Navigating Homebirth Transfers: What You Need to Know

Giving birth at home can be a deeply personal and empowering experience. Many parents choose homebirth for the comfort, privacy, and holistic care it provides. Yet even with careful planning and professional support, a transfer to a hospital may be necessary. Understanding why transfers happen—and what to expect—can help families feel prepared and reduce anxiety.

Why Transfers Happen During Homebirth

Transfers from home to hospital are less common than many think. A 2000 study involving 5,418 U.S. women who opted for home birth under the care of Certified Professional Midwives (CPMs) found that approximately 12% had to transfer to the hospital during or after birth, and about three-fourths of these cases were non-emergent (Johnson & Daviss, 2005, PubMed).

Homebirth midwives work with low-risk pregnancies, carefully screening and monitoring for any health concerns that might increase the likelihood of hospital intervention. Their role is to support a natural birth while providing ongoing risk assessment and preventative care.

Antepartum Transfers: The antepartum period encompasses all weeks of pregnancy leading up to the onset of labor. An antepartum transfer occurs when care is transitioned from a homebirth plan to a hospital before labor begins—usually because a developing condition requires closer monitoring or additional medical resources for the mother or baby.

Intrapartum Transfers: The intrapartum period encompasses everything that occurs from the onset of labor until the baby's birth. Most homebirths progress smoothly, but some may stall, last longer than expected, or show early signs that more support is needed. Intrapartum transfers are rarely emergencies. Midwives are trained to identify “yellow flags”—early indicators that allow for a calm, timely transfer before an urgent situation develops.

What Happens in an Emergency?

Emergencies during homebirth are rare but do occur. Midwives prepare for these situations by carrying necessary supplies, medications, having an assistant, and maintaining up-to-date skills to manage complications if they arise. When such emergencies occur, hospital care can be lifesaving.

Emergent vs. Non-Emergent Transfers

Understanding the difference between emergent and non-emergent transfers can help families feel more prepared.

• Non-emergent transfers usually occur due to prolonged rupture of membranes, maternal exhaustion, slow labor progress, desire for pain relief or rest, and sometimes even augmentation.

• Emergent transfers involve urgent medical issues requiring immediate hospital care to protect the health of the mom or baby.

  
  

Midwives continuously assess risk to identify when a transfer is needed, aiming to keep everyone safe while respecting the family's birth preferences. When a non-emergent transfer is being considered, midwives engage in open, informed discussions with the parents to ensure everyone understands the situation, the options, and the reasons for recommending hospital care. This shared decision-making process ensures that any transition happens with clarity, consent, and a sense of partnership—not urgency.

Planning for a Transfer

Discussing the possibility of transfer is a crucial part of prenatal care with a homebirth midwife. Together, families and midwives create an emergency plan that outlines:

• When a transfer might be recommended

• How the transfer process will work

• What to expect during transport

• What to expect after returning home

Knowing these details in advance helps reduce stress if a transfer becomes necessary.

Processing Your Birth Journey

Your baby and birth deserve to be celebrated. If a transfer was necessary, honor the strength, intuition, and flexibility it took to adjust plans. It’s normal to have mixed emotions, especially if your birth unfolded differently from what you had envisioned or if you hoped for a vaginal birth but ultimately needed a cesarean. You can be grateful for your baby’s safe arrival and still feel sadness, disappointment, or grief about how the birth unfolded. Both truths can exist together.

Allow yourself space to process your emotions—cry, journal, talk with your partner, or seek support from a mothers’ group, counselor, or trusted provider. Healing often happens as you share your story, whether through words, photos, or connection with others who understand. Over time, many parents find that honoring both joy and grief helps them integrate their experience and move forward with strength and compassion for themselves.

Final Thoughts

Choosing a homebirth means embracing a natural, supportive environment for labor and delivery. At the same time, it means recognizing that sometimes hospital care is the safest option.

Transfers are not a failure but a sign of responsible care and commitment to safety.

Families who understand the reasons for hospital transfers and plan for them feel more confident and secure. This knowledge empowers parents to focus on the joy of welcoming their baby, knowing they have a strong support system no matter what happens.

If homebirth is part of your vision, having open conversations with your midwife about transfer plans can bring clarity, confidence, and peace of mind. Being informed empowers you to make the choices that feel right for you and your family.