optimal outcomes occur when home births are planned and there is a system whereby women and families can transfer to a facility when needed. true comparison of the safety of home birth cannot occur in a country without a widespread , integrated system to provide transition to hospital birth should the need arise when planning a home birth. if our goal is to promote safe birth, then barriers such as those found by these women when they tried to bridge the gap between home birth care and hospital-based providers must be removed. for women giving birth within the hospital setting, changes can be implement that will make it a more satisfying experience without compromising safe maternal or newborn care