Table 1 Transfers to hospital among 5418 women intending home births with a certified professional midwife in the United States, 2000, according to timing, urgency, and reasons

Variable No (%) needing urgent transfer No (%) needing transfer Timing of transfers Stage before delivery: 1st* 62 (1.1) 380 (7.0) 2nd* 51 (0.9) 134 (2.5) Not specified 4 (0.1) 32 (0.6) After delivery: Maternal transfers 43 (0.8) 72 (1.3) Newborn transfers 25 (0.5) 37 (0.7) All 185 (3.4) 655 (12.1) Reasons for transfer During labour: Failure to progress in 1st stage 4 (0.1) 227 (4.2) Failure to progress in 2nd stage 12 (0.2) 80 (1.5) Pain relief 4 (0.1) 119 (2.2) Maternal exhaustion 1 (<0.1) 112 (2.1) Malpresentation 20 (0.4) 94 (1.7) Thick meconium 13 (0.2) 49 (0.9) Sustained fetal distress 31 (0.6) 49 (0.9) Baby's condition 5 (0.1) 21 (0.4) Prolonged or premature rupture of membranes 0 (0.0) 19 (0.4) Placenta abruptio or placenta previa 5 (0.1) 10 (0.2) Haemorrhage 5 (0.1) 7 (0.1) Pre-eclampsia or hypertension 5 (0.1) 13 (0.2) Cord prolapse 3 (0.1) 6 (0.1) Breech 1 (<0.1) 3 (0.1) Other 9 (0.2) 17 (0.3) Post partum: Newborn transfers: Respiratory problems 14 (0.3) 33 (0.6) Evaluation of anomalies 2 (<0.1) 8 (0.1) Other reasons 9 (0.2) 17 (0.3) Maternal transfers: Haemorrhage 21 (0.4) 34 (0.6) Retained placenta 14 (0.3) 28 (0.5) Suturing or repair of tears 1 (<0.1) 14 (0.2) Maternal exhaustion 2 (<0.1) 4 (0.1) Other reasons 5 (0.1) 8 (0.1)

^* 104 of these women were transferred to hospital after midwives' first assessment of labour (1.9% of labours), 38 of which were considered urgent.

Totals for urgent transfers are based on primary reason for transport only, but column for all transfers adds up to more than number transported as both primary and secondary reason (if reported) for transport to hospital are presented.