First Nations women’s experiences of childbirth out-of-hospital and the Australian Paramedic System: A scoping review.

First Nations women’s experiences of childbirth out-of-hospital and the Australian Paramedic System: A scoping review.

Background: Birthing on Country principles in Australia have seen a revitalisation in midwifery care over the last
decade with it being seen as a metaphor for the best start to life for First Nations peoples. This scoping review
aimed to explore the extent of evidence of Australian First Nations women’s experiences of out-of-hospital
childbirth and the alignment with Birthing on Country principles to inform paramedic practice.
Methods: Four databases were searched including MEDLINE, CINAHL, EBSCOhost Health and Scopus utilising the
Joanna Briggs Institute (JBI) methodology for Scoping Reviews. Inclusion and exclusion criteria were identified.
All articles were reviewed in a two stage process.
Results: Fifty two papers were yielded with 6 meeting the inclusion criteria. Using reflective thematic analysis
four key themes were generated; Birthing on Country and identity, inequitable access to healthcare, trusting
relationships and medicalisation of birth.
Conclusions: There is a large gap in the literature surrounding delivery of care by paramedics to First Nations
women birthing out-of-hospital in Australia. This review proposes supports and actions required to implement
Birthing on Country principles into paramedicine. Further, standard maternity care has been found to be
insufficient for First Nations women due to a lack of culturally safe care