Health system funders, designers, and managers need to develop and rollout sustainable plans for ensuring that the necessary human resources, skills, and equipment are in place in a structured manner at each level of the health system. As transfer to another facility during the second stage of labor is very problematic and is likely to be associated with poor outcomes because of the additional delay, every effort should be made to provide the assisted vaginal delivery component of Basic Emergency Obstetric Care so that delivery can be effected at health center level without the need for transfer.