Newborns born outside of hospitals at higher risk of hypothermia during emergency responses

Emergency services call handlers and paramedics have improved their working practices in response to findings from UWE Bristol research into out-of-hospital births.

The research found that the 3,700 babies are born in the UK each year outside of a hospital are experiencing poorer health outcomes when compared to babies born in hospital. 

Guidelines recommend that every baby should have their temperature checked, as hypothermia is a serious health risk for newborns in the minutes immediately following birth.

UWE’s Dr Laura Goodwin found that during the three-year period of study investigating normal deliveries, only 2.7% of babies born out-of-hospital in the South West of England had temperature measurements recorded by paramedics and of these, 72% were hypothermic on arrival at hospital. Dr Goodwin suggests that this could be due to paramedics only taking the temperatures of babies they were concerned about.

When paramedics attend out-of-hospital births this is often without a midwife and Dr Goodwin notes that “taking of the baby’s temperature is not always prioritised or possible due to the stressful nature of an unplanned out-of-hospital birth”.

On the basis of this research, Dr Goodwin collaborated with the Lead Quality and Improvement Clinician at South Western Ambulance Service NHS Foundation Trust (SWASFT) to change paramedic practice in ways that have resulted in better measurement and management of neonatal temperature. 

Changes have been implemented by the NHS Pathways and AMPDS (Advanced Medical Priority Dispatch System) triage systems in the UK and in over 50 other countries. Dr Goodwin said one of the reasons temperatures were not being taken was due to a lack of neonatal equipment carried by ambulances. To address this, SWASFT has introduced TransWarmer infant warming mattresses to all frontline vehicles, restocked their under-arm thermometers, and revised the digital patient care record system (ePCR system) to better highlight documentation of newborn observations. 

Our specialist maternity team here at Browne Jacobson aims to support the NHS and NHS Resolution’s commitments to safer maternity care by identifying themes and trends within its regional areas as well as delivering training.

Browne Jacobson endorses every improvement made to NHS maternity services in the UK. We have significant experience conducting sensitive investigations to help resolve concerns and disputes fairly. If you would like further information regarding our services, please visit our Maternity Services Resources Hub.