Preparing Midwifery Records for a Transfer of Care
Plan the communication before it becomes urgent
A midwifery practice may need to transfer care to another clinician or facility. The receiving team needs useful information promptly, and the original practice needs to know who will send it and how.
ACOG's midwifery policy supports collaboration across birth settings and standardized safety, transfer, and transport protocols. Its 2025 position statement specifically addresses transfer protocols for out-of-hospital birth. Those are professional policy resources; state law, facility requirements, and the patient's clinical circumstances still govern the actual arrangement. [1, 2]
A record handoff process should be part of the transfer plan, not a task first assigned after the patient has left.
Define the information and the responsible person
Have the clinical team determine the information needed for a useful handoff, including the reason for transfer, relevant findings, care already provided, and outstanding concerns. Keep contact information current so the receiving clinician can reach the person responsible for the record.
Decide who sends the information when the primary clinician is occupied with patient care. Test the secure transmission route and establish a backup for a failed fax or unavailable system. An emergency is a poor time to discover that no one can access the necessary records.
For example, a prenatal summary saved weeks earlier may not describe the condition that led to transfer. Send the relevant current information as well as the earlier history. Record when the handoff occurred and any follow-up communication.
Reconcile the record before billing
After the clinical handoff, review which services each practice actually furnished and what the payer requires for that arrangement. Do not let a scheduled delivery or prenatal package populate the final claim without reviewing what occurred.
A transfer does not automatically determine every professional or facility charge. Obtain the applicable billing instructions and document the basis for the practice's claim. Explain unresolved financial questions without suggesting that the clinical transfer itself proves a particular payment outcome.
If mother and newborn both receive care, preserve each patient's separately documented services. Identify which records and communications concern the mother and which concern the infant rather than treating the family as one chart.
Review completed transfers as an operations exercise. Did the receiving team get usable information? Was a current contact available? Did the final claim match the care provided? Fixing a weak handoff process before the next transfer supports both continuity and accurate billing.
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