CASE STUDY: Active Labor: Susan Wong

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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?

 

Sample Solution

  1. As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?

The priority data that I would collect from this couple to help define relevant interventions to meet their needs include:

  • Medical history: This includes Mrs. Wong’s prenatal care history, her abnormal alpha-fetoprotein levels at 16 weeks of pregnancy, and her husband’s medical history.
  • Psychosocial history: This includes the couple’s relationship with each other, their support system, and their cultural and religious beliefs.
  • Emotional status: This includes the couple’s feelings about the pregnancy, their concerns about the potential anomaly, and their coping mechanisms.

I would also collect data about Mrs. Wong’s labor and delivery, such as her contractions, her cervical dilation, and the fetal heart rate.

  1. 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?

If this couple experiences a negative outcome in the birthing suite, I would help them by:

  • Providing emotional support and comfort.
  • Helping them to understand their options and to make informed decisions.
  • Connecting them with other resources, such as social workers and chaplains.

My personal views on terminating or continuing a pregnancy with a risk of a potential anomaly are complex. I believe that every woman has the right to make her own decision about her body and her pregnancy. However, I also believe that it is important to provide women with accurate information about the risks and benefits of all of their options.

Some factors that may influence my views include:

  • The severity of the potential anomaly.
  • The woman’s age and health.
  • The woman’s wishes and values.
  • The woman’s support system.
  1. 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?

The Human Genome Project has revolutionized our understanding of human genetics. It has also made it possible to develop new tests to predict genetic disorders, such as open spinal defects.

In the future, maternity care will likely change in the following ways:

  • More women will be offered genetic testing early in pregnancy.
  • Women who test positive for a genetic disorder will have more information about their options and will be able to make more informed decisions about their pregnancies.
  • Maternity care providers will need to be trained to provide genetic counseling and to support women who make difficult decisions about their pregnancies.

Personal Views

I believe that the Human Genome Project is a positive development for maternity care. It has the potential to help women and their families to make more informed decisions about their pregnancies. However, it is important to use this technology responsibly and ethically. It is also important to ensure that all women have access to genetic testing and counseling, regardless of their income or insurance status.

I also believe that it is important to respect the autonomy of women who make difficult decisions about their pregnancies. Women should have the right to choose what is best for themselves and their families, without judgment or coercion.

 

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