Birthplace decisions Information for pregnant women and partners on planning where to give birth

What else would be helpful to know?

Transfer

When people think about ‘transfer’, they often think this will be an emergency, but in practice, most transfers are for non-emergency reasons (such as a long labour, or ‘delay’ in labour). CMUs and midwives providing home birth services work closely with hospitals and ambulance services to provide safe, timely and co-ordinated care during transfers. So, while you may be transferred, you may still go on to have an uncomplicated birth in the Labour Suite. Emergency transfers, while less common, will still be coordinated to be as safe as possible by your midwife, the wider team, and the ambulance service.

Transfer from home or CMUs is more likely for women expecting their first baby. Between a third (36%) and half (45%) of women who plan first births at home or in CMUs are likely to require transfer into a Labour Suite. For women expecting their second, third or fourth baby, transfer into hospital is less likely. About 10% of women planning second or subsequent births at home or in CMUs are likely to require transfer into a Labour Suite.

Some women may need to be transferred from the Labour Suite to theatre or to a high dependency unit. Where possible the midwife caring for you will support you during this transfer.

Neonatal Transfer

Neonatal transfer services are in place to provide babies with safe and efficient transfers to and from specialist neonatal care services. This is important as unwell newborns may have difficulty with breathing or keeping warm and require support as they are transferred.

It is important to discuss what the local arrangements are for transfer of your newborn baby from home and CMU. Within the AMU the neonatal team will be able to easily access your baby and start care prior to transfer to the neonatal unit if required, similar to Labour Suite.

What if my baby needs neonatal care?

Most babies are born healthy and without any complications. However, around one-in-ten babies will need some specialist care. Some of these babies will need to be looked after in a neonatal unit, while others can be looked after on the maternity ward.

A baby might need neonatal care if they were born too early (preterm), too small, or if they are unwell. Some babies are born with particular complications that require services such as surgery or help from heart specialists (cardiology). Babies born as part of a twin or multiple pregnancy are more likely to need neonatal care.

There are 15 neonatal units in Scotland. Each of these units provides a particular level of specialised care. Neonatal care is available in most hospitals where babies are born in Scotland, but more specialised treatment for the smallest and sickest babies is limited to fewer, more specialist neonatal units.

You will be advised about the best place to give birth for you and your baby. If your baby is likely to need neonatal care you will be advised to give birth in a unit that can provide that care, rather than your baby being transferred after birth.

It will not always be possible to transfer mothers before they give birth, and in those cases our specialist neonatal transfer service, ScotSTAR will transfer those babies in specialist ambulances equipped to care for neonates. Babies will be transferred back to their local neonatal unit for ongoing care as soon as possible.

For more information please see the Information for Expectant Parents resource on Neonatal Service in Scotland. To find out more about Neonatal Units in Scotland, visit: Neonatal Units - Scottish Perinatal Network

Consent: it’s your decision

Before a doctor, midwife, nurse, or any other professional can examine or treat you they must have your consent: which means you give your agreement. Unbiased evidence must always be provided to support any conversation about birthplace, treatment, or examination.

You can give consent if you can make decisions for yourself. Being able to make decisions means you can understand what is involved and can think clearly about the advantages and disadvantages of different actions. You must be given enough information, and you should be allowed to make up your own mind without pressure from other people.

You can ask for a second opinion at any time during your care and you can have someone else present at appointments to support you or help you express your views.

Further information on consent is available:

NHS Inform - Communication and involving you