Over the previous two decades the incidence and number of unplanned out of hospital births Victoria has increased. As the only out of hospital emergency care providers in Victoria, paramedics would provide care for women having birth emergencies in the community. However, there is a lack of research about the involvement of paramedics provide for these women and their newborns. This research reports the clinical profile of a 1-year sample caseload of births attended by a state-wide ambulance service in Australia.
Retrospective data previously collected via Victorian Ambulance Clinical Information System (VACIS ®) an in-field electronic patient care record was provided by Ambulance Victoria. Cases were identified via a comprehensive filter, and analysed using SPSS version 19.
Over a 12-month period paramedics attended 324 out-of-hospital births including 190 before paramedics’ arrival. Most (88.3%) were uncomplicated precipitous term births. However, paramedics documented various obstetric complications including postpartum haemorrhage, breech, cord prolapse, prematurity and neonatal death. Furthermore, nearly one fifth (16.7%) of the women had medical histories that had potential to complicate their clinical management, including taking illicit or prescription drugs. Mothers were more likely to be multiparas. Births were more likely to occur between 2200 and 0600 h. Paramedics performed a range of interventions for both mothers and babies.
Paramedics provided emergency care for prehospital out-of-hospital births. Although most were precipitous uneventful births at term, paramedics used complex obstetric assessment and clinical skills. These findings have implications for paramedic clinical practice and education around management of unplanned out of hospital births.
Ford J, Pett G. BBA’ birth. Analysis of one year’s ‘born before arrival’ births (n=29) and trends in BBA birth 2000-07 in a large English maternity unit. MIDIRS Midwifery Digest. 2008;18(2):217–23.
Scott T, Esen UI. Unplanned out of hospital births - who delivers the babies? Ir Med J. 2005;98(3):70–2. PubMed
Hey EN. Collaborative survey of perinatal loss in planned and unplanned home births. Br Med J. 1996;313(7068):1306–9. CrossRef
Loughney A, Collis R, Dastgir S. Birth before arrival at delivery suite: associations and consequences. British Journal of Midwifery. 2006;14(4):204–8. CrossRef
Di Benedetto MR, Piazze JJ, Unfer V, Ouatu D, Pollastrini L, Vozzi G, Marzano PF, Anceschi MM. An obstetric and neonatal study on unplanned deliveries before arrival at hospital. Clin Exp Obstet Gynecol. 1996;23(2):108–11. PubMed
Hagan K, Medew J. Many country obstetric units ‘risk closure’. In: The age. Melbourne; 2010.
Australian Standard Geographical Classification (ASGC). 2006. http://www.abs.gov.au/Ausstats/abs@.nsf/0/0D204FD3DCD90564CA256F19001303A2?opendocument.
Victorian Government. In: Department of Health, editor. Capability framework for Victorian maternity and newborn services. Melbourne: Victorian Government; 2010.
Riley M, Halliday J. Births in Victoria 1999-2000. In: Melbourne Perinantal data collection unit, Victorian Government department of human services; 2001.
Consultative Council on Obstetric and Paediatric Mortality and Morbidity. Victoria's mothers and babies, Victoria's maternal, Perinatal, child and adolescent mortality 2010–2011. Melbourne: Perinatal Data Collection Unit; 2014.
Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2011. 2016. http://www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001.
Ambulance Victoria. Annual Report 2009–2010. Melbourne: Ambulance Victoria; 2011.
Consultative Council on Obstetric and Paediatric Mortality and Morbidity. Annual report 2009. Melbourne: Perinatal Data Collection Unit; 2012.
Jones D. Babies born before arrival (BBA) in Newham, London during 2007-2008: a retrospective audit and commentary. MIDIRS Midwifery Digest. 2009;19(2):219–24.
Royal College of Obstetricians & Gynaecologists. Prevention and Management of Post Partum Haemorrhage. 2016. http://www.rcog.org.uk/womens-health/clinical-guidance/prevention-and-management-postpartum-haemorrhage-green-top-52.
World Health Organisation. WHO recommendations for the prevention and treatment of postpartum haemorrhage. Geneva: WHO Press; 2012. p. 3. http://apps.who.int/iris/bitstream/10665/75411/1/9789241548502_eng.pdf.
Li Z, Zeki R, Hilder L, Sullivan EA. Australia’s mothers and babies 2010. Perinatal statistics series no. 27. Cat. No. PER 57. Canberra: AIHW National Perinatal Epidemiology and Statistics Unit; 2012.
Figo Safe Motherhood Newborn Health Committee. Management of the second stage of labor. Int J Gynaecol Obstet. 2012;119(2):111–6. CrossRef
Kopas ML. A review of evidence-based practices for Management of the Second Stage of labor. Journal of Midwifery & Women's Health. 2014;59(3):264–76. CrossRef
Australian Resuscitation Council. Guideline 13.4 Airway management and Mask Ventilation of the Newborn Infant. 2016. https://resus.org.au/guidelines/.
Graves BW, Haley MM. Newborn transition. J Midwif Womens Health. 2013;58(6):662–70. CrossRef
PSANZ. Clinical Practice Guideline for Perinatal Mortality Version 2.2. 2009. https://www.psanz.com.au/assets/Uploads/Section-3-Evidence-Based-Clinical-Practice-Guidelines.pdf.
Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2012;5:CD003519. PubMedCentral
McDonald SJ, Middleton P. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev. 2013;7:CD004074.
Khan J, Vesel L, Bahl R, Martines J. Timing of breastfeeding initiation and exclusivity of breastfeeding during the first month of life: effects on neonatal mortality and morbidity-a systematic review and meta-analysis. Maternal & Child Health Journal. 2015;19(3):468–79. CrossRef
Collins D. Legally speaking. Ambulance transfer results in delivery and injury to the infant. Contemporary OB/GYN. 2010;55(11):30.
Health & Care Professions Council. Homepage - Check the register. http://www.hpc-uk.org/.
Spiby H, Green JM, Hucknal C, Richarson Foster H, Andrews A, Mother and Infant Research Unit DoHS, University of York. Labouring to better effect: studies of services for women in early labour. The OPAL study (OPtions for assessment in early labour). In: Report for National co-Ordinating Centre for NHS Service Delveryand Oragnisation R & D (NCCSDO). York: National Co-ordinating Centre for NHS Service Delveryand Oragnisation R & D (NCCSDO); 2006.
Tilden EL, Lee VR, Allen AJ, Griffin EE, Caughey AB. Cost-effectiveness analysis of latent versus active labor hospital admission for medically low-risk, term women. Birth: Issues in Perinatal Care. 2015;42(3):219–26. CrossRef
- Epidemiology of unplanned out-of-hospital births attended by paramedics
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