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Transfer to Hospital From a Home Birth
Updated: Aug 9
One of the questions I get asked most often by families planning a home birth is simple but important: what does a transfer to hospital from a home birth actually look like?
It is a completely reasonable thing to wonder about, and I think it deserves an honest, clear answer rather than reassurance for the sake of it.
Planning a home birth does not mean ruling out hospital care. It means having a plan for every outcome, including the ones we hope we will not need.
My job as your midwife is to recognise early when something needs extra attention, and to make sure that if a transfer is needed, it happens calmly, safely, and without anyone feeling rushed or frightened.
I always encourage the families I work with to keep an open mind when writing their birth plan, because none of us know exactly how your body or your baby will labour. A fluid birth plan, one that leaves room for care to go down a different route if needed, tends to make things feel far less overwhelming if a transfer does happen.
At your birth planning appointment, we talk through the possible changes labour can take, so you feel prepared and informed, and if a transfer to hospital was needed, it would be less of a traumatic event for you.
We also talk about what happens if your home birth plans change, so you understand your options and know that a change in your planned place of birth does not mean your home birth has failed.
Why a transfer to hospital from a home birth might be needed
There are a number of reasons I might recommend a transfer to hospital from your home birth, either during labour or shortly after birth. This is not an exhaustive list, but examples include:
Concerns about your baby's heartbeat during labour
Signs of pre-eclampsia
Bleeding before the baby is born (antepartum haemorrhage)
Heavy bleeding after the birth that is not settling at home (postpartum haemorrhage)
Thick meconium in the waters, which can be a sign your baby needs closer monitoring
Mum feeling very unwell, or baby needing extra support or attention after birth
Failure to progress, where labour goes on for a long time without cervical progress, often because baby's head is not quite in an ideal position
None of these mean something has gone wrong with your care. They mean I am doing exactly what I am there to do, watching closely, acting early, and keeping you and baby safe.
Keeping the hospital informed about a transfer to hospital from a home birth
When I arrive at a home birth, I always call the hospital to let them know I am with you and that you are labouring at home. Once your baby and your placenta have both been safely delivered, I call again to let them know you have had your baby and that everything is well. This means that if a transfer to hospital from your home birth is ever needed, the hospital already knows where we are and what has happened so far.
A non-urgent transfer to hospital from a home birth
Sometimes a transfer to hospital is not an emergency at all. A common example is when a mum decides she would like an epidural for pain relief. In this situation, there is no rush and no danger, it is simply a change of plan. Your partner would usually drive you in, and I would follow on separately. I am not able to transport labouring clients in my own car, as this falls outside what my insurance covers, but I stay closely involved throughout.
If something arises that needs a quicker response, we call for an ambulance to transfer you to hospital. There is a specific way I request this, asking for an ambulance for an obstetric emergency for mum and baby, and in my experience the response is fast.
As your lead midwife, I always travel in the ambulance with you. I stay by your side, and I am the person who hands over your care and your birth story to the hospital team, making sure they have the full picture from the very start of your labour.
If a transfer to hospital from a home birth leads to theatre
If your care moves towards needing a caesarean, I am not usually permitted into theatre with you in an emergency situation. In this case, your partner goes in with you, and I wait close by for updates. I will see you again once you are settled, and I stay involved in your postnatal care once you are home, continuing that same continuity of care that has been there from the start.
What a transfer to hospital from a home birth really means
Whatever the reason for a transfer to hospital from your home birth, the aim is always the same: a smooth, calm handover where you and your baby are looked after every step of the way. You are never simply passed over to someone new. I stay with you, I advocate for you, and I make sure the hospital team understands your birth and your wishes. I am also there to support your partner, who can sometimes find a transfer harder in some ways, feeling a little on the sidelines with not much they can practically do. I make sure they are kept informed throughout, so they understand what is happening and what might happen next.
Get in touch if you'd like to talk through a home birth or your birth options.
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