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. 2018 Jan 8;18(1):15.
doi: 10.1186/s12884-017-1638-4.

Epidemiology of unplanned out-of-hospital births attended by paramedics

Gayle McLelland  1 , Lisa McKenna  2   3 , Amee Morgans  4 , Karen Smith  5   6
Affiliations

Epidemiology of unplanned out-of-hospital births attended by paramedics

Gayle McLelland et al. BMC Pregnancy Childbirth. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Ambulance; Birth before arrival; Childbirth; Emergency care; Out of hospital births; Paramedic; Prehospital.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by Monash University Human Research Ethics Committee - Project Number: CF 10/0558–2,010,000,268. As this study reports upon data collected during paramedics’ management individual patient consent was not possible, however approval was received from the Research Committee of Ambulance Victoria.

Consent for publication

N/A

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Selection process for inclusion in analysis of paramedics’ attendance at women having a BBA
See this image and copyright information in PMC

References

    1. 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):217–223.
    1. Unterscheider J, Ma'Ayeh M, Geary MP. Born before arrival births: impact of a changing obstetric population. J Obstet Gynaecol. 2011;31(8):721–723. doi: 10.3109/01443615.2011.605484. - DOI - PubMed
    1. McLelland G, McKenna L, Archer F. No fixed place of birth: unplanned BBAs in Victoria, Australia. Midwifery. 2013;29(2):e19–e25. doi: 10.1016/j.midw.2011.12.002. - DOI - PubMed
    1. Rodie VA, Thomson AJ, Norman JE. Accidental out-of-hospital deliveries: an obstetric and neonatal case control study. Acta Obstet Gynecol Scand. 2002;81(1):50–54. doi: 10.1046/j.0001-6349.2001.00420.x. - DOI - PubMed
    1. Scott T, Esen UI. Unplanned out of hospital births - who delivers the babies? Ir Med J. 2005;98(3):70–72. - PubMed

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