One of our students prepared a birth plan for a client who would be dealing with anemia (a deficiency of red blood cells typically resulting in weariness) during her labor. With our student’s permission we are reproducing her plan on how to work with this particular complication that required more medical interventions.
- Need: impaired movement from IV because of need to stay hydrated
Action: Aid with IV stand so that it seems like less of a burden (if walking or movement is allowed)
- Need: impaired mobility because of continuous fetal monitoring of heart rate
Action: Help client discuss with providers what positions and movement is allowed which will not effect the fetal monitor readings. Once the client and you have this information, it will be easier to find a comfortable position(s)
- Need: impaired mobility because of oxygen mask in order to maintain high oxygen saturation
Action: Distract the client through guided visualizations, hypnosis, etc. so that her mind is not as focused on the mask.
- Need:client will likely become exhausted more quickly
Action: Limit positions which are more energy-intensive. Help client to pace herself and her energy.
- Need: fear that there will be further complications that develop due to anemia
Action: Help client to focus on the positive aspects of her pregnancy and labor. Provide additional information about the condition so that she can be most informed.
- Need: pain related to IV
Action: Use heat or ice(whichever feels better). Before the iv is put in, warm
the hand where is is going to be placed.
- Need: anxiety related to possible need for blood transfusion
Action: Help to facilitate open dialogue between client and provider so that client is aware as her condition continues.
- Need: anxiety related to anemia diagnosis
Action: Focus on what client can do to help herself including following perscribed care provider instructions (taking vitamins, taking additional iron, changing diet). Help client to formulate her worries into questions which she can ask her care provider.
- Need: risk for impaired parent/infant bonding related to complications from anemia
Action: Help client to ensure that her provider is well-equipped to deal with her condition. If she is not satisfied with her care, help her to find another care provider.
- Need: opportunities for enhanced feelings of empowerment
Action: Make sure client understands her choices and is given choices by her care providers both before and during birth.
By keeping the above needs in mind, the client is able to formulate a more exact (and many times more realistic) birth plan.