Foundation Program Sites


Families who choose to give birth at home or in a freestanding birth center deserve the best possible care when plans change and they need to access hospital services.

Smooth Transitions™ is a Washington state-based quality improvement program enhancing the safety of these hospital transfers.

We bring together community midwives, hospital providers and staff, and EMS personnel to build a collaborative model of care that puts birthing families at the center.  

We offer presentations throughout Washington state and provide direct support to participating hospitals. We are also available to consult with perinatal collaboratives and organizations in other states interested in replicating this work.

If you like the work that is being done and would like to make a donation to the Smooth Transition program, click on the button below.

Mission: To address our shared responsibility for improving hospital transfers from planned community-based births to promote greater patient safety and satisfaction.


  • Improve the whole person safety* and efficiency of the transfer process through the establishment of system-wide protocols
  • Collect and analyze transfer outcome data for the purpose of quality improvement
  • Build greater collaboration between community-based midwives, EMS, and hospital care team
  • Enhance the patient experience of care when transfers occur

*Smooth Transitions considers “whole person safety” to encompass emotional, psychological, social, cultural, spiritual, and physical processes and outcomes.

We believe that collaboration within an integrated maternity care system is essential for optimal mother-baby outcomes. All women and families planning a home or birth center birth have a right to respectful, safe, and seamless consultation, referral, transport and transfer of care when necessary. When ongoing inter-professional dialogue and cooperation occur, everyone benefits.”

Best Practice Guidelines: Transfer from Planned Home Birth to Hospital

“Like most hospitals, we have struggled with how best to accommodate patients who have planned an out-of-hospital birth under the care of a midwife but are transferred in during labor or postpartum. With the help of the Smooth Transitions team, we have significantly changed the attitudes and the experience of these transfers. The tools available through the Smooth Transitions™ playbook have guided us along this process, and I strongly recommend this program to any hospital that wants to improve the transfer experience for all involved.” 

Roger Rowles MD, Former Medical Director of Perinatal Services, Virginia Mason Memorial Hospital, Yakima, WA

CLICK HERE - If you are interested in learning more or have inquiries about the Smooth Transition program

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