BACKGROUND:
Planned home and birth center (community) births are increasing in the United States, and some require transfer to hospital settings for higher-level care. Safe, respectful, and seamless transfers depend on effective communication and interprofessional collaboration. However, little is known about hospital labor and delivery nurses’ perspectives on transfers. Globally, safe and respectful transfer from community to hospital birth settings are recognized as essential to integrated maternity care systems. Understanding the perspectives of hospital-based providers is essential to improving care continuity and outcomes across all settings.

OBJECTIVES:
To explore hospital labor and delivery nurses’ experiences with, and perceptions of, transfers from community to hospital care, focusing on communication, teamwork, unit culture, and attitudes toward home and birth center birth.

METHODS:
A cross-sectional survey study was conducted with labor and delivery nurses (n = 517) from 49 U.S. states, recruited through the Association for Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) listserv. Participants completed a 76-item survey. Quantitative data were analyzed descriptively; qualitative responses underwent thematic analysis.

RESULTS:
Five key factors emerged: decision-making and autonomy, relationships and collaboration, policies and processes, support for physiologic birth, and risk perception and safety. Responses revealed variation in communication practices, attitudes toward community birth, and the degree to which hospital environments support collaborative care during transfers.

CONCLUSIONS:
Findings identify barriers and facilitators to effective transfer care and offer insights into strategies for improving collaboration between hospital teams and community providers. This work aligns with global efforts, including those of the World Health Organization, to promote respectful maternity care and strengthen integration of midwifery services across birth settings. Emphasizing respectful, person-centered approaches may enhance experiences and outcomes for birthing people.

KEY MESSAGE:
Hospital nurses play a critical role in shaping safe, respectful, and collaborative care during transfers from home and birth center to hospital birth settings. Poster session 4 (Group B)