Why you might need to transfer during labour

To transfer means being moved from one place to another during labour, such as from a midwife-led birth centre to a labour ward. Here we explain why you might need to be transferred.

What does it mean to be transferred during labour?

Being transferred usually means being moved from a birth centre or your home to a labour ward during labour. In this video, a consultant midwife from Imperial College Healthcare NHS Trust explains what being transferred means in practice.

Travelling to the labour ward or birth centre

When you're in labour, before you go to the hospital or birth centre where you've planned to give birth, you should phone up the number you've been given. Some birth centres may send a midwife to see you at home before you come in but, in most cases, they'll speak to you over the phone to check that:

  • You're at the right stage of labour to come in
  • The labour ward or birth centre is open and has room for you.

You should plan in advance how you're going to get yourself to the hospital or birth centre. Know how long it will take to get there at different times of day and make sure you've planned for someone to take you.

If you're going by car, you'll need to know where you're going to park, and if there are any special arrangements for cars arriving with a woman in labour. Use our Birth Choice tool to visit the page dedicated to your local unit to find out about car parking and other useful facilities there.

Ambulances are not available to transport you to hospital so, if you don't have a car, you may need to arrange a taxi.

If you've planned to have a home birth, a midwife will come and visit you at home when you let them know that you're in labour. They may stay with you or, if you're in early labour, leave and arrange to come back later. Once you're in established labour, the midwife will stay with you and call another midwife to be there for the birth so that there are two midwives present.

transfer to labour ward during birth

Giving birth in an alongside birth centre Giving birth in a freestanding birth centre
Having a home birth

Giving birth in an alongside birth centre

If you're at low risk of complications and you plan to give birth in an alongside birth centre, birth is as safe for your baby as if you plan to give birth in a labour ward. Planning to give birth in an alongside birth centre also reduces the chances of having medical interventions. On average, about 40% of first-time low-risk mothers will have to transfer across to a labour ward from an alongside birth centre during labour or soon after the birth. The chances of being transferred are a lot lower for low-risk women having a second or subsequent baby, at about 13%.

Why might I be transferred to the labour ward?

During labour it might become necessary for you to go to the labour ward because:

  • You want extra pain relief, such as an epidural, which isn’t available in the birth centre
  • You or the baby are not coping well with labour and it would be safer for you to be in the labour ward.

As the labour ward will be nearby, you can transfer easily, most likely by wheelchair. Your midwife may be able to stay with you once you're in the labour ward, or you may be looked after by a different midwife.

Giving birth in a freestanding birth centre

If you're at low risk of complications and you plan to give birth in a freestanding birth centre, birth is as safe for your baby as if you plan to give birth in a labour ward. In addition, rates of medical intervention are reduced. For those at a low risk of complications, first-time mothers are more likely to be transferred from a freestanding birth centre during labour or soon after the birth than second or subsequent-time mothers. On average about a third (36%) of low-risk first-time mothers will have to transfer, compared with only about one in ten (9%) of women who have had a baby before.

Why might I be transferred to the labour ward?

During labour, it might become necessary for you to go to the labour ward because:

  • You want extra pain relief, such as an epidural, which isn’t available in the birth centre
  • You or the baby are not coping well with labour and it would be safer for you to be in the labour ward.

While transfers are not usually emergency scenarios the transfer is likely to be in an ambulance. You’ll be transferred to a local hospital but it may not necessarily be the nearest one to where you live, and may even be in the opposite direction. This usually depends on the availability in your area on the day itself. Your midwife may be able to stay with you once you're in hospital, or you may be looked after by a different midwife who works on the labour ward.

Having a home birth

If you're at low risk of complications and have had a baby before, and plan to give birth at home, birth is as safe for your baby as if you plan to give birth in a labour ward. For first-time mothers, a planned home birth increases the risk for the baby by a small amount.

The Birthplace study, which involved 64,500 women and babies, found that for first-time mothers planning a home birth, the number of babies having a serious problem such as lack of oxygen to the brain or birth injury was 9.3 per 1,000 births, compared with 5.3 per 1,000 in a labour ward in a hospital.

Find out more about the rates of intervention and outcomes for babies in different birth settings.

If you've already had a baby and are planning to give birth at home, you're unlikely to be transferred from your home during labour or just after the birth. On average, only 12% of low-risk women having a second or subsequent baby will have to transfer from their home during labour or soon after the birth. In contrast, about 45% of low-risk first-time mothers will have to transfer to a hospital from their home during labour or just after the birth.

Why might I be transferred to the labour ward?

During labour, it might become necessary for you to go to the labour ward because:

  • You want extra pain relief, such as an epidural, which isn’t available at home
  • You or the baby are not coping well with labour and it would be safer for you to be in hospital.

You’re likely to be taken by ambulance to a local hospital, but be aware it may not be the nearest one to where you live. As explained in our video your midwife will accompany you to the hospital and is likely to then hand over your care to the midwives at the hospital. In some cases your midwife may be able to stay with you once you're in hospital.

Use our Birth Choice tool to look up your local units and compare transfer rates to help you make your decision.


References

These are the sources of information used in this article:

Birthplace in England Collaborative Group, Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study, BMJ 2011;343:d7400 (2011)

National Collaborating Centre for Women's and Children's Health, Intrapartum care: care of healthy women and their babies during childbirth. NICE Clinical Guideline 190,London: National Institute for Health and Clinical Excellence (2014)

Understand your maternity options

Labour ward? Birth centre? Home birth? Explore the differences between the UK's most common options for where to give birth.

Compare the options