title: Under scrutiny: Midwives' experience of intrapartum transfer from home to hospital within the context of a planned homebirth in Western Australia.
abstract: BACKGROUND
  Women's experience of homebirth has been a focus of research, with limited international research and no Australian evidence of the experiences of midwives in relation to their experience of intrapartum transfers within the context of a planned homebirth.
  
  
  OBJECTIVE
  To explore the experience of Western Australian midwives involved in an intrapartum transfer from home to hospital.
  
  
  METHODS
  A descriptive phenomenological study was conducted. Women who elect to have a homebirth in Western Australia have the choice of care from privately practising midwives or a publicly funded program. Midwives who were currently practising or had practised within the past three years and experienced an intrapartum transfer were invited to participate. In-depth interviews were conducted with 13 midwives and data analysed using the Stevick-Colaizzi-Keen method.
  
  
  RESULTS
  Analysis revealed an overarching theme "under scrutiny" which captured four themes: "decision to transfer: getting the timing right"; "reception at the hospital: welcoming or not"; "maintaining continuity of carer" and "reflections: coming to terms with the experience".
  
  
  CONCLUSIONS
  The decision to transfer to hospital represents a profound shift in expectations for the woman and midwife that is often not recognised by hospital staff. Intrapartum transfer is a challenging clinical decision for all parties; midwives, women, partners and health services. Increased effort by maternity health professionals to improve communication and collaboration must be a priority to better support women and their partners who make an informed decision to have a planned homebirth.
authors.affiliation: Women and Infants Research Foundation, King Edward Memorial Hospital, Perth, Australia.
authors.forename: Colleen
authors.initials: C
authors.lastname: Ball
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia; Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Perth, Australia. Electronic address: y.hauck@curtin.edu.au.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Hauck
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia.
authors.forename: Lesley
authors.initials: L
authors.lastname: Kuliukas
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia; Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Perth, Australia.
authors.forename: Lucy
authors.initials: L
authors.lastname: Lewis
authors.affiliation: Women and Infants Research Foundation, King Edward Memorial Hospital, Perth, Australia; School of Women's and Infants' Health, The University of Western Australia, Perth, Australia.
authors.forename: Dorota
authors.initials: D
authors.lastname: Doherty
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003299:Cooperative Behavior; D003657:Decision Making; D036861:Delivery, Obstetric; D005260:Female; D006700:Home Childbirth; D006760:Hospitalization; D006801:Humans; D008880:Midwifery; D009721:Nurse Midwives; D010360:Patient Transfer; D010564:Personnel, Hospital; D011247:Pregnancy; D036301:Qualitative Research; D014904:Western Australia
keywords: Homebirth; Intrapartum transfer; Midwives' experience; Phenomenology