Spotlight on Research

Unplanned out-of-hospital births occur in approximately 0.5% of all UK births. They are associated with unfavourable perinatal outcomes and increased mortality. It is estimated that the UK ambulance service attends 3700 births before arrival at hospital (BBAs) each year but given that there are over 33 000 paramedics, the likelihood of witnessing a BBA is low. An important risk factor for mortality following BBA is hypothermia, and this is recognised in the JRCALC guidelines. Emergency medical services (EMS) are well placed to record temperature and provide warming strategies but previous research suggests that paramedics do not routinely record neonatal temperature following BBA.

This study aimed to determine the proportion of cases in which neonatal temperature is documented by paramedics attending BBAs and to explore the barriers to temperature measurement by paramedics.

Phase I of this two-phase multi-method study involved analysis of anonymised data from electronic patient care records between 1 February 2017 and 31 January 2020 in a single UK ambulance service. The aim was to determine the frequency of BBAs attended, the percentage of these births where a neonatal temperature was recorded, and what proportion of these were hypothermic. Phase II explored experiences of, as well as barriers and facilitators to, neonatal temperature measurement and management following BBA through interviews with 20 operational paramedics from the same ambulance service.