• “Chapter 3: Do What You Need to Do – Pamela and Chloe,”Homebirth in the Hospital, pp. 41-53
• “Chapter 4: Baby Wants Out! – Sueli and Marcus,” Homebirth in the Hospital, pp. 55-63
Reading from course materials: Read Case Study 2 and Case Study 3
List three instances from Homebirth in the Hospital and three instances in Case Study 3 that there was a decision made. This can be by the mother or the medical provider. List what method of problem solving was used. Since some of these share similar ideas, you may find that they overlap in some instances. That is okay. Just do your best to try and identify which category you feel they fit the best. With the list also include why you believe the situations you choose fall into each category.
Example:
• Decision made
• What type of decision
• Why you would categorize it this way
Case 2
The birthing process has critical significance in any woman’s life; nevertheless, they feel so insecure that they don’t even care to discover the facts and reality regarding doulas throughout their most sensitive period. This action causes the loss of a tremendous opportunity. There exists no one in the delivery room whose primary mission is to make the mother emotionally strong all the time (Sanjaya et al., 2021). Doulas should have insight into the motivations behind woman choices. When Doulas can step out of their preconceived notions about birth and into the shoes of the women we assist, Doulas can better meet the patient need as they supplement nursing care by offering emotional and interpersonal assistance.
When it comes to medical interventions, the doula educates the woman about the potential outcomes of her choices and any necessary safeguards or interventions. Doulas may help maximize the positive effect of pain medicine and decrease the negative ones. No matter how well the pain is managed, the support and reassurance provided by the doula are valuable. In this case, for instance, A doula may be helpful during contractions, during which the epidural shouldn’t be considered until active labor has been established (often after 5 cm of dilating). Pitocin is to restart patient laboring when an epidural has halted contractions momentarily or permanently. Depending on how long your patient is laboring, delaying the epidural until later in the process might reduce the number of drugs you consume. Pain after an epidural seldom disappears entirely. At times, you may need to find other means of comfort.
For patient education, the doula plays a very significant role. As doulas, one of the primary responsibilities is to teach expectant and new parents about pregnancy, labor, and parenthood. Doulas and epidurals should be included in any discussion about pain relief during labor and delivery. Informed consent for epidurals should entail discussing the pros and cons of getting an epidural, especially at various points in laboring, and setting appropriate goals. Explaining how epidurals might help ensure a healthy delivery is crucial. For example, epidurals may be used in treating diverse medical conditions, such as high blood pressure, anxiety, stress, exhaustion, and so on.
Our instance demonstrates the critical importance of Doulas in guiding patients through the decision-making process. The patient requested personalized attention and a controlled delivery. Her most recent birth experience was big responsible for this. The patient was unyielding that only minimal dose of pain medication should be used during labor. Her body, she felt, could do the duties at hand. To have an epidural, the patient must sit motionless for a long time, generally throughout a few contractions.
During the nursing interventions, the doula helps by ensuring that the mother’s position in bed is the right one to facilitate the baby to descent into the pelvis. A skill doula will help assists the patient with the high risks that involves with receiving an epidural. Massage of the mother’s legs after a successful epidural helps alleviate swelling from intravenous fluids. Even if the drugs may have slowed down her labor, a massage may help her relax the portions of her body that she is having problems concentrating on, leading to better sleep and a less tense delivery. A serious complication with an epidural is the mother’s inability to push successfully. A doula may support the patient by suggesting numerous alternate postures during the pushing period. Above all, having someone who knows what is going on with the mother emotionally wise may be reassuring. The doula is there to keep you present during this miraculous rite of passage and to always provide emotional support. If the partner decides to take a nap after the patient has received an epidural because they mistake your apparent comfort for the absence of anxiety or fear of the incumbent delivery (Bertone, 2019).
Having a doula that is familiar with and informed about the catheter insertion procedure might help ease anxiety. The anesthesiologist may have more success with a successful placement, and the mother may feel the effects of the epidural sooner. The Doula can help the mother prepare mentally and emotionally. The next phase of the labor is when the epidural is planned. The negative feelings she has after giving birth with an unexpected epidural as soon as possible.
