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


Upon completion of this course, the learner will be able to:

1. Identify at least one system level safety issue in community birth transfers in their own community.

2. List four strategies for improving communication between provider types during a community birth transfer.

3. Describe two methods receiving hospital providers can use to improve clinical care and safety during community birth to hospital transfers.

4. Explain the benefits of collaborative transfer improvement work (such as joint case review) for patients, midwives, EMS, and receiving hospital providers.

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




HiveCE is an approved provider of continuing education by the California Board of Nursing, and this course is provider approved by the California Board of Registered Nursing, Provider Number 17686, for 4 contact hours, through November 30th, 2025. (This is widely accepted nationwide as continuing education for nurses and midwives. This course is accepted by NARM as Category 1 CE for CPM renewal.)

Accepted by NARM for the Midwifery Bridge Certificate, Category 3.

This course was previously approved by MEAC for 4 hours of continuing education through October 1st, 2023, under approval numbers M21-22-19-1001DE  and M1920-17-1001DE.

This course was previously approved by ACNM for 4 hours of continuing education, under approval numbers 2019/085 through October 16th, 2021, and 2021-116 through November 17th, 2023.

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


Note: Course completion does not authorize the learner to use skills outside their scope. Please refer to your state guidelines for determining scope of care.

For information regarding our refund policy and other Frequently Asked Questions, please refer to our FAQ. If you have additional questions, please email [email protected].

Course curriculum

  • 01
    1: Introduction
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    • How To Use HiveCE
    • 1.1 Intro
    • 1.2 The Problem
    • 1.3 What is community birth?
  • 02
    2: Care Providers Involved In Community Birth
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    • 2.1 Midwives
    • 2.2 Emergency Medical Services (EMS)
    • 2.3 Receiving Hospital Providers
  • 03
    3. Solutions for Smooth Transfer
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    • 3.1 Working Together
    • 3.2 Home Birth Summit Model Practices for Midwives
    • 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"
  • 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
    • 4.3 Communication: Calling 9-1-1
    • 4.4 Communication: Midwives and EMS
    • 4.5 Communication: EMS and Receiving Providers
    • 4.6 Communication: Midwives and Receiving Providers
    • 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, References and Resources
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    • 7.1 Conclusion
    • Initiating Midwife-Hospital Communication
    • Flier to Initiate Midwife-Hospital Communication
    • Home Birth Summit Best Practice Guidelines: Transfer from Planned Home Birth to Hospital
    • Home Birth Summit Maternal Transfer Form
    • Home Birth Summit Newborn Transfer Form
    • Printable PDF: Sample Hospital Transfer Plan
    • Printable PDF: Sample Hospital Transfer Worksheet
    • Homebirth: An Annotated Guide To The Literature
    • Baby Friendly Hospital Initiative - Baby Friendly USA
    • Midwives Model of Care™
    • Philosophy of the American College of Nurse-Midwives
    • ACOG Committee Opinion #664: Refusal of Medically Recommended Treatment During Pregnancy
    • Articles
    • Further Resouces
  • 08
    8: Post-Test and CE Certificates
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    • Evaluation Questions
    • Post-Test for CE Certificate
  • Silke Akerson

    Instructor Bio:

    Silke Akerson, CPM, LDM, MPH 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 9 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, CPM, LDM, MPH

    Midwife & Herbalist

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Take the course, print your CE certificate, retain access for later reference...

Reviews

  • By MaryAnn Hall

    “I found this course to be thorough, concise, and well thought out. I have been a practicing homebirth midwife since 1982 and have been doing, teaching, and pushing for these very things for years. There were even a few things I had not thought o...”

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    “I found this course to be thorough, concise, and well thought out. I have been a practicing homebirth midwife since 1982 and have been doing, teaching, and pushing for these very things for years. There were even a few things I had not thought of. I hope that this training will help all of us to be able to practice in a little more perfect world.”

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  • By Debby Engelbrecht

    “Very good.”

    “Very good.”

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