Transfers from home births and birth centers to hospitals happen regularly and are an important part of safe care for birthing people and babies. We know that approximately 10-20% of planned community births (homebirth and birth center births) transfer to the hospital when pain medication or labor augmentation is needed, or when complications arise. 

Yet midwives, emergency services personnel, nurses, and receiving hospital providers don't receive training on how to work together as a care team. We often find ourselves trying to provide care in stressful emergency situations without the information or skills we need to do so effectively.

We're ready to change that and work together to improve care! This one-of-a-kind course:

  • is a curriculum designed by and for midwives, emergency services personnel, nurses, and receiving hospital providers
  • shares new collaborative methods for improving home birth and birth center to hospital transfers 
  • teaches communication skills critical to keep calm and clear during stressful situations
  • includes clinical best practices
  • models scenarios demonstrating these best practices for communication and care
  • teaches creative tools for bridging relationships with other provider types
  • includes everything you need to know about the other providers involved to support optimal care and smooth transfer across all settings of a community birth transfer


This course will help all provider types work together smoothly so we can improve outcomes and the experience of care for mothers and babies.


This course has been approved by MEAC for 4 hours of continuing education. The approval number for this course is M1920-17-1001DE, and this approval is current through October 1st, 2021.

This course has been approved by the NARM Bridge Program for Category III. 

This course has been approved by ACNM for 4 hours of continuing education. The approval number for this course is 2019/085, and this approval is current through October 16th, 2021.

Other CE applications are in process.

This course is free for all volunteer EMS personnel! For a free enrollment, please email jesica@HiveCE.com with: your name, your email, and the name of the organization you volunteer with (Example: Campbell County Volunteer Fire Department). 

Course curriculum

  • 01
    1: Introduction
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    • 1.1 Intro
    • 1.2 The Problem
    • Readings
    • 1.3 What is community birth?
    • Learn More About Community Birth
  • 02
    2: Care Providers Involved In Community Birth
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    • 2.1 Midwives
    • Midwives Model of Care™
    • Philosophy of the American College of Nurse-Midwives
    • 2.2 Emergency Medical Services (EMS)
    • 2.3 Receiving Hospital Providers
    • Baby Friendly Hospital Initiative - Baby Friendly USA
  • 03
    3. Solutions for Smooth Transfer
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    • 3.1 Working Together
    • 3.2 Home Birth Summit Model Practices for Midwives
    • Home Birth Summit Best Practice Guidelines: Transfer from Planned Home Birth to Hospital
    • 3.3 Home Birth Summit Model Practices for Hospital Providers
    • 3.4 Quality Improvement and Home Birth Summit Policy Development
    • 3.5 Success Story: The "Poster Midwife"
    • Smooth Transitions
  • 04
    4. Best Practices for Communication During Community Birth Transfers
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    • 4.1 Best Practices for Improving Transfer
    • 4.2 Best Practices for Communication: Prenatal Planning and Education
    • Printable PDF: Sample Hospital Transfer Plan
    • Printable PDF: Sample Hospital Transfer Worksheet
    • 4.3 Communication: Calling 9-1-1
    • 4.4 Communication: Midwives and EMS
    • Clinician Fact Sheet: The Importance of a Low-Stress Environment for Birth and the Immediate Postpartum
    • Citizens for Midwifery Directory of State Midwifery Organizations
    • 4.5 Communication: EMS and Receiving Providers
    • 4.6 Communication: Midwives and Receiving Providers
    • Home Birth Summit Maternal Transfer Form
    • Home Birth Summit Newborn Transfer Form
    • ACOG Committee Opinion #664: Refusal of Medically Recommended Treatment During Pregnancy
    • 4.7 Model Practices Role-Play: Maternal Hemorrhage Scenario
  • 05
    5. Clinical Best Practices During Community Birth Transfers
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    • 5.1 Maternal Emergency Transfer Best Practices
    • 5.2 Newborn Emergency Transfer Best Practices
    • Article (bonus section): The Laryngeal Mask Airway and Its Use in Neonatal Resuscitation: A Critical Review of Where We Are in 2017/2018
  • 06
    6. Challenging Situations
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    • 6.1 When Conflict Arises
    • 6.2 Model Practices Role-Play: Newborn Resuscitation Scenario
    • 6.3 Interview with Dr. Wendy Smith
  • 07
    7. Conclusion and Further Resources
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    • 7.1 Conclusion
    • Further Resouces
    • Maternal and perinatal outcomes by planned place of birth among women with low-risk pregnancies in high-income countries: A systematic review and meta-analysis.
    • Homebirth: An Annotated Guide To The Literature
  • 08
    8: Post-Test and CE Certificates
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    • MEAC Evaluation Form
    • MEAC Post-Test and CE Certificate (for midwives)
    • HiveCE Post-Test and CE Certificate (for EMS personnel)
  • Silke Akerson

    Instructor Bio:

    Silke Akerson, CPM, LDM is a midwife and herbalist in Portland, Oregon. She has been in home birth practice since 2000, has worked in midwifery leadership and policy since 2010, and is currently the executive director of the Oregon Midwifery Council. She has been working collaboratively with emergency services personnel and receiving hospital providers on transfer improvement for the past 7 years. She is passionate about continuing education for midwives and allied providers as ways of ensuring quality care for all families and encouraging continued growth for ourselves as practitioners.

    Silke Akerson

    Midwife & Herbalist

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