Announcer: Covering all aspects of women's health, this is "The Seven Domains of Women's Health," with Dr. Kirtly Jones on The Scope.
Dr. Jones: Every woman comes on to Labor and Delivery . . . well, most women come into Labor and Delivery hoping for a healthy, wonderful, peaceful, home experience in the hospital where it's safer. We really count on people to give us the information that helps us prepare for when things don't go well.
Today in The Scope studio, we're talking to Janet Fisher, the nurse educator on Labor and Delivery at University of Utah Hospital. What would you recommend in terms of dialog with your clinician and information that would help your clinician be prepared for something that might not go well?
Janet: It's really important that a woman shares with us all information about her medical history, any surgeries that she's had, any social things that she may do. This is not by way of making judgments of people, it's really just important that we know everything because things may have an impact on the woman or her baby. In order for us to take safe care of somebody, if we have complete information about you, then we are going to make very safe decisions on how to care for you if you are having an emergency.
Dr. Jones: Right. So women who've had, let's say, we'll take high blood pressure and pregnancy in the past, they're at risk for that again. We would be very careful watching them during their pregnancy and labor and delivery. Women who might be taking some recreational drugs and maybe they don't want to talk about it, but it may profoundly affect not only their blood pressure, but it may have a counter-effect on what we treat their blood pressure with. So honesty is the best way for a healthy baby and a healthy mom, yeah?
Janet: It absolutely is. Once again, there are absolutely no judgments being made here. Our sole objective is to take safe care of you and safe care of your baby. And the best way to do this is for you to be very open and honest about everything.
Dr. Jones: The other situation that I remember seeing on Labor and Delivery are . . . I would say there's a tension between women who want a natural process to happen and a birth is a natural process, but they feel like there's too much intervention and there are too many medications. About 50% of women who become high-risk deliveries walked into the hospital as low-risk women.
Janet: That's true, yes.
Dr. Jones: So when women come with a set of expectations, and some of these are written down, a delivery plan, asking for a little flexibility, we'll do the teaching and the explaining, but a little flexibility when we see things happening that make us worry, and having a discussion.
Janet: Well, I think, once again, we want everybody to have the birth experience that they have planned. It's very important to us to support every woman's plan because it is a major life event. It's something that you will always remember. But part of the reason you came to the hospital, and one of the major responsibilities as a health care provider, is that we have to constantly be monitoring you to make sure that you are staying on the path that we know is normal.
If we see you starting to deviate from that normal, it's our responsibility to tell you that and to talk to you about what our concerns might be and what our recommendations are. When this works best is if, as a woman, you are open to listening to us and to realize that what we bring to you is a lot of years of experience and knowledge and that we are not trying to circumvent your plan. Our goal is for you and your baby to be happy and healthy.
Dr. Jones: Both of these things we've just talked about, one is being open and disclosing all the parts of your health, and the other is being, both clinicians and women, being open to conversations when things aren't going so well, is all about having a conversation.
Janet: Very much so.
Dr. Jones: Doctors and nurses need to have the conversation so our patients feel safe. And patients need to have the conversation with us when they're nervous about something so that we can explain. I think at University Health Care, we work very hard to make those conversations go both ways.
Janet: Absolutely. I know it seems rather odd because here you are coming into the hospital to have a birth, a very personal and intimate experience, and these strangers are walking into the room, but you will be amazed at how quickly we bond. You come to rely on us and, hopefully, trust us. That is one of our biggest goals, when we're taking care of you, is to develop a trustful relationship. A big part of that is ongoing conversations with you and we want to listen, we want to hear what you have to say. By contrast, we want you to listen to us as well.
Dr. Jones: What our goals are for the ideal experience of a very difficult time because no one who has had a birth would say it's an easy process, but we want what's best for the mom and the baby. We want happy memories as well.
Janet: Absolutely. A positive birth experience is a number one goal for you and your family.
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