What might cause the need for a hospital transfer?

During a planned home birth, you might need to be transported to a hospital for monitoring or treatment if complications develop. Your health care provider might recommend transfer to a hospital if:

  • Labor isn't progressing
  • Your baby shows signs of distress
  • Your baby presents in a position other than headfirst
  • You need pain relief
  • You have high blood pressure
  • You experience bleeding

What are the possible risks of a planned home birth?

While most pregnant women who choose to have planned home births deliver without complications, research suggests that planned home births are associated with a higher risk of infant death, seizures and nervous system disorders than are planned hospital births.

How do I prepare for a home birth?

You can prepare for a planned home birth by:

  • Choosing trained health care providers to assist. Choose a certified nurse-midwife, a certified midwife, a midwife whose education meets specific standards or a doctor practicing obstetrics within an integrated and regulated health system. Make sure he or she has access to consultation with doctors or specialists at a collaborating hospital. If you're interested in additional support, consider hiring a professional labor assistant (doula). The American Academy of Pediatrics recommends having present at least one trained person whose primary responsibility is caring for your newborn.
  • Creating a birth plan. Will you use any specific methods to cope with pain? Do you want to labor in a tub? Will you breast-feed your baby immediately after delivery? Discuss your birthing plan with your health care provider and ask about supplies you'll need, such as protective coverings for your floor or mattress.
  • Preparing for a hospital transfer. Discuss with your health care provider the signs and symptoms that might necessitate going to a hospital and how a transfer will affect your birthing plan. Ideally, your home or other planned birth location is within 15 minutes of a hospital with 24-hour maternity care. Make sure you have access to transportation. Ask your health care provider to make arrangements with a nearby hospital to ensure that you can be promptly transferred and treated, if necessary.

Hospitals or certified birth centers are the safest settings for delivery. However, you have the right to make an informed decision about where you prefer to deliver. Keep in mind that life-threatening problems can occur during labor and delivery without warning. In those cases, the need to transfer you and your baby to a hospital could delay care, which could put your lives at risk. Understand the risks and benefits of a home birth before you make a decision about where to deliver.

July 07, 2017 See more In-depth