Article Text
Abstract
Background Paramedics assess, treat and transport labouring women who require intrapartum care in the out-of-hospital setting, yet very little is known about the experiences of mothers who birth whilst being supported by paramedics. Internationally, the healthcare literature describes predisposing factors, clinical risk and maternal and neonatal clinical outcome. However, there is little quality research available that explores the care provided by paramedics or that describes the views of women with recent experience of birth involving paramedic care.
Methods Through narrative inquiry this study utilised a feminist approach to explore the experiences of women who birth in paramedic care, their care needs, and the physical, emotional and psychosocial issues surrounding these cases.
Results 22 narrative interviews with women who birthed in paramedic care in Australia within the last 5 years were undertaken. This identified a series of factors that contributed to the planned hospital birth occurring in the out-of-hospital setting. The Results identified the themes: Birth Knowledge, The Birth Experience and Reflections on Birth. Women in this study began their story by discussing previous birth experience and their knowledge and personal beliefs concerning the birth process. Women described their previous interactions with maternity care providers and issues that caused them to delay attending hospital. Specific to the birth event, women reported feeling empowered, confident and exhilarated during the birth. However, they also identified concerns with paramedics not providing privacy, having poor interpersonal skills, a lack of consent for procedures, feeling judged and issues related to bonding.
Conclusion This study identified a series of factors that contribute to the planned hospital birth occurring in the out-of-hospital setting. Women described various deficiencies in the antenatal and intrapartum care received by maternity services in Australia. Women also described opportunities for improvement in the care provided by paramedics, specifically deficiencies in technical and non-technical skills.