First things first, you need to ask the midwives what
their experience is with transfers, rather than the nit-picking
legalese in the handouts. Secondly, the ambulance staff will
also be calling ahead to the hospital and making arrangements
for whatever makes the most sense. And remember, the ER is
set up for a variety of emergencies.

Thanks for calming me down! Obviously in just one meeting we didn't talk
about everything, but she did talk about having contacts at the hospital
and even the option of transferring to midwifery led care at the
hospital (as I understand it there is one midwife who has delivery
priviledges), but we didn't talk about emergencies.

I've even gone to that hospital in an ambulance, I was pretty unwell
then, but now thinking back I do remember them having radio contact.

It's really hard for me having only lived here 2 years to be able to
contrast things that are really quite similar superficially, I've seen
inside 2 ERs here and they look just like the ones I've seen in the UK
and they appear to function the same way. But there are obvious
differences, for example in the UK they would rarely have dedicated
imaging facilities, other than x-ray. They also really don't like to
deal with pregnant women and a woman in labour would only rarely walk
into the ER, in theory you should call ahead and go to the unit, but
staff have told me they always get some come to the door who are booked
with them, they just failed to follow instructions and a fair number who
just show up at the door and they wouldn't turn them away or make them
jump through hoops. So the idea of showing up at the ER with a labour
emergency scares the heck out of me because I can't get my head round
that anyone there might have a clue, because in the UK, chances are they
wouldn't.

I'm really glad of the frequent appointment schedule there is so much to
get my head round, my previous pregnancies the schedule has been booking
at around 8 weeks, then 16 weeks, 24 weeks, 28 weeks, 32 weeks, 34, 36
etc. and possibly less than that for a straightforward 2nd pregnancy, I
was on weeklies at the end because with a previous IUGR baby and a very
small bump, she wanted to check it grew each week, which it did and then
suddenly got enormous (well average really, but it felt enormous to me
having never got bigger than normal for 7 months pregnant before).

Thanks for reassuring me Ericka, my husband was getting concerned too,
he was lucky enough to be in Santa Barbara recruiting at the beginning
of the week, which gave him a chance to meet old friends, who like us
had two babies two years apart in the UK followed by a 4 year gap and a
birth in the US. She's American, but he is English and unlike other
friends who've had babies in both countries, she was anxious over the US
system rather than reassured - I get the impression she would have liked
a homebirth with a midwife, but her FIL is an obstetrician and it was
just a no go area with her husband.

I think I need to go check out mothering.com!

Cheers
Anne