Get access

Triage Issues in an Out-of-Hospital Birth Center


  • Patricia M. Barnes CNM, MS,

    Corresponding authorSearch for more papers by this author
    • Patricia M. “Happy” Barnes received a perinatal nurse practitioner certification from Houston Baptist University in 1978 and a masters of science in midwifery from Baylor College of Medicine in 1997. She currently practices midwifery at Nativiti Women's Health and Birth Center, Houston and with Specialists for Women at The Woodlands Memorial Hospital, The Woodlands.

  • Melanie S. Dossey CNM

    Search for more papers by this author
    • Melanie S. Dossey founded Nativiti Women's Health and Birth Center of Houston in 1995. She received her certificate in midwifery from Baylor College of Medicine in 1988. As Assistant Director of the Regional Perinatal Program at the University of Texas Medical Branch at Galveston, Ms. Dossey gained the experience she has needed to establish and maintain a successful freestanding birth center. In addition to directing Nativiti, she practices midwifery at The Woodlands Memorial Hospital with Specialists for Women in The Woodlands.

Nativiti Women's Health and Birth Center, 17510 Red Oak Drive, Suite 100, Houston, TX 77090


Effective triage in an out-of-hospital birth center helps low-risk women avoid high-risk care. Background issues include the contributions of evidence-based practice, informed consent, patient education, problem-focused documentation, after-hours access to client data, and the value of intuition. Telephone triage, immediate referral, birth center management, and follow-up with counseling are outlined for common out-of-hospital triage problems: first trimester bleeding, nausea and vomiting, second and third trimester bleeding, urinary tract symptoms, decreased fetal movement, contractions < 37 weeks, rupture of membranes, contractions ≥ 37 weeks, and “emergency” delivery.