Duration and urgency of transfer in births planned at home and in freestanding midwifery units in England: secondary analysis of the Birthplace national prospective cohort study

Table 2 Primary reason for transfer, timing and urgency by planned place of birth and parity ¹

	Home				Freestanding midwifery unit
	N = 16,619				N = 11,197
	Nulliparous		Multiparous		Nulliparous		Multiparous
	n	%	n	%	n	%	n	%
Women not transferred	2481	55.9	10682	88.4	3284	65.5	5478	90.8
Women transferred	2008	44.1	1448	11.6	1868	34.5	567	9.2
Primary reason for transfer ²
Malposition	11	0.3	15	0.1	8	0.1	3	<0.1
Malpresentation	34	0.8	35	0.3	28	0.5	13	0.2
Failure to progress 1st stage	521	11.2	206	1.7	457	8.0	76	1.2
Fetal distress 1st stage	95	2.2	85	0.7	165	3.2	36	0.6
Meconium staining	246	5.4	178	1.4	247	4.5	53	0.8
Epidural request	131	2.8	44	0.4	139	2.4	23	0.3
Hypertension	41	0.9	32	0.2	48	1.0	16	0.2
Antepartum haemorrhage	34	0.8	26	0.2	32	0.6	14	0.2
Failure to progress 2nd stage	300	6.7	78	0.6	316	5.3	48	0.7
Fetal distress 2nd stage	30	0.6	11	0.1	29	0.5	6	0.1
Postpartum haemorrhage	53	1.2	88	0.7	37	0.7	53	0.9
Retained placenta	85	1.8	161	1.2	81	1.7	96	1.5
Repair of perineal trauma	203	4.4	180	1.4	144	2.9	37	0.6
Other before birth³	149	3.4	110	0.9	58	1.3	33	0.5
Other after birth, maternal reasons	9	0.2	18	0.1	9	0.1	11	0.2
Other after birth, neonatal reasons	42	0.9	141	1.1	33	0.6	32	0.6
Not known	24	0.6	40	0.4	37	1.0	17	0.5
Timing of transfer ²
During labour (before birth)	1563	34.2	764	6.0	1521	26.9	316	4.9
Immediately after birth	401	8.6	633	5.0	304	6.0	237	3.9
Not known	44	1.3	51	0.6	43	1.5	14	0.5
Urgency of reason for transfer ²
Potentially urgent (before birth)⁴	462	10.3	206	1.6	540	9.5	102	1.5
Non-urgent (before birth)⁵	640	13.6	244	2.0	589	10.3	98	1.5
Potentially urgent (after birth)⁶	53	1.2	88	0.7	37	0.7	53	0.9
Not classified⁷	853	19.1	910	7.3	702	14.0	314	5.3

¹Including only women with known parity. Proportions are weighted to allow for different durations of data collection.
²As a proportion of all nulliparous/multiparous women planning birth in each setting.
³Including: prolonged rupture of membranes; failure to progress with no stage of labour specified; fetal distress with no stage specified or other concerns about the baby during labour; concerns about the mother during labour; pain relief other than epidural; maternal request, other than for epidural; non-medical reasons, including NHS resource issues such as staffing; clear breach of MU criteria or other factors that might indicate unsuitability for out of hospital birth.
⁴Transfers before birth for fetal distress (1st or 2nd stage or stage not specified), failure to progress in the 2nd stage or antepartum haemorrhage (excluding those where timing was not known or inconsistent).
⁵Transfers before birth for failure to progress in the 1st stage or epidural request (excluding those where timing was not known or inconsistent).
⁶Transfers after birth for postpartum haemorrhage.
⁷All other reasons for transfer (including not known) not classified as potentially urgent or non-urgent above.

ISSN: 1471-2393