Vinuli Withanarachchiea2, Verity Todd3, Bridget Dickera3, Sarah E Maessena3
1Clinical Evaluation, Research, and Insights, Hato Hone St John New Zealand, Auckland, New Zealand
2Shore & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
3Paramedicine Research Unit, Paramedicine Department, Auckland University of Technology, Auckland, New Zealand.
Biography:
Abstract:
Purpose
Despite their crucial role in prehospital obstetric emergencies, little research explores ambulance personnel’s perspectives on out-of-hospital births. This study aims to 1) identify how ambulance personnel’s demographics and experience relate to their confidence in treating patients in labour, and 2) explore ambulance personnel’s perspectives on managing emotional needs and administering analgesia in Aotearoa New Zealand (NZ).
Methodology
In this mixed-methods study, frontline clinical personnel from Hato Hone St John, NZ’s main road ambulance provider, were invited to complete an online survey about unplanned out-of-hospital births. Self-reported confidence in attending births and administering analgesia was compared across demographic and professional characteristics. Qualitative content analysis was applied to free-text questions.
Results
Of 147 personnel who completed the survey, only 37% felt their training equipped them to confidently manage births, with more experience associated with higher confidence. Men and those who had not given birth were more comfortable providing analgesia. Qualitative analysis identified four categories: 1) Managing their own emotions, 2) Gender differences in views of unplanned births, 3) Managing interpersonal communication with women in labour, family, and other health professionals, and 4) Views on pain management.
Conclusion
These complex cases present a variety of emotional and unpredictable challenges, exacerbated by perceived unclear guidelines and limited care options. Multi-disciplinary training with midwives and ongoing professional development are warranted. Findings indicate that women in labour may be cared for differently depending on the clinician’s personal experiences and attitudes toward pain relief, highlighting the need for adaptable approaches during these high-risk, low-frequency events.