Acceptance and Perceptions of Mothers and Providers on Paramedic-Led Midwifery Services in Maternal Care Deserts
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Abstract
Background: Maternal care deserts, characterized by limited or no access to essential maternity services, contribute to high maternal and infant morbidity and mortality rates. While emergency medical service and community paramedicine have expanded preventive and perinatal services in other countries, U.S.-based research on integrating paramedics into maternal health delivery remains limited, particularly in underserved areas.
Purpose: The purpose of this study was to explore the level of acceptance, perceived benefits, and challenges of paramedics providing midwifery-type services in maternal care deserts in the Commonwealth of Virginia. Specifically, we investigated the perspectives of expecting mothers and paramedics regarding the perceived acceptability of expanding paramedics’ roles to address the growing maternal care crisis in underserved areas.
Methods: We used a qualitative phenomenological design and recruited participants through digital outreach and complete semi-structured interviews that lasted 30-60 minutes via Zoom. Interviews were recorded with consent and transcribed. The primary investigator analyzed data using thematic analysis with manual coding and codebook development.
Results: The study included 23 participants (12 paramedics, 11 mothers) from maternal care deserts in Virginia. Five themes emerged: acceptance, perceptions of paramedic-led midwifery (PLM), barriers, benefits, and implementation needs.
Conclusion: Paramedic-led midwifery is a community-supported approach to improving care in maternal care deserts. Findings underscore the need for enhanced training, policy change, and collaboration. With intentional implementation, paramedic-led midwifery holds promise as a model to advance maternal health equity in underserved U.S. regions.
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