What to Expect in the Event of a Hospital Transfer
As your midwives, we prioritize the safety and well-being of both you and your baby. While most out of hospital births proceed smoothly, there are situations where transferring to a hospital becomes the safest option. We want you to feel informed and prepared in the event that a hospital transfer is necessary..
Reasons for Hospital Transfer
Transfers can happen during labor or immediately after birth for a variety of reasons, including:
Prolonged Labor – If labor is not progressing despite all efforts.
Maternal Exhaustion – If you are too fatigued to continue laboring effectively at home.
Non-Reassuring Heart Tones – If your baby’s heart rate suggests distress.
Excessive Bleeding – If we are not able to control a hemorrhage.
Retained Placenta – If there are concerns that the placenta is not delivering or has partially delivered.
Respiratory Distress in Baby - If this happens, we will call an ambulance and the baby will be taken directly to the closest hospital with a NICU for evaluation.
Other Medical Complications – Including high blood pressure, signs of infection, a severe tear, or other concerns for you or baby that require medical intervention.
How Transfers Happen
In most cases, transfers are for non-emergency situations, giving us plenty of time to discuss our concerns with you and your partner. We will explain why we believe a hospital transfer is in our best interest and ensure you understand the reasoning behind the decision. In an emergency situation, we may not have time to explain, but will act quickly and efficiently to ensure the smoothest transition possible to keep you and your baby safe.
Non-Emergency Transfers: We will transport you by private vehicle, typically with a support person and your midwife following in her own vehicle. * If you are transferring for a medical induction or pain relief, your midwife will join you when you need her - typically with an induction we join clients when they are in active labor and if you opt for an epidural when you are ready to push!
Emergency Transfers: If urgent care is needed, we will call 911 for EMS transport if you are having a home birth. At the birth center depending on the situation we may encourage driving by private car as we can get there in just a few minutes.
The hospitals we typically transfer to are:
Baylor University Medical Center (L&D 3600 Junius St Dallas, 75246)
Children’s Medical Center Dallas (1935 Medical District Dr Dallas, 75235)
If you are at home we will go to the closest hospital for emergent reasons. For non-emergent transfers we encourage clients to use Baylor University Medical Center.
What to Expect Upon Arrival at the Hospital
If utilizing Baylor University Medical Center we like to transfer to our consulting physician, Dr Deborah Fuller. She is in-network with many private insurance plans. Her cash pay prices are reasonable. Clients with co-ops and medicaid may opt to transfer to the hospitalist.
Your midwife will call the hospital and give report, then fax your records to the hospital. We encourage you to bring your folder with your printed records as well. While the staff will be expecting you, you may still need to wait in the triage area until a room and care providers are available. Please note that your midwife has no control over how long it takes for you to receive care.
Even when present please keep in mind that your midwife is no longer in charge of your medical care and cannot provide medical treatment in a hospital setting. She can help you understand your options and advocate for your birth preferences.
You will need to complete intake paperwork and sign consent forms for procedures such as a blood transfusion (if necessary), emergency cesarean section, vaginal delivery, and newborn care. Signing these forms does not mean you won’t receive additional informed consent if needed or that you cannot change your mind. Rather, they ensure that treatment, including emergency care, can be provided without delay.
You will be assessed by the hospital’s obstetric team. If you have not yet given birth, you will be placed on continuous fetal monitoring to track the baby’s heart rate and contractions, and have lab testing done. You may bring your own labor gown to wear if you wish.
Depending on the situation and what is needed, hospital staff may recommend you receive interventions such as IV fluids, medications, pain relief, monitoring, or a cesarean birth if necessary.
How Long Will the Midwife Stay?
For transfer of care during active labor not planning on an epidural, your midwife will transfer to the hospital with you and offer support and advocacy until a plan of care is in place. If birth is imminent, she will remain with you for the birth, if possible. If you are transferring for pain medication, your midwife will join you when it’s time to push. For clients without a doula - wanting additional support our student midwives are available for a fee of $500 paid directly to the student.
For a planned medical induction prior to labor, your midwife is available 24/7 for phone support. She will join you during active labor if you plan to go unmedicated. If you receive an epidural she will join you when birth is imminent, usually when you are ready to push.
In the case of a cesarean birth, hospital policies may not allow your midwife in the operating room. If the midwife has been awake and supporting you for many hours, she may need to go home to rest. If she is able to remain at the hospital during your surgery, she will wait in the designated area until the procedure is complete and you have been transferred to post-op recovery.
After the Transfer
After you are discharged from hospital care, the midwife will resume postpartum care for you, providing there are no risk factors that would require a higher level of care. The midwife will typically see you in your home in 2-3 days after you are released from the hospital. You may see the midwife for in office appointments at 2 and 6 weeks. More appointments are available if needed. Please reach out to the midwives if you have concerns and would like to request additional visits.
How to Prepare for the Unexpected
Have a hospital bag packed with essentials just in case. Some suggestions here.
Prepare a backup birth plan that is simple and highlights only your most important preferences. If a transfer becomes necessary, it is because additional risk factors have developed, and interventions that you may have otherwise declined (such as an IV, continuous fetal monitoring, labor augmentation, or pain relief options) may be required. While you will still have the ability to discuss options, declining all interventions may not be helpful or in your best interest. Remember: we are transferring because we need their help, and our goal is a safe outcome for both you and your baby. A simple birth plan template can be found here.
Keep your ID and insurance information easily accessible.
Discuss any transfer preferences with your midwife in advance.
Trust that we will prioritize your safety while respecting your birth preferences as much as possible.
Our goal is always to provide you with a safe, supported, and empowered birth experience—whether at home, the birth center or in the hospital. Please reach out to your midwives with any questions or concerns.