The vulnerability of maternity patients is exacerbated by the prehospital setting. EMS providers are often underexposed and undertrained for maternal emergencies, which further complicates care delivery. This review aimed to explore prehospital maternity-related emergencies encountered by EMS providers, their experiences, and the training available for such cases. Medline, EMBASE, Maternity, Scopus, and Web of Science were searched for published studies in English from 01/01/2002 to 10/08/2024 using a pre-set list of terms. Studies concerning prehospital maternity-related events attended by EMS, the description or evaluation of maternity care training courses for EMS providers, were included. Eligible studies were critically appraised using the (MMAT) tool. An integrative synthesis was used in this review as the heterogeneity of the studies prevented a meta-analysis. From 9678 identified studies, 35 studies were included. Prehospital maternity-related emergencies remain infrequent, less than 1% of EMS emergency calls globally, with a higher incidence rate in low-income countries. Most of these were labor and childbirth-related emergencies. Maternal and neonatal outcomes were positive, with less than 0.1% of maternal and infant mortality. Qualitative data highlighted providers' lack of confidence when attending to maternal emergencies. Language barriers and cultural competency should be considered when caring for maternal patients. Training courses included common maternal emergencies, and post-training evaluations showed improvements in knowledge and skills for EMS providers. EMS providers showed critical involvement during prehospital maternity-related emergencies, indicating the importance of high-quality training. When designing training courses, the unique environments of prehospital settings and the needs of their targeted population should be considered. Further research should explore the impact of training courses on patient outcomes.
Almubarak et al. (Fri,) studied this question.