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Perinatal data are reported each year in Germany for women planning community birth. So far, data sets have not been linked to describe time\u2010related factors associated with nulliparous transfer to hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the prevalence of referral for nulliparae and assess maternal and labor characteristics associated with intrapartum transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Perinatal data from 2010 to 2015 were linked (<jats:italic>n<\/jats:italic>\u2009=\u200926,115). Women were reviewed with respect to international eligibility criteria for community birth; 1997 women were excluded (7.6%). Descriptive statistics were reported; unadjusted and adjusted odds ratios with 95% confidence intervals (CI) tested the predictive effect of demographic and labor factors on rates of intrapartum transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One in three nulliparous women (30.6%) were transferred to hospital. Compared with community births, transferred women were significantly more likely to experience longer time intervals during labor: from rupture of membranes (ROM) until birth lasting 5 to 18\u2009h (OR 6.05, CI 5.53\u20136.61) and 19 to 24\u2009h (OR 10.83, CI 9.45\u201312.41) compared to one to 4\u2009h; and from onset of labor until birth 11 to 24\u2009h (OR 6.72, CI 6.24\u20137.23) and 25 to 29\u2009h (OR 26.62, CI 22.77\u201331.11) compared to one to 10\u2009h. When entering all factors into the model, we found the strongest predictors of transfer to be fetal distress, longer time intervals between ROM until birth and onset of labor until birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nulliparous transfer rates were similar to rates in other high\u2010income countries; 94% of referrals were non\u2010urgent. Time was found to be an independent risk factor for the transfer of nulliparae planning community birth.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12752","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T17:21:56Z","timestamp":1692638516000},"page":"39-51","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intrapartum time intervals and transfer of nulliparae from community births to maternity care units in Germany"],"prefix":"10.1111","volume":"51","author":[{"given":"Janice","family":"Hill","sequence":"first","affiliation":[{"name":"Midwifery Research and Education Unit Hannover Medical School  Hannover Germany"},{"name":"Department of Midwifery Research Institute of Health Sciences, Faculty of Medicine, University of T\u00fcbingen  Tubingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Zinsser","sequence":"additional","affiliation":[{"name":"Midwifery Research and Education Unit Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Wiemer","sequence":"additional","affiliation":[{"name":"Society for Quality in Out of Hospital Birth (QUAG) Hinter den H\u00f6fen 2  Storkow Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6348-0054","authenticated-orcid":false,"given":"Mechthild M.","family":"Gross","sequence":"additional","affiliation":[{"name":"Midwifery Research and Education Unit Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Stoll","sequence":"additional","affiliation":[{"name":"Midwifery Research and Education Unit Hannover Medical School  Hannover Germany"},{"name":"Department of Family Practice, Faculty of Medicine University of British Columbia 5950 University Boulevard  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100319"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2019.07.005"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12497"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d7400"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12616"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2011-000262"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.04.027"},{"key":"e_1_2_9_9_1","volume-title":"WHO Recommendations: Intrapartum Care for a Positive Birth Experience","author":"World Health Organization","year":"2018"},{"key":"e_1_2_9_10_1","volume-title":"A Guide for Advocating for Respectful Maternity Care","author":"Windau\u2010Melmer T","year":"2013"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-023-01584-1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182991"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246697"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12288"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03414.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2009.00322.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12858"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0180846"},{"key":"e_1_2_9_19_1","unstructured":"Gesellschaft f\u00fcr Qualit\u00e4t in der au\u00dferklinische Geburtshilfe QUAG e.V. 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