Triage issues in an out-of-hospital birth center.

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 > or = 37 weeks, and "emergency" delivery.