Emergency Child Birth: Deliveries Outside of Hospitals

Paramedics receive enhanced skills training 

When the baby decides it’s time, it’s time. In the movies, unexpected childbirths are common, and a taxi driver manages to safely deliver the baby. But in reality, an unexpected childbirth can be complicated, and it takes skills to assist moms in labour.

Two years ago, emergency childbirth was identified as a delegated medical act, meaning health care professionals, such as Paramedics, would receive specialized skills training and qualify to provide the necessary service outside of hospital settings. That’s especially important in our region, where the distance between home and a hospital can be hundreds of kilometers.

In Northwestern Ontario, Paramedics are educated through the Northwest Region Prehospital Care Program (NWRPCP) at Thunder Bay Regional Health Science Centre. The NWRPCP provides certification, training and medical oversight to over 400 Paramedics working from Kenora to Manitouwadge.

“Given the remoteness of some communities in our region from hospitals or birthing centers, it was inevitable that our Paramedics were going to play a primary role in assisting patients who go into labour”, said Paul Starkey, Clinical Educator with the NWRPCP. “This initiative was definitely geared for Northwestern Ontario.”

It’s working. Since the training was rolled out in 2017, Paramedics certified under the NWRPCP have been involved in 30 out-of-hospital deliveries throughout Northwestern Ontario. All thirty deliveries resulted in positive outcomes for the mothers, parents and babies.

Brett Biasiol, a Paramedic with Superior North Emergency Medical Services (EMS) Paramedic, has already overseen four deliveries within the city of Thunder Bay. Biasiol, a Paramedic with three years of experience, attributes the positive outcomes to the training provided by the NWRPCP.

“I’ve been very fortunate at such an early stage of my career to be a part of four natural and healthy deliveries,” said Biasiol. “The emergency childbirth training provided me with the confidence to manage each situation. However, I need to credit all of my colleagues as none of this would be possible without the amazing support they provided. I’m truly blessed to work with such a professional group.”

The successful deliveries are a testament to both the commitment of Northwestern Ontario Paramedics, and to an innovative education approach. The Ontario Base Hospital Group (OBHG) partnered with the Association of Ontario Midwives (AOM) to develop the education plan for the Emergency Childbirth Medical Directive through the Paramedic Emergency Skills Program (PESP). This unique partnership resulted in a greater understanding and appreciation for the professions of Midwives and Paramedics. Each Paramedic in Ontario received an enhanced eight hours of mandatory education prior to being authorized by a medical director to perform delegated skills under medical directives.

Partnerships such as the one between the AOM and the OBHG demonstrate that innovation and collaboration enhance the paramedic practice. Likewise, continuous quality improvement activity partnerships between the NWRPCP and EMS service operators serve the communities in our region. No matter how remote the location, or what the prehospital emergency circumstance may be, people in Northwestern Ontario can continue to expect a competent and professional Paramedic response in a time of need.