There are times when we need to transfer during birth.  If baby lets us know they are not happy, or Mom is having challenges and things have moved outside of normal then it can be time to seek the care and help a hospital offers.

Here are the things I want my clients to understand:

• I want the best possible outcome for Mom and baby, that's why we transferred.
• Hospitals have tools that I do not have, and those tools will be helpful or necessary for the situation.
• I value the skills and expertise of the hospital providers, and I am grateful they are able to help.
• If hospital policy allows, I will stay with Mom at the hospital through birth and for a short while after birth.
• If hospital policy does not allow me to stay, I will be available by Skype or another platform if preferred.
• ​I do not have privlieges to practice midwifery in the hospital, so I will shift into more of a doula role providing labor support. I will assist as much as hospital staff are comfortable with. This varies among hospitals.
• Hospitals have protocols they have to follow, and they may not have much wiggle room within those protocols. The protocols may be in place to allow the hospital to be more efficient, or may be required by the liability insurance of the hospital. If we have time, we will go to a hospital that does not have protocols prohibiting a desired outcome such as VBAC.
• I will share pertinent information from the chart, and provide lab results to hospital staff to facilitate a smooth transition, and to make sure they have all the information they need to provide the best care they can for Mom and baby.
• I will provide postpartum care once Mom and baby are released from the hospital.

Hospital care can be beneficial and lifesaving when labor and birth move outside of normal, and I am thankful we can turn to them if needed.  I know transferring is stressful.  I will do my best to make the transfer as smooth and stress free as I can.

There are times when we need to transfer during birth.  If baby lets us know they are not happy, or Mom is having challenges and things have moved outside of normal then it can be time to seek the care and help a hospital offers.

Here are the things I want hospital staff to understand:

• We recognized the need for help and appreciate that the hospital has tools that are not available at home.
• We all want both Mom and baby to have the best outcomes possible, that's why we transferred.
• Everyone is tired so a little more time may be needed to process what is being done, what is being recommended and what options are available during the transition from a home birth environment to the hospital environment.
• If the client is asleep, please come back at a later time to make introductions and to discuss care, or have these conversations with family members who are present. If there are going to be several practitioners coordinating care, it would be helpful in the first hours to meet with one or two practitioners that can explain everything instead of trying to meet everyone.
• The client and family may need to have medical terminology explained, and may ask a lot of questions to understand what is being recommended and to make fully informed decisions.
• The midwife wants to be as helpful as possible. She has important information such as lab results, and a record of how labor was progressing she can share with the medical team. She will provide labor support, and would be happy to help as much as the hospital staff are comfortable with. She is not trying to take over for any of the hospital staff, and truly values their skills and expertise.
• The client may have made decisions regarding newborn procedures or other things before birth, and may wish to stay with those decisions unless the situation calls for changes. Please ask the client's preferences.
• The midwife will provide follow up care after Mom and baby leave the hospital. ACOG recommends at least two in person postpartum appointments in the first six to twelve weeks.  My standard is to do four. I will track baby's weight and provide breastfeeding support as well as monitor my client's recovery.

​Transfers are stressful for everyone involved. An understanding and collaborative effort on the part of everyone involved will result in a smoother and less stressful transfer.  I look forward to the day when home birth is recognized as an acceptable and legitimate option for low risk pregnancies by medical providers in the area I serve.