Tommy's PregnancyHub

In utero transfer to a neonatal unit

If baby is likely to be born very prematurely, you may need to move to a specialist neonatal unit at another hospital. This is known as ‘in utero transfer’.

If the healthcare team thinks you are 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, this means transferring the baby while they are still in the uterus. If you give birth in the specialist unit, your healthcare team will have immediate access to the right equipment and expertise that your baby needs.

Why you may be offered a transfer to a neonatal unit

You may be offered a transfer to another hospital if:

  • you or your baby need enhanced care 
  • the neonatal unit at your hospital is closed 
  • the neonatal equipment (such as a cot) isn’t available where you are 
  • there is not enough staff at the neonatal unit to look after you and your baby where you are 
  • there is not enough staff in the delivery suite to give you the care you need where you are. 

A transfer may not be possible if:

  • the hospital doesn’t have enough space to accept the transfer
  • you don’t want to go (see below)
  • there is a risk that you may give birth on the way to the hospital
  • your baby needs to be born as soon as possible
  • you need immediate medical attention, for example if you have severe pre-eclampsia.

If you need urgent medical attention, the team may transfer your baby after they are born so they have access to the care they need. 

Who will go with me to the neonatal unit?

You will travel in an ambulance and an experienced midwife will go with you. The midwife will stay with you until you have safely arrived at the new unit and they have handed over care to the maternity team there.

Do I have to go to the neonatal unit?

You cannot be transferred unless you give your consent (permission). If your healthcare team believe that an in-utero transfer is the best thing to do for you and your baby’s health, they will discuss this with you. They will make sure that you understand all the advantages and disadvantages so that you can make an informed decision. 

You can ask the team any questions you need to, such as: 

  • Why is a transfer the best thing to do for me and my baby?
  • How long will the transfer take?
  • Who will come with me?
  • What happens if I need to deliver on the way?
  • What are the risks if I don’t want to go?

If you refuse to give consent (permission), you can’t be transferred. Your healthcare team will then talk to you to make sure that you understand the risks this may pose for you and your baby. However, it’s worth knowing that the healthcare team can overrule your wishes after your baby is born. If they believe that a transfer is in your baby’s best interest, they can do this without your permission. 

All these discussions should be fully documented in your maternity notes.

You and your baby may go back to your original hospital when you are both stable and don’t need such specialist care anymore. This may cause some anxiety, especially as your baby is still so small. But the healthcare team will only organise a transfer if your baby is well and stable. Don't be afraid to ask any questions you need to feel comfortable. 

British Association of Perinatal Medicine (2008) Management of acute in-utero transfers: a framework for practice https://hubble-live-assets.s3.amazonaws.com/bapm/attachment/file/35/IUTs_Jun08_final.pdf