title: Victorian paramedics' encounters and management of women in labour: an epidemiological study.
abstract: BACKGROUND
  Although it is generally accepted that paramedics attend unexpected births, there is a paucity of literature about their management of women in labour. This study aimed to investigate the caseload of women in labour attended by a statewide ambulance service in Australia during one year and the management provided by paramedics.
  
  
  METHODS
  Retrospective clinical data collected on-scene by paramedics via in-field electronic patient care records were provided by Ambulance Victoria. Patient case reports were electronically extracted from the Ambulance Victoria's Clinical Data Warehouse via comprehensive filtering followed by manual sorting. Descriptive statistics were analysed using Statistical Package for Social Sciences (SPSS v.19).
  
  
  RESULTS
  Over a 12-month period, paramedics were called to 1517 labouring women. Two thirds of women were at full-term gestation, and 40% of pre-term pregnancies were less than 32 weeks gestation. Paramedics documented 630 case reports of women in early labour and a further 767 in established labour. There were 204 women thought to be second stage labour, including 134 who progressed to childbirth under paramedic care. When paramedics assisted with births, the on-scene time was significantly greater than those patients transported in labour. Pain relief was provided significantly more often to women in established labour than in early labour. Oxygen was given to significantly more women in preterm labour. While paramedics performed a range of procedures including intravenous cannulation, administration of analgesia and oxygen, most women required minimal intervention. Paramedics needed to manage numerous obstetric and medical complications during their management.
  
  
  CONCLUSIONS
  Paramedics provide emergency care and transportation for women in labour. Most of the women were documented to be at term gestation with minimal complications. To enable appropriate decision making about management and transportation, paramedics require a range of clinical assessment skills comprising essential knowledge about antenatal and intrapartum care.
authors: School of Nursing and Midwifery, Monash University, PO Box 527, Frankston, VIC, 3199, Australia. Gayle.McLelland@monash.edu.
authors: Gayle
authors: G
authors: McLelland
authors: Research Development Manager, Ambulance Victoria, 375 Manningham Road, Doncaster, 3108, Australia. amee.morgans@monash.edu.|Adjunct Senior Research Fellow, Department of Primary Health Care, Monash University, Frankston, VIC, 3199, Australia. amee.morgans@monash.edu.
authors: Amee
authors: A
authors: Morgans
authors: School of Nursing and Midwifery, Monash University, Building 13C, Clayton Campus, Clayton, 3199, Australia. lisa.mckenna@monash.edu.
authors: Lisa
authors: L
authors: McKenna
mesh_terms: D000293:Adolescent; D000328:Adult; D000488:Allied Health Personnel; D000552:Ambulances; D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data*; D015331:Cohort Studies; D036861:Delivery, Obstetric; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004634:Emergency Medical Technicians; D016021:Epidemiologic Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007748:Labor Stage, Second; D007743:Labor, Obstetric; D008875:Middle Aged; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D059408:Pain Management; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
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