The safety climate in prehospital deliveries. A sequential-exploratory mixed-methods study

Background: Prehospital deliveries are fairly rare in the ambulance care system. Since it is almost impossible to gain experience via emergency calls alone, they rank third in the perceived fear of emergency physicians. This study aimed to record the experience of prehospital deliveries, current knowledge regarding the topic, the assessment of training and desires to increase competence. Methods: Five qualitative interviews were conducted with participants. Based on the evaluation of these interviews, a quantitative questionnaire was created and made available online. Results: The interviews revealed the categories "emotions before and during the situation", "training", "competence", "personal responsibility", "dealing with women" and "interdisciplinary cooperation". In particular, the uncertainty during rescue operations was raised by the respondents. The quantitative survey examined care aspects more closely, including the categories "birth assistance", "complications of the mother", "complications of the child" and "initial care of the child". The highest level of certainty (39.3% "certain" or "very certain") was reported by the respondents (N = 742) in the primary care of the child. In the other categories they only made up 16-16.2%. Requests for further training and better cooperationwith midwives, such as internships or prehospital support, were identified. Conclusion: The vocation training should teach rescue service personnel the necessary competences that they need in these situations. In addition, there should be more opportunities for job shadowing and further training to provide optimal care for mothers and children during deliveries.