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Using data collected from open-ended, semistructured interviews, participant observation, and reciprocal ethnography, we identified six key themes\u2014three from each provider type. Collectively, providers\u2019 narratives illuminate the central stressors that characterize home-to-hospital transfers, and from these, we identify three larger sociopolitical mechanisms that we argue are functioning to maintain fractured articulations at the time of transfer. These mechanisms impede efficient and mutually respectful interactions and can result in costly delays. However, they also contain the seeds of possible solutions, and thus are important starting points for developing an integrated maternity system premised on mutual accommodation and seamless articulations across all delivery locations.<\/jats:p>","DOI":"10.1177\/1049732314524028","type":"journal-article","created":{"date-parts":[[2014,3,5]],"date-time":"2014-03-05T22:06:46Z","timestamp":1394057206000},"page":"443-456","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":52,"title":["Homebirth Transfers in the United States"],"prefix":"10.1177","volume":"24","author":[{"given":"Melissa","family":"Cheyney","sequence":"first","affiliation":[{"name":"Oregon State University, Corvallis, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Everson","sequence":"additional","affiliation":[{"name":"Oregon State University, Corvallis, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Burcher","sequence":"additional","affiliation":[{"name":"Albany Medical College, Albany, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,3,5]]},"reference":[{"key":"bibr1-1049732314524028","unstructured":"American College of Nurse Midwives. 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