Paramedic training, experience, and confidence with out-of-hospital childbirth (OOHB) in Australia

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.