Jen Gabler Study Guide Flashcards
At Abril’s 36-week appointment, you meet her husband for the first time and discover that he only speaks Spanish. Abril acts as translator throughout the appointment, which works well and you feel he’ll be a supportive birth partner. What do you need to do for him?
Arrange to have a bilingual assistant at the birth who can communicate with him directly so that conversations do not need to go through Abril when she’s in labor.
In your practice, you’ve seen several clients who tested positive to COVID-19 during their pregnancy, and a high percentage of them had abnormal-looking placentas. What can you conclude from this?
This is anecdotal evidence. It is an interesting observation, worthy of further study, but it is not conclusive.
You move to a state that regulates midwifery. One law there states that you must transfer care to an obstetrician at 42.0 weeks. However, your Practice Guidelines state that you will provide care up to 42.6 weeks. What does this imply?
The state laws supersede your Practice Guidelines and must be followed. You should update your guidelines to reflect the laws in this state.
At her very first appointment, Deborah tells you that she doesn’t want a vaginal exam under any circumstances during labor. What do you do?
Explain the situations when you might feel the need to perform a vaginal exam during labor, and that there is the possibility that not being able to do a vaginal exam might require you to transfer care in a situation where this could have been avoided if you’d done one.
Your client has told you she’s made a decision about her treatment for a specific part of her care, and