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
ACOG Takes an Important Step to Strengthen Transfer Systems for Community Birth
then updated January 7, 2026.
By Amy Romano, MBA, MSN, CNM, FACNM
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
Step Up Together has been featured on
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