Case 3
Situation #1: Birthing Center/Home Birth
Education Provided
As a doula, educating my client would be provided to my patient about the various benefits of a birthing center or home birth. The likelihood of interventions for my patient to feel free and choose the environment and position that are most comfortable. During labor, the ability to have a more intimate and undisturbed birth experience is a potential that the cost will be lower compared to hospital birth. I would explain the safety considerations for both birthing centers and home birth. The need for a skilled midwife and the importance of being within an hour of a hospital in case of an emergency presents itself during the home birth.
What would you need to discuss with the care provider?
Clarifying the client preferences and the midwife’s policies and protocols for birthing centers and home births. I need to discuss the providers’ protocols for potential emergencies, such as transfer to a hospital.
Labor or prenatal support you would offer:
During labor and delivery, support would be provided to my patient by helping them to manage their pain and reminding them of the benefits of their chosen birth setting. Providing calming and encouraging words that will help them to remain focused on their birthing goals. I would also offer prenatal support by helping my clients to prepare for their birth, including providing information about the birthing center or home birth, allowing them to create a birth plan, and providing emotional support.
Situation # 2 (Not an Option): Epidural
Education Provided
As a doula, educating my clients about the potential benefits and risks of an epidural, such as pain relief, the potential for faster labor and delivery, and the potential for increased risk of infection. I would also provide information about alternatives to an epidural, such as hydrotherapy, massage, and breathing exercises.
What would you need to discuss with the care provider?
I would need to discuss the client’s preferences and the provider’s protocols for administering an epidural, such as the need for an IV, the need for monitoring, and the potential risks and side effects.
Labor or Prenatal Support Offer:
During labor and delivery, I would provide support to my clients by helping them to manage their pain, reminding them of the benefits of their chosen birth setting, providing calming and encouraging words, and helping them to remain focused on their birthing goals. I also offer prenatal support by helping my clients to prepare for their birth, including providing information about the potential benefits and risks of an epidural, helping them to create a birth plan, and providing emotional support.
Situation # 3 (Not an Option) – Vacuum extraction
Education Provided
As a doula, I would educate my clients about the potential benefits and risks of vacuum extraction, such as the ability to reduce the duration of labor and the potential for increased risk of fetal injury. I would also provide information about alternatives to vacuum extraction, such as using forceps or manual extraction under the supervision of a skilled midwife.
What you need to discuss with the care provider?
The discussion for my client preferences is to collaborate with the provider’s protocols for performing a vacuum extraction. The needs for monitoring and the potential risks and side effects for this procedure is very important.
Labor or Prenatal Support Offer:
During labor and delivery, I would provide support to my clients by helping them to manage their pain, reminding them of the benefits of their chosen birth setting, providing calming and encouraging words, and helping them to remain focused on their birthing goals. I would also offer prenatal support by helping my clients to prepare for their birth, including providing information about the potential benefits and risks of vacuum extraction, helping them to create a birth plan, and providing emotional support.
Situation #4 (Not an Option)- Induction
Education Provided
As a doula, I would educate my clients about the potential benefits and risks of induction, such as the ability to reduce the duration of labor and the potential for increased risk of fetal injury or infection. I would also provide information about alternatives to induction, such as waiting for the labor process to start on its own or allowing the body to go into labor naturally, if possible.
What you need to discuss with the care provider?
I would need to discuss the client’s preferences and the provider’s protocols for performing an induction, such as the need for monitoring and the potential risks and side effects.
Labor or Prenatal Support Offer:
I would provide support by helping them to manage their pain. I would remind my clients of the benefits of their desired birth setting, providing calming and encouraging words. The goal is to help them to remain focused on their birthing goals. I will offer prenatal support by helping my clients to prepare for their birth, including g information about the potential benefits and risks of vacuum extraction. Helping them to create a solid birth plan and providing emotional support.
