A Neonatal Transfer from Birth Center to Hospital with a Postpartum Hemorrhage During Transport

There is increasing interest from women and birthing people for midwifery-led care with community birth options in birth centers and for home birth. Birth centers are a high-value and high-quality option for place of birth and also address the increasing need to provide access to perinatal care for women in maternity care deserts. This case report reviews the transfer of a postpartum patient and her newborn from an accredited, freestanding birth center to the designated hospital. The reasons for transfer were neonatal respiratory distress with hypoxemia and an emergent postpartum hemorrhage that was initially reported as a stable maternal transfer to be admitted with the neonate. The newborn was treated for meconium aspiration syndrome in the neonatal intensive care unit while the patient was treated for uterine atony and a cervical laceration as the causes of the postpartum hemorrhage. This case review demonstrates the importance of efficient hospital transfers with skilled care for perinatal emergencies during transport, effective interprofessional collaboration, and quality improvement actions for complications that required transfer to the hospital for treatment. This case review emphasizes the importance of accurate and prioritized communication within the birth center team and between emergency services and receiving hospital clinicians as dynamic changes in patient status occur. The clinical reasons for transfer, along with the transfer process, must be examined for areas of improvement when emergent medical complexity necessitates a hospital transfer for medically matched treatment.