2.3.c Home Birth Transfer
After the onset of labour about 1 in 10 women planning a home birth will experience transfer to a hospital.”
- Coulter & Collins. 2011 (9)
“The majority of maternal and newborn transfers are non-urgent and the most common reason cited for transfer is failure to progress among primiparous woman (78%)".
- Coulter & Collins. 2011 (9)
There are common reasons when a person may benefit from the additional equipment or personnel available in the hospital. Evidence-based site selection involves an ongoing review of both health and logistical factors, and guides decision making about when to consider and initiate a transfer into hospital.
To facilitate a smooth transfer, the provider pays attention to the physical and mental state of the person. Some questions to consider are: Is it safe to move this person in this moment? What is the emotional and psychological state of the family? How can your anticipatory guidance facilitate their transition? The client’s own priorities for labour and birth care will still need to be acknowledged in the new location, even if they may be affected by the clinical reason for transfer.
In order to conduct a smooth transfer providers need to prepare for an exchange of information. Upon arrival a verbal handover that includes information on the course of care prior to admission can help the receiving providers to provide continuity and culturally appropriate, respectful care. Structured communications tools, such as an SBAR, can be used to facilitate effective communication of clinical and psychosocial information. Records should be shared and pertinent information summarized. Now that team-based care is being provided, clear communication between client, primary provider, and consultant providers are key to effective teamwork. The coordination of care is improved when each person has an understanding of the roles of other providers, and anticipatory conversations can reduce interprofessional conflict and tension.
I believe it’s crucial for the team to allow sufficient time for a proper handover and for introductions to be made when a transfer from a home birth is coming into the hospital environment. Then we’re all on the same page.”
“I want to be treated as a respected colleague during transports and included in dialogues about the best course of action.”
-Cheyney, Everson & Burcher. 2014. (11)