The California Maternal Quality Care Collaborative (CMQCC) has released a major new resource: the CMQCC Community Birth Transfer Toolkit, designed to improve how hospitals, community midwives, and EMS teams work together when a transfer to a higher level of care is needed. Because California has long been a national leader in maternity care quality improvement,
New CMQCC Community Birth Transfer Toolkit Signals a Turning Point for Midwifery Integration
then updated March 20, 2026.
By Amy Romano, MBA, MSN, CNM, FACNM
What We Learned from Our First Open Community Debrief: Practicing Intrapartum Transfer for Fetal Bradycardia
then updated March 12, 2026.
By Amy Romano, MBA, MSN, CNM, FACNM
On March 2, Step Up Together launched our new Quarterly Community Debriefs with a discussion focused on First Stage Fetal Bradycardia and intrapartum transfer from community settings. Community Debriefs are 60-minute sessions that bring together professionals across the maternity care system—community midwives, hospital teams, EMS personnel, educators, and quality improvement leaders—to reflect on what happens
No More Silos: A Unified Response to Maternal Emergencies
then updated February 25, 2026.
By Emily Bronson
Perinatal emergencies are the classic “low-frequency, high-acuity” challenge for EMS: they’re uncommon enough that confidence and muscle memory can fade, but when they happen, the stakes are large: two patients, rapidly changing physiology, and a system that has to coordinate fast from dispatch to the receiving hospital. Step Up Together® bridges the gap between silos.
Rural Health Transformation Must Include Maternal and Newborn Health
then updated January 28, 2026.
By Emily Bronson
When care is far away, the risks don’t wait. Complications in pregnancy, labor, postpartum, or the newborn period still happen, sometimes in homes, in birth centers, in clinics, or en route to the nearest hospital. Rural communities are strongly associated with long travel times to seek care, fewer prenatal visits, more preterm births, and higher
ACOG Takes an Important Step to Strengthen Transfer Systems for Community Birth
then updated January 7, 2026.
By Amy Romano, MBA, MSN, CNM, FACNM
In a significant move that aligns with their increasing focus on community-based and collaborative care models, the American College of Obstetricians and Gynecologists (ACOG) has released a new position statement: Transfer Protocols for Out-of-Hospital Birth (2025). This guidance explicitly affirms that safe maternity care across levels and locations of care depends on clear, respectful, and
Disaster-Ready Maternity Care: Perinatal Transfer Drills Belong in Emergency Preparedness
then updated December 15, 2025.
By Emily Bronson
Pregnancy, labor, postpartum complications, and newborn needs don’t stop during emergencies. Yet many disaster preparedness plans still treat maternity as a downstream clinical issue rather than a time-sensitive mobility, communication, and coordination problem that starts at home, in a birth center, on the road, or in an overwhelmed emergency department (ED). The Step Up Together®
Step Up Together for PQCs: From Drills to Sustainable System Change
then updated December 3, 2025.
By Emily Bronson
Perinatal Quality Collaboratives (PQCs) exist to turn evidence into action so maternal and infant health care gets safer and more equitable. The National Network of PQCs (NNPQC) and the CDC describe PQCs as state or multi-state networks that rapidly improve care through data-guided implementation. After more than a decade of focus on hospital-based preparedness, there
What It Really Means to Join a Step Up Together Action Collaborative
then updated August 28, 2025.
By Amy Romano, MBA, MSN, CNM, FACNM
If you’re considering joining a Step Up Together Action Collaborative—or encouraging your hospital or community partner to do so—you might be wondering: what does participation actually look like? The short answer: it’s a structured, time-limited commitment with real benefits for your team and your patients. The longer answer is that there’s a rhythm to the
The 3 Delays: Strengthening Your Transfer Process Before It’s Urgent
then updated August 11, 2025.
By Amy Romano, MBA, MSN, CNM, FACNM
When an emergency happens in a community birth setting, every minute counts. In Step Up Together, we use the 3 Delays Framework to help teams identify and address the most common barriers to safe, timely, and respectful transfers from home or birth center to hospital care. The 3 Delays model has been used worldwide to
Practice Makes Prepared: Choosing Between Partial and Full Transfer Drills—and Why Both Matter
then updated July 23, 2025.
By Amy Romano, MBA, MSN, CNM, FACNM
In community birth settings like birth centers and home birth practices, emergencies are rare—but when they happen, everyone needs to be ready. That’s why interdisciplinary emergency drills are so critical: they help teams practice protocols, build trust across settings, and make life-saving decisions more efficient under pressure. At Step Up Together, we’ve seen firsthand how
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