TRANSFER PROTOCOLS FOR HOMEBIRTH

Transcription

1 TRANSFER PROTOCOLS FOR HOMEBIRTH Ericka Vander Sys, DNP, CNM Disclosure Statement The presenter has no financial relationships or conflicts of interest. Objectives The participant will be able to understand:! the incidence of homebirth in the US! the incidence of transfer of care! roles and responsibilities of care providers! importance of home birth transfer protocols! pertinent liability information from HB 4598! examples of best practices 5(

2 Homebirth in the US MacDorman, M.F., Mathews, T.J., & Declercq, E. Trends in out of hospital births in the United States, NCHS Data Brief, No Retrieved at Homebirth is a growing trend MacDorman, M.F., Mathews, T.J., & Declercq, E. Trends in out of hospital births in the United States, NCHS Data Brief, No Retrieved at Why women choose homebirth Listening to Mothers III survey! 30% would consider homebirth! 64% believe it is a right a woman should have if she chooses.! Cost effectiveness! Empowerment/Choices! Interventions and interruptions! Disrespect/dismissal! Connections! Satisfaction Vedam, S., Leeman, L., Cheyney, M, Fisher, T.J., Myers, S., Kane Low, L., & Ruhl, C. (2014). Transfer from planned home birth to hospital: Improving interprofessional collaboration. Journal of Midwifery & Women s Health, 59 (6), Bernhard, C., Zielinski, R., Ackerson, K., & English, J. (2014). Home birth after hospital birth: Women s choices and reflections. Journal of Midwifery & Women s Health, 59 (2), (

3 Incidence of transfer of care Study of 16,924 women between 2004 and 2009 who planned home births at the onset of labor.! 89.1% gave birth at home! Majority of IP transfers were for FTP (40.7%)! Desire for pain relief (15.2%)! NR FHTs or meconium (10%)! Malpresentation (6.4)! Maternal exhaustion (5.3%) Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D., & Vedam, S. (2014). Outcomes of care for 16,924 planned home births in the United States: The Midwives Alliance of North America statistics project, 2004 to Journal of Midwifery & Women s Health, 59(1), Home Birth Summit Best Practices Guidelines: Transfer from Planned Home Birth to Hospital! Model practices for midwives! Model practices for hospital-based care providers and staff! Quality improvement and policy development 7(

4 Model practices for midwives! Prenatally develops a transfer plan and documents it! Continual assessment throughout pregnancy and newborn period! Notification of impending transfer! Continues to provide care to woman/infant in interim! Provides verbal report upon arrival to hospital in addition to a legible copy of prenatal and labor records! Midwife may continue care if privileges allow, otherwise transfer of care occurs! Midwife continues to promote good communication between hospital-based care providers and woman.! If a woman chooses, midwife may remain to provide continuity and support. Model practices for hospital-based care providers/staff! Psychosocial needs of woman addressed! Communication with midwife in addition to information from woman! Direct admission! Keep woman and infant together! Shared decision making with the woman! Accommodate the presence of midwife and primary support person! Coordination of follow up care! Relevant medical records are sent to the midwife Quality improvement and policy development! Communication channels and information needed! Provision for emergency transfers! Opportunities to debrief with providers and woman! Documentation of woman s perspective during transfer! Defined process to regularly review all transfers! Continuing education regarding home birth, shared continuing medical education, and relationship building 8(

5 HB 4598 SEC A HEALTH CARE PROVIDER IS NOT LIABLE FOR AN INJURY RESULTING FROM AN ACT OR OMISSION BY A MIDWIFE WHO IS LICENSED UNDER THIS PART, EVEN IF THE HEALTH CARE PROVIDER HAS CONSULTED WITH OR ACCEPTED A REFERRAL FROM THE LICENSED MIDWIFE. AS USED IN THIS SECTION, "HEALTH CARE PROVIDER" MEANS AN INDIVIDUAL WHO IS LICENSED OR REGISTERED UNDER THIS ARTICLE. Examples of best practices New Mexico -UNMH Washington State -7 hospitals/20% of all births Michigan -Spectrum Health Vedam, S., Leeman, L., Cheyney, M, Fisher, T.J., Myers, S., Kane Low, L., & Ruhl, C. (2014). Transfer from planned home birth to hospital: Improving interprofessional collaboration. Journal of Midwifery & Women s Health, 59 (6), (