Why you might need to be transferred to hospital

Even when you have successfully booked a home birth, circumstances might arise which lead to a change of plan, so that your care during pregnancy, or even during labour, is transferred to hospital.

In pregnancy about 15 in every 100 women are advised to switch to hospital care. In labour, about 3 in 10 women having their first baby are transferred to hospital, but far fewer second or subsequent births are transferred.

Not all of the reasons listed below are absolute reasons for hospital birth, but it is important that your carers feel confident in their skills for this kind of birth in a home setting, and complications like these may mean that they recommend a change of plan.

In pregnancy

• Pregnancy-induced hypertension (pre-eclampsia)
• A pregnancy that has gone well beyond due date
• A low-lying placenta. If your placenta completely or partially covered the cervix, a Caesarean delivery would be the only safe way to deliver your baby
• Twins or a multiple birth
• The baby is not in a good, head-down position. For example, your baby may be breech, (though a breech baby might turn to a head-down position at the last moment)
• A previous Caesarean birth

In labour

• A labour that begins before you are 37 weeks pregnant (your baby may need special care)
• The baby showing signs of distress: meconium-stained liquor or the pattern of the heartbeat could indicate this
• Absence of progress in labour. However, a labour that is progressing slowly is not in itself a problem. Although it is tiring, it does not or mean that the baby or mother is at risk. If mother or baby are becoming distressed, however, a move to hospital may be suggested so that labour can be artificially accelerated
• Bleeding in labour
• A mother who feels she needs more pain relief than can be offered at home, for example an epidural