Transfers to hospital in planned home birth in four Nordic countries - A prospective cohort study

Ellen Blix*, Merethe H. Kumle, Karen Ingversen, Anette S. Huitfeldt, Hanne K. Hegaard, Ólöf A. Ólafsdóttir, Päl Oian, Helena Lindgren

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)


Introduction. Women planning a home birth are transferred to hospital in case of complications or elevated risk for adverse outcomes. The aim of the present study was to describe the indications for transfer to hospital in planned home births, and the proportion of cases in which this occurs. Material and methods. Women in Norway, Sweden, Denmark and Iceland who had opted for, and were accepted for, home birth at the onset of labor, were included in the study. Data from 3068 women, 572 nulliparas and 2446 multiparas, were analyzed for proportion of transfers during labor and within 72 h after birth, indications for transfer, how long before or after birth the transfer started, time from birth to start of transfer, duration and mode of transfer, and whether the transfer was classified as potentially urgent. Analyses were stratified for nulliparity and multiparity. Results. One-third (186/572) of the nulliparas were transferred to hospital, 137 (24.0%) during labor and 49 (8.6%) after the birth. Of the multiparas, 195/2446 (8.0%) were transferred, 118 (4.8%) during labor and 77 (3.2%) after birth. The most common indication for transfers during labor was slow progress. In transfers after birth, postpartum hemorrhage, tears and neonatal respiratory problems were the most common indications. A total of 116 of the 3068 women had transfers classified as potentially urgent. Conclusions. One-third of all nulliparous and 8.0% of multiparous women were transferred during labor or within 72 h of the birth. The proportion of potentially urgent transfers was 3.8%.

Original languageEnglish
Pages (from-to)420-428
Number of pages9
JournalActa Obstetricia et Gynecologica Scandinavica
Issue number4
Publication statusPublished - 1 Apr 2016

Bibliographical note

Publisher Copyright:
© 2016 Nordic Federation of Societies of Obstetrics and Gynecology, Acta Obstetricia et Gynecologica Scandinavica.

Other keywords

  • indications for transfers
  • midwifery
  • Planned home birth
  • potentially urgent transfer
  • transfer to hospital


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