Abstract
Background
Out-of-hospital births (OOHBs) are rare representing ∼0.05% of prehospital callouts.
OOHBs are at increased risk of complications including life-threatening conditions
such as postpartum haemorrhage and neonate resuscitation. This research investigated
Australian paramedics perceptions of’ training, experience, and confidence with OOHBs.
Methods
Semi-structured qualitative interviews were undertaken in late 2021 via online conference
or face-to-face. Sessions were audio-recorded and transcribed. Data was analysed and
coded into over-arching themes using thematic analysis.
Results
Fourteen participants were interviewed from military, industrial, and jurisdictional
ambulance services. Nine participants were female, and experience ranged from 1.5
to 20 years. Six Australian states were represented, incorporating rural and metropolitan
regions. Participants reported sporadic or infrequent training. No participant had
exposure to OOHBs during their undergraduate degree, with the most experienced paramedic
only attending six births. Participants with little/no experience reported low confidence,
and even more experienced participants reported anxiety when attending OOHBs, particularly
if there were long distances to definitive care or potential complications.
Conclusion
Many paramedics expressed low confidence and high anxiety regarding OOHBs, especially
regarding complications. Many felt insufficient time was dedicated to OOHBs during
education and training. This has the capacity to impact on patient care and outcomes.
Abbreviations:
AHPRA (Australian Health Practitioner Regulation Agency), BBA (Birth before arrival), CPD (Continuing professional development), CPG (Clinical practice guideline), CPR (Cardiopulmonary resuscitation), EMS (Emergency medical service), MGT (Modified grounded theory), OOHB (Out of hospital birth), PPH (Postpartum haemorrhage), VR (Virtual reality), WA (Western Australia)Keywords
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Article info
Publication history
Published online: September 10, 2022
Accepted:
August 26,
2022
Received in revised form:
August 19,
2022
Received:
April 9,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.
