ONGOING COLUMNS: Perinatal Patient Safety
When a woman presents in labor, often she goes along with directions from nurses, midwives, and physicians during the childbirth process, trusting that they know best (Sakala, Declercq, Turon, & Corry, 2018; Simpson, Newman, & Chirino, 2010). Some women have a birth plan, but most do not. In a recent study (N = 14,630 births), only 12% of women had a birth plan and less than one-third had attended prepared childbirth classes (Afshar et al., 2017). Women often seek childbirth information on-line, but not all sites offer accurate data (English, Alden, Zomorodi, Travers, & Ross, 2018; Sakala et al.).
During childbirth hospitalization, many clinical events involve choice (see table). The list is not all-inclusive. Most allow ample time for detailed conversation and patient consent. Information should be provided at the appropriate literacy level and language. Interpreter services should be used as needed. Women should be treated as true partners in their care. They have the most vested interest in what is happening to them and they know their own bodies and preferences best. Shared decision making involves communication between clinicians and patients to make healthcare decisions that are consistent with key patient preferences (National Quality Forum [NQF], 2018). Information should be evidence-based, unbiased, and individualized, and include potential benefits and risks (NQF). Nurses are ideally positioned as part of the healthcare team to facilitate shared decision making during childbirth.
Afshar Y., Wang E. T., Mei J., Esakoff T. F., Pisarska M. D., Gregory K. D. (2017). Childbirth education class and birth plans are associated with a vaginal delivery. Birth
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English C. L., Alden K. R., Zomorodi M., Travers D., Ross M. S. (2018). Evaluation of content on commonly used web sites about induction of labor and pain management during labor. MCN. The American Journal of Maternal Child Nursing
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Sakala C., Declercq E. R., Turon J. M., Corry M. P. (2018). Listening to mothers in California: A population-based survey of women's childbearing experiences
. Washington, DC: National Partnership for Women & Families.
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