Virginia Via Research Day Book 2026

Medical Student Research Public Health

19 EMS Encounters for Obstetrical Incidents: A Preliminary Analysis on the Pre-Hospital Trends in the Wake of Rising Labor and Delivery Unit Closures in the United States

Cassandra Crouse, OMS-III; Meaghan Gilbert, OMS-IV; Alison LePera, DO, PhD; Ramu Anandakrishnan, PhD; Anita Register, DO Corresponding author: ccrouse@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

were assessed using red, yellow, green black, and non acute/routine. Stastical methods included Pearson’s chi square test and correlation coefficient. Results: There was a significant difference in OB encounters between years with a p-value < 2.2 X 10 16. The Pearson’s correlation between Year and OB entries per 1 million total entries during the study period was -0.44. If years 2019 and 2020 are excluded, the correlation coefficient is +0.98, respresenting the change in OB entries. There is a strong positive correlation for percent critical cases of +0.81 and a strong negative correnation for percent low acuity cases of -0.77 during the study period. Conclusion: While there was a significant change in out of hospital obstetric encounters between 2019 2024, the net decrease in proportion of encounters was an unexpected result. This finding, however, parallels the general decline in U.S. birth rates. Of note, the highest number of hospitals that lost obstetrics during years 2019 and 2020 (57 and 66, respectively), are also

the two years in which OB entries per 1 million total entries were the highest. The up-trending level of acuity finding year to year necessitates high quality EMS provider traning and preparedness. Future collaboration may involve EMS providers, medical directors, emergency physicians, OB/GYNs, and neonatologists in which they simulate these high fidelity scenarios. The National Registry of EMTs does not have a speciifc OB/GYN continued education requirement for recertification, and this is another possible avenue for expanded competency in OB emergencies.

Context: The 2024 March of Dimes report noted 1 in every 25 obstetric units in the U.S. closed their doors in the last 2 years. Without a nearby labor and delivery unit, alternative options for pregnant patients to seek immediate care include calling 911 or travelling to the closest emergency room or urgent care. Unplanned prehospital deliveries have been linked to increased perinatal morbidity risks for both the neonate and the mother. Objective: We will define recent epidemiologic changes in out of hospital obstetric incidents and acuity. We hypothesized that the increasing number of obstetric unit closures has led to a higher volume of 911 activations and encounters. Methods: Data was obtained from the National EMS Information System (NEMSIS) for years 2019 2024. NEMSIS is a de-identified dataset representing patients in the out-of-hospital setting, and it is publically available for research use. All ICD-10 codes for maternal conditions were included. Acuity trends

This study was approved by IRB #2258786-1

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