They can do 1st and 2nd degree tears at home just fine, so you shouldn't need to transfer. For anything more than that (which is unlikely at a home birth), you'd need to transfer in, but it would be non-emergency and you'd have time to get your stuff together, go in and then should be able to come right back home if everything else is otherwise fine. I had a 2nd degree tear, which was no big deal. The midwives did the stitches while I laid on the bed and my husband was having skin to skin with our daughter. It wasn't pleasant, only part that really hurt other than the cervical exam (didn't feel the tear itself), but they did give me a lidocaine injection to numb the area, and I could have had gas and air too if I'd wanted it (I didn't).