Background

Planned home births and birth center births (also known as community births) are relatively common in Oregon compared to most of the United States. Four percent of births in Oregon and 1.6 percent of births in the US overall are
planned community births. Community births in the US have been increasing since 2004. Families choose community birth for a number of reasons and come from all walks of life, and all races, religions, and class backgrounds.

Planned community births unfold normally at home or birth center most of the time but part of what makes community birth safe is the ability to transfer to a hospital when it does not. Hospital transfer occurs in 15% of planned community births in Oregon, most often occurring when pain management and augmentation is required or as complications arise.

When transfer is needed, Midwives, emergency responders, and receiving hospital providers function as a care team. When working together, outcomes and experiences are improved for birthing individuals and babies. Working as a team requires clear communication, understanding of each of different roles, and coordination of care.

Transfer Toolkit

In 2020, building on foundational work by the Oregon Midwifery Council, a statewide, multidisciplinary committee was convened to review the culture and process for community to hospital transfers across the state. This work included soliciting feedback from individuals who have experienced transfers and offers insight into areas in need of improvement. These recommendations have been summarized in this toolkit designed to facilitate a structured approach to improving community to hospital transfer. The OPC and Oregon Midwifery Council, in partnership with Comagine Health, will continue supporting hospital teams, Midwives, and birthing individuals and their families.