Best Practice Guidelines: Transfer from Planned Home Birth to Hospital

These guidelines were designed to facilitate the safe and mutually respectful transfer of care of a woman and her family from a planned home birth to the hospital. The model blueprint was created as the result of a unique collaboration among physicians, midwives, nurses and consumers.

Obtain the Guidelines

Planned Home Births Are on the Rise

More women are choosing to have planned out-of-hospital birth, either at home or in birth centers. According to data published by the Centers for Disease Control, the number has grown by 56% from 2004-2012.  Changes to the Affordable Care Act expands access to maternity care options, including birth centers. Although currently less than 2%, the number of women choosing to have their babies at a birth center or at home is expected to continue to rise.

Transfer Guidelines Focused on Mother and Infant Safety

When healthy mothers plan a home birth, they are most often cared for and monitored by skilled midwives. Infrequently, the mother or infant requires transfer from the home or birth center to the hospital to access specialized procedures or care.  Good communication and coordination between providers during these transfers minimizes the potential for negative impact on outcomes.  As the safety of the mother and infant is always of the highest priority, it is important to have detailed guidelines used by all health care providers involved in such transfers.

Developed by Maternal and Infant Care Providers and Stakeholders Committed to Collaboration

These Guidelines were developed by the Collaboration Task Force.  This group formed at the Home Birth Consensus Summit in 2011 to address the Interprofessional Collaboration and Communication vision statement. The group is comprised of obstetricians, family medicine physicians, midwives, consumers, women’s health advocates, and nurses. This group researched existing standards for universal intrapartum transport, transfer, consultation, and collaboration guidelines for all professionals who are involved when a woman or baby is transferred to a hospital from a planned home birth, as well as the evidence on practices that lead to improved interprofessional coordination.

Adopting the Guidelines in Your Community

The content in these guidelines is provided as open source to encourage widespread use.  Please feel free to use this document as a starting point for development of policies for use in your practice or hospital.  Members of this group are available to deliver a webinar, presentation, or in-house education session to your organization.  Please contact us if you would like more information.

How You Can Help – Endorsing the Guidelines

The Collaboration Task Force of the Home Birth Summit welcomes endorsements of the guidelines from organizations, institutions, health care providers, and other stakeholders. Click here to endorse the guidelines.

Acknowledgements

The following organizations have developed guidelines for maternity care for use within their jurisdiction.  These guidelines were reviewed as best practice examples during the development of the Best Practice Transfer Guidelines.

  • New York State Association of Licensed Midwives. Position Statement on Planned Home Birth in New York. July 2011.
  • Gifford Medical Center, Randolph, VT. Certified Professional Midwife Relationship Statement. January 2013.
  • Midwives Association of Washington State -Transport Guideline Committee with the Ad Hoc Physician – Licensed Midwife Workgroup of the State Perinatal Advisory Committee. Planned Out-Of-Hospital Birth Transport Guideline. February 2011.
  • The College of Midwives of BC and the Midwives Association of BC. Implementing Midwifery Services in British Columbia – A Manual for Hospitals and Health Regions. March 2006.
  • Association of Women’s Health, Obstetric and Neonatal Nurses. Templates for Protocols and Procedures for Maternity Services. 3rd edition, Nov. 1, 2012.