Reflection: Obstetric Interventions in Childbirth

Description

In a recent maternity ward shift, I participated in the care of a first-time mother amid active labor. The labor proceeded without complications, and the patient had thoroughly prepared for a non-interventional birth, articulating a clear preference to minimize unnecessary medical procedures. Nevertheless, as labor advanced, indications of fetal distress became apparent through irregularities in the baby's heart rate.

Feelings

During that moment, a range of emotions washed over me. Concern for the well-being of the mother and the baby weighed heavily on my mind, yet I found myself unable to convince the patient, who adamantly insisted on a natural birth. The patient's reaction and the decision to proceed with an obstetric intervention left me feeling apprehensive.

Evaluation

The decision to step in was firmly based on a genuine regard for the mother's and the baby's safety and well-being. The alarming fetal heart rate patterns demonstrate that fetal distress is a major issue that needs immediate therapy to prevent potentially serious negative outcomes (Zhao et al., 2018). My patient-centred strategy and communication may have been more effective. I should have adequately explained the situation to the patient, helped her grasp the benefits and drawbacks, and actively included her in making a choice. This would have enhanced her cooperation and empowered her to make more informed decisions about her care.

Analysis

It becomes apparent that effective communication and team decision-making are crucial in circumstances involving obstetric intervention (Lippke et al., 2021). In this situation, the healthcare professionals should have a more open conversation with the patient and her support group to ensure they are fully aware of the rationale behind the intervention (Bombard et al., 2018). For example, a study by Krist et al. (2017) highlights the positive impact of shared decision-making in obstetric care. It emphasises that involving the patient in the decision-making process, significantly during interventions, enhances the patient's sense of autonomy and increases patient satisfaction with care. Furthermore, healthcare providers must foster a more collaborative decision-making process to alleviate the patient's anxiety and disappointment (Marshall et al., 2021). Lastly, patient-centred care models are associated with improved clinical outcomes (Epstein, 2010).

Conclusion

The experience taught me the importance of balancing the clinical necessity for intervention with the patient's desires and autonomy. It reaffirmed the significance of clear and compassionate communication during such critical moments. In the future, I will strive to improve my communication skills and involve patients and their families more actively in decision-making, even in emergencies.

Action Plan

I am dedicated to enhancing my practice in similar situations through a multifaceted approach. Firstly, I will enrol in specialised training for effective communication during obstetric emergencies, equipping myself with skills to engage patients in high-stress scenarios, ensuring their comprehension and participation in decision-making (Krist et al., 2017). Additionally, seeking mentorship from experienced colleagues who excel in shared decision-making will be invaluable for honing my abilities. Moreover, I'll work on a comprehensive patient-centred approach that addresses obstetric care's clinical and emotional aspects (Dong et al., 2022). This holistic approach will better prepare me to navigate similar situations, empower patients, and provide the highest quality of care.

References

Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., & Pomey, M. P. (2018). Engaging patients to improve quality of care: A systematic review. Implementation Science , 13 , 1-22. https://doi.org/10.1186/s13012-018-0784-z

Dong, K., Jameel, B., & Gagliardi, A. R. (2022). How is patient‐centred care conceptualized in obstetrical health? Comparison of themes from concept analyses in obstetrical health‐ and patient‐centred care. Health Expectations : An International Journal of Public Participation in Health Care and Health Policy , 25 (3), 823-839. https://doi.org/10.1111/hex.13434

Krist, A. H., Tong, S. T., Aycock, R. A., & Longo, D. R. (2017). Engaging patients in decision-making and behavior change to promote prevention. Studies in Health Technology and Informatics , 240 , 284. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996004/

Lippke, S., Derksen, C., Keller, F. M., Kötting, L., Schmiedhofer, M., & Welp, A. (2021). Effectiveness of Communication Interventions in Obstetrics—A Systematic Review. International Journal of Environmental Research and Public Health , 18 (5). https://doi.org/10.3390/ijerph18052616

Marshall, T., Stellick, C., Abba-Aji, A., Lewanczuk, R., Li, M., Olson, K., & Vohra, S. (2021). The impact of shared decision-making on the treatment of anxiety and depressive disorders: Systematic review. BJPsych Open , 7 (6). https://doi.org/10.1192/bjo.2021.1028

Zhao, Z., Zhang, Y., & Deng, Y. (2018). A Comprehensive Feature Analysis of the Fetal Heart Rate Signal for the Intelligent Assessment of Fetal State. Journal of Clinical Medicine , 7 (8). https://doi.org/10.3390/jcm7080223.

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