Updated April 2014, next review April 2017

Giving birth to your premature baby

In utero transfer to a neonatal unit

Moving you both to a specialist neonatal unit may be the safest option if your baby is likely to be born very prematurely. This is known as 'in utero transfer' as they are effectively making sure your baby is in the best place for her care while she is still in your womb.

Transfer time

If the healthcare team considers you at high risk of going into labour very prematurely (especially if you are under 27 weeks), they may recommend that you go to a specialist unit before your baby is born.

This is known as in-utero transfer (in other words, transferring the baby while she is still in the uterus). It is often safer to transfer the baby while she is still protected inside you than after she is born. If you give birth in the specialist unit, then from the moment she is born she will have the right equipment and expertise waiting for her.

Read about the different leves of care offered by the different units here.

When it's safer to stay put

For some women, it's safer not to move. If you have an infection or severe pre-eclampsia, or if there are problems with your baby or with the placenta, then the team will need to deliver her as quickly as possible.

Similarly, if you are at high risk of giving birth on the way to the unit, or if your condition is unstable (for example, if you have severe hypertension), you will stay where you are. The team will then transfer the baby after she is born.

Making preparations

Before you are transferred, the team will need to make sure that there are enough staff members and beds available to ensure that you are cared for properly.

During the transfer you will be accompanied by a midwife but not a paediatrician; the logic is that if you are so likely to deliver that you need a paediatrician, then you shouldn't be transferred at all. If delivery seems imminent during the journey, you will be taken to the nearest hospital rather than to the specialist unit.

Do I have to go?

You have the right to refuse to be transferred before you deliver, even though this may pose risks to yourself or your baby. However, once your baby is born the hospital can overrule your wishes, and has the right to transfer her to the unit if this is in her best interests.



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The following organisations can give you more information about the topics covered in this section.


Source

BAPM (2008) Management of acute in-utero transfers: a framework for practice, London, British Association of Perinatal Medicine

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Find out about the different levels of care offered by baby units and transferring your baby once she is born.

'We should have been in a level 3 neonatal unit, but we had to stay at the hospital where my baby was born, which was only a level 2 unit, because he wasn't well enough to move. It wasn't ideal. For example, there wasn't anyone experienced in advising on breastfeeding a baby of his size.'

JESSICA

DID YOU KNOW?

About one quarter of women who are transferred to a specialist unit have still not delivered their baby four days later.