregnancy to postpartum

  • Reprogram negative patterns, stories, and beliefs that undermine your confidence, strength and self trust so you can rock your birth

Physicians and midwives around the world recommend my teachings to their pregnant clients and many Doulas across the country learn the secrets of blissful birthing from me to supplement their Doula Training & Certification process!

To learn more, visit:  LOVE YOUR BIRTH Online Childbirth Course!

It is based on my years of experience, as a midwife and yoga teacher, helping thousands of women tap into their calm and live and birth from a place of grounded relaxation and joy. 

Check out my pregnancy herbal tonic recipe and some of my favorite supplements I recommend below, to augment a wholesome healthy diet, so you can meet the increased needs of your body and your growing baby.


Do you need supplements? Here are some of my favorite I recommend to mamas in my practice.

Make your Red Raspberry Leaf and Nettle herbal in needed nutrients and specifically nourishing for pregnancy, birth and postpartum. Place 1 oz of dried red raspberry leaf, 1 oz of dried nettle leaf in a quart-sized glass canning jar with strainer, fill it with boiling water, cover and steep for at least 2 -4 hours at room temperature. Strain and place in a covered pitcher. You can make it in larger quantities and store in the fridge. For taste, dilute with water or steep for less time (but no less than half an hour), add lemon or lime juice, mint leaves or a teaspoon of honey. Drink 1-4 cups daily hot or cold.