OB/GYN and Newborn Care on the NREMT Paramedic Exam

Where OB and newborn items sit on the Paramedic test plan

On the National Registry Paramedic Certification Examination, obstetrics and gynecology share a domain with medical emergencies: Medical/Obstetrics/Gynecology, at 24–28% of the exam. The test plan does not give obstetrics its own share, and it integrates pediatric items across the clinical domains. These are the Paramedic test plan's domains; the EMT exam uses a different blueprint.

This page covers the decisions current guidance states clearly: cardiac arrest in pregnancy and the first decisions after birth from the 2025 AHA guidelines, and pregnancy as a risk factor in the 2021 field triage guideline. Delivery and complication procedures are not taught here; learn them from your program and protocols. Your medical director decides real care.

Cardiac arrest in pregnancy: three 2025 recommendations

The 2025 AHA guidelines list three recommendations for a pregnant patient in cardiac arrest, each class 1:

Displacement and airway support begin immediately while CPR continues. Activate the appropriate resuscitative-delivery capability at once under medical direction. The guideline does not make waiting for hospital arrival the rule: location, expertise and authorization determine what the responding system can provide.

Read the condition in the first row carefully. The trigger is the height of the fundus, at or above the umbilicus, and the displacement happens while compressions continue. Three kinds of option work against these rows:

• Pausing compressions to reposition the patient, when the recommended displacement is done during compressions
• Delaying airway management until after delivery, when the guideline says to prioritize it
• Leaving pregnancy-specific care to the hospital, when the displacement and airway rows apply on scene

The free mixed set includes an arrest item in late pregnancy. Once the three rows and their conditions are clear, check the uterine-displacement item in the free NREMT Paramedic set →.

The first decisions after birth

The 2025 neonatal recommendations attach each action to a gestational age or a condition:

Starting at 21% oxygen is easy to get wrong if you learned to start high. The 2025 neonatal guidance pairs the starting concentration with pulse oximetry, so the oxygen is adjusted from what the oximeter shows rather than set high and left there.

Two thresholds, worked

The newborns below are fictional.

• Born at 36 weeks and needing ventilation. At 36 weeks, this newborn meets the 35-week threshold for starting at 21% oxygen and the 34-week threshold for a laryngeal mask as the primary interface.
• Born at 34 weeks and needing ventilation. The laryngeal-mask row still applies, because it starts at 34 weeks. The 21% row does not, because it starts at 35 weeks. The starting oxygen for this newborn comes from your protocol and the full neonatal guideline, not from the 21% row.

Two weeks of gestation change which rows apply, which is why a stem's gestational age is a cue rather than background. With those thresholds in mind, try the newborn starting-oxygen item in 20 mixed NREMT Paramedic questions →.

Pregnancy in trauma field triage

The 2021 National Guideline for the Field Triage of Injured Patients lists pregnancy beyond 20 weeks among the EMS-judgment risk factors. Those factors sit in the yellow tier. A patient who meets a yellow criterion and no red criterion should be taken preferentially to a trauma center, which need not be the highest-level one, within the regional trauma system.

A pregnant patient who meets any red criterion, such as a qualifying vital sign or injury pattern, is triaged on that red criterion to the highest-level trauma center available within the regional system. The trauma and field triage guide explains both tiers and their thresholds.

Related pages for the rest of the domain

• Infants after the birth transition. Neonatal resuscitation at birth uses its own guidance. Infant compressions and pediatric resuscitation outside that transition are covered in the pediatrics guide.
• The rest of the medical domain. The medical emergencies guide shows how to study the 24–28% domain as decisions.
• What changed in 2025. The 2025 AHA changes guide lists every pregnancy and newborn row beside the adult changes.