Hypothetical woman that has come to the hospital with specific medical complaints

This case contains a hypothetical woman that has come to the hospital with specific medical complaints. As a doula, you will be providing care that is non-medical in nature. This case study shows how the roles of different birth professionals differ, as well as how they compliment each other. It also shows how doulas can use critical thinking skills during the birth.
Listen to the OBGYN Morning Rounds case study for chorioamnionitis (from audio player below). Audio is taken from: http://obgynmorningrounds.com/blog6/rounds/hospitalized-patients/chorioamnionitis
Below is a summary of what you should have learned from the case study for chorioamnionitis.
Medical Care Given
In this scenario, there are various medical procedures done. These include assessing for disease by checking uterine tenderness and noting symptoms that might indicate disease, performing cervical exams, inserting a straight catheter, ordering and performing labs, monitoring fetal heart rate, prescribing medication, starting IV, pitocin and epidural.
Needs Identification, Prioritization and Doula Actions
Through New Beginnings you will learn how to assess and identify needs that you will be able to implement. This format is based off of the nursing process and Maslow’s Hierarchy of needs(both of these will be taught later in the course).
Physiologic Needs
Hunger
Actions implemented: If planned beforehand with the medical provider, suggest easily digestible foods. Peppermint tea can be offered to help relax smooth muscles and aid in digestion. Peppermint oil may be used for a similar purpose(make sure you follow the safety rules regarding the use of essential oils). If food is not desired, clear liquids like jello, broth, or Popsicle may be given.
Fatigue
Action implemented: Assess the mother’s fatigue. Try helping her find positions that may be comfortable for her to sleep in. If the mother is expected to be in the hospital long, a pad of some sort to put on the laboring beds will aid with comfort. In addition, it is important her pain is eased enough to rest. This may include non medical means such as positioning, hot pads, or water. But you may also want to discuss medicated options if desired to help to allow her to sleep if needed.
Thirst
Actions implemented: If planned beforehand with the medical provider, give her water or juice. She may have an iv bag already going. If that’s the case she may not need as much liquids, but might appreciate ice chips or small sips of liquids.
Safety Needs
Pain related to medical diagnosis of chorioamnioitis
Actions implemented: Hot pads or ice packs may help where it hurts the most. To help decrease the pain, try different positioning.
Pain related to labor
Actions implemented: While movement is great for normal labor, this may not be true in a labor with an infection. Try different movements, but only if it helps. To help release her own natural endorphins, try massage. Lavender, rose, or jasmine oils can be used if the woman is full term(again make sure safety rules are followed).
Body temperature fluctuation related to fever.
Actions implemented: Discuss with her care-provider if there may be something they would do medically. In addition, ice packs and fans can be used if desired.
Pain related to cervical check.
Action implemented: Encourage a discussion between the woman and her care provider regarding the number of cervical checks needed or desired. For those that are needed, help her start some deep breathing exercises and visualizations before, during, and immediately after the exam. Balling up her fists and placing them behind her hips during the exam will tilt the cervix closer, making it easier to reach.
Pain related to catheter insertion.
Action implemented: Deep breathing and visualizations will help with this procedure as well.
Pain related to iv.
Action implemented: Warm or cold compresses where the iv is inserted is sometimes helpful. Additionally, warming up the hand before the procedure will help make it easier to find a vein.
Fear.
Actions implemented: Knowledge helps to alleviate fear. Make sure that she has all the information she needs to understand what is going on. Since this baby is early, she is going to need information on what to expect. Assess and enable her to use any spiritual resources available. Things like prayer, meditation or other spiritual practices can help when she is feeling fearful. Focus on the actions and conditions she does have control over.
Social Needs
Opportunity for enhanced social network.
Actions implemented: Discuss with the woman who she really feels comfortable having at this birth as well as whether or not she wants outside distractions like the phone or computer network. Help the spouse or significant other to feeling included in the birth process.
Esteem Needs
Opportunity for enhanced self-esteem.
Actions implemented: Encourage her to express her needs or desires, even if they don’t seem significant.
Opportunity for enhanced decision making.
Actions implemented: Encourage her to ask questions and discuss what she would like to have happen. Make sure that she is OK with any procedure that is being done. Before any procedure is done (e.g., vaginal exam, iv, medication), make sure she gives at least her verbal consent.