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CASE STUDY: Active Labor: Susan Wong

Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy.

She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information

. Reflective Questions

  1. As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?
  2. How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views?
  3. With the influence of the recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy, how will maternity care change in the future?
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Sample Answer

As a nurse caring for Mrs. Wong, I would collect the following priority data to help define relevant interventions to meet her needs:

  • Medical history: This includes a complete medical history of Mrs. Wong and her partner, including any previous pregnancies, surgeries, or illnesses. This information will help to identify any potential risk factors for complications during the labor and delivery process.
  • Psychosocial history: This includes information about Mrs. Wong’s and her partner’s mental health, coping mechanisms, and support systems. This information will help to identify any potential emotional or social needs that the couple may have during this time.
  • Labor history: This includes information about the length and progression of Mrs. Wong’s labor, as well as any pain relief or interventions that were used. This information will help to assess the progress of labor and make informed decisions about interventions.

Full Answer Section

  • Fetal status: This includes information about the fetal heart rate, position, and movement. This information will help to assess the well-being of the fetus and identify any potential risks.

In addition to collecting this data, I would also provide Mrs. Wong and her partner with ongoing support and education throughout the labor and delivery process. This includes answering their questions, providing comfort and reassurance, and helping them to make informed decisions about their care.

If Mrs. Wong and her partner experience a negative outcome in the birthing suite, I would provide them with emotional support and grief counseling. I would also help them to connect with other resources, such as support groups or online forums, where they can connect with others who have experienced similar losses.

My personal views on terminating or continuing a pregnancy with a risk of a potential anomaly are complex and nuanced. I believe that every woman has the right to make her own decisions about her body and her pregnancy. I also believe that women should be provided with all of the information that they need to make informed decisions about their care.

I believe that factors such as the woman’s personal beliefs, the severity of the potential anomaly, and the woman’s support system should all be considered when making a decision about whether or not to terminate a pregnancy.

The recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy have the potential to change maternity care in the future. I believe that this information will empower women to make informed decisions about their pregnancies and to seek early intervention if necessary.

I also believe that this information will allow healthcare providers to better tailor their care to the individual needs of each patient. For example, if a woman is at high risk for an open spinal defect, she may be offered more frequent ultrasounds or fetal monitoring.

Overall, I believe that the Human Genome Project has the potential to revolutionize maternity care and improve the lives of many women and their babies.

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