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If a high-risk situation or complication arises during prenatal care, there may be time for the midwife and her client to attempt to arrange alternative options and a transfer of care to a supportive health care provider. However, if an high-risk emergency situation or any other issue arises in which the midwife feels that the required care is outside of her services, time may be short and urgency may be felt by both midwife and client. During prenatal care, the labor, birth or postpartum if a situation arises in which the midwife feels the need to do an emergency transport and/or transfer care of a client and/or her baby to the care of a health care provider or medical facility and the client refuses to allow transport, these are steps that should be taken to ensure that the client's rights and safety are protected as well as those of the attending midwife and her birth attendants during a problem situation. At no time should a midwife abandon her client while in her care, but make all efforts to assist the client in obtaining necessary medical attention.
The midwife must inform the parents of the risks and complications and follow any set protocols regarding the specific problem.
It is helpful, if EMS is called and arrives at the home in this situation and the client still refuses to be transported for further medical attention, to obtain the name of the EMS service and the responding emergency medical technicians on the scene. This should also be included in the client's file in the event things should not go well and medical and legal problems arise later.
RELATED LINKS
MoonDragon's MDBS Birthing Guidelines: Transfer Criteria
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