Safety and interventions

Being transferred during labour

7 min read

If you’re giving birth at home or in a birth centre, you’ll be moved to a labour ward if your midwife is concerned for you or your baby’s health. Here we explain how and why you might be transferred.

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Birth doesn’t always go to plan, and if you or your baby need additional help during labour or after, you’ll be transferred from your home or birth centre to a hospital. It’s useful to understand what happens during a transfer and why you might need one, so that you’re prepared for all eventualities when you go into labour.

Look up your chosen birth centre with our Birth Choice tool to find out which hospital you’ll be taken to if you need to be transferred and how long the journey may take.

Why might I be transferred during the birth?

When you’re in established labour, your midwife will keep a close eye on you and your baby to make sure everything is as expected.

If your midwife is concerned that your labour isn’t progressing, or their regular checks show that you or your baby may not be coping well, you will be recommended to transfer to a labour ward where more monitoring and medical help can be given to ensure both you and your baby are safe.

You may be transferred to hospital if:

  • Your labour is stalling (in the first, second or third stage).
  • You want extra pain relief, such as an epidural, which isn’t available in the birth centre or at home.
  • It seems like your baby may not be coping well with labour, for example if their heart rate is slowing or meconium is found in your waters when they break.
  • You need more help after the birth, for example if you’ve had severe tearing or the placenta doesn’t come out in one piece.
  • Your baby needs to be admitted to a special baby care unit at the hospital for monitoring or treatment.

It can be comforting to know that most transfers are precautions rather than emergencies.

A common reason for transfer is if your cervix doesn’t seem to be opening enough for you to start pushing. In this case, you may be advised by your midwife to go to hospital, where you can receive drugs to help your labour along. This isn’t an emergency, and you’ll be able to talk through your options before being transferred, to make the right decision for you.

Most common reasons for transfer to hospital during labour

What happens during a transfer?

Once the decision to transfer has been made, your midwife will call an ambulance to take you to the hospital, although in some cases you may be able to go in your own car. If you’re in an alongside birth centre, you can go to the labour ward in a wheelchair.

Sometimes, your midwife may call the ambulance as a precaution but with the hope that you won’t need it. Claire had her daughter Rowan in a freestanding birth centre:

‘If I’d read beforehand that there’d be an ambulance waiting outside for me because I had to get my baby out so quickly, that would be scary. But in reality, it wasn’t. And my midwife was going to come with me in the ambulance and stay with me the whole time, and that was a real comfort.’

You won’t have to travel in the ambulance on your own – your midwife will come with you. Once you’ve arrived at the hospital, your midwife may be able to stay with you, or your care will be handed over to a midwife who works on the labour ward and is more experienced in hospital births.

Your birth partner can also come with you in the ambulance and it can be a good idea to talk the process through with them in advance, so they know what to expect if you’re transferred – and so they can remember to grab your hospital bag on the way out.

If you need to transfer after the birth, for example to have more extensive stitching that can’t be done by your midwife at home or in the birth centre, your partner and newborn baby will be able to come with you in the ambulance to the hospital. If you need to be admitted to the postnatal ward for overnight care, your baby will stay with you the whole time.

Similarly, if your baby needs medical attention in hospital after the birth, you will also come along to the hospital. Usually, you’ll be able to go in the same ambulance, but sometimes you may have to travel in a different ambulance to your baby.

In this video, a consultant midwife explains what being transferred means in practice:

How likely is it that I will be transferred?

Regardless of where you plan to give birth, you’re more likely to need to be transferred to the labour ward if you’re having your first baby, compared to women who have given birth before.

If you’re having your first baby

A large study of women at low risk of complications found you have a fairly high chance of having to go the hospital at some point during the birth if you’re pregnant with your first baby.

Almost half of first-time mothers planning a home birth and just over a third of those wanting to be in a freestanding birth centre have to transfer to the labour ward.

How many first-time mothers are transferred to hospital during birth?

If you’ve had a baby before

You have a good chance of not needing to be transferred from your planned place of birth if you’re at low risk of complications and have had a baby before.

Just one in ten mothers who have had at least one baby previously have to be moved from a birth centre or their home during labour or shortly after the birth.

How many women who have had a baby before are transferred to hospital during birth?

Which hospital will I be transferred to?

Which hospital you’ll be taken to depends on the birth setting you’re planning to have your baby in. Usually, but not always, you’ll be taken to the hospital closest to you.

It’s worth noting that the transfer time from your home or a birth centre to the labour ward can vary depending on factors like traffic congestion and the time of day that you’re driving, as well as whether you’re travelling in an ambulance with blue lights on.

If you’re concerned about how long it would take you to be transferred to the hospital in an emergency, make sure to mention this to your midwife at one of your antenatal appointments so you can get tailored advice for your situation.

Alongside birth centre

You’ll be able to go to the labour ward situated in the same hospital as the birth centre. Often, it’s just a case of going down a corridor or to a different floor and you may be able to walk there yourself or be taken in a wheelchair.

Planning to give birth in an alongside birth centre can be a really good option if you’re at low risk of complications and keen to avoid the medical environment of the labour ward, but feel worried about the prospect of possibly having to go to the hospital in an ambulance.

Use our Birth Choice tool to find and explore alongside birth centres near you.

Freestanding birth centre

You’ll be taken to a hospital nearby which has a labour ward and postnatal ward. Every freestanding birth centre has plans in place for which hospital you’ll be taken to if you do need to be transferred, and we have collected this information for you.

Use our Birth Choice tool to find your local freestanding birth centre and see which hospital you’ll be moved to and an estimate of how long the transfer journey takes.

Home birth

You’ll be taken to a local hospital, but it may not be the nearest one to where you live. This is because you’re generally transferred to the hospital where the community midwives attending your home birth are based.

To feel as prepared as possible, it can be a good idea to talk to your home birth midwife at one of your antenatal appointments about the routine for transfers in your area, including how long the journey from your home to the hospital can take. Look up the details and statistics for your home birth team by searching for the hospital that your midwives are based at.

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)

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