Transfer in labour

A concern for couples choosing to give birth in a Community Maternity Unit or at home is the possibility of transfer in labour to a consultant unit in a big hospital such as Ninewells. Whilst it is important to recognise and discuss this possibility, it is also important to realise that transfer occurs in the minority of labours - and only if you or your baby would benefit. Your midwife will be able to tell you the actual transfer rate for your unit.

Studies have shown that you are far less likely to need the particular expertise of a doctor during your labour if you choose to have your baby in a Community Maternity Unit or at home. This is because the midwives who care for you are experts in normal labour and birth, the environment is adapted for your comfort and safety and the people caring for you are passionate about your ability to give birth yourself.

Throughout pregnancy and labour, the midwives are assessing both you and your baby to ensure that you remain suitable for birth within the Community Maternity Unit. It is impossible to remove all risk, no matter where you choose to give birth - but there are often ‘warning signs’ that alert the midwife that things may not go to plan.

The most common reason for transfer is that labour is progressing very slowly and some added assistance might be of benefit. The midwife will fully discuss any concerns she has and you will be in control of all decisions made.

If you and your midwife decide that transfer is necessary, the midwife will make all the arrangements so the hospital is prepared for your arrival. Transfer is generally done by ambulance, and your midwife comes with you for the journey. Birth partners can also come in the ambulance, but it is often more practical to follow behind in the car.

The Scotland-wide Perinatal Collaborative Transport Study (CoTS) published in July 2008 confirmed that Community Maternity Units are “central to the delivery of midwifery care in Scotland”. It explained that “All Community Maternity Units and Consultant-Led Units up to level 11b have procedures and guidelines in place covering the transfer of mothers and / or infants to another hospital offering a higher level of care when this is necessary.” Reassuringly, 94 per cent of transfers from Community Maternity Units to Consultant-Led Units in the study followed agreed pathways of care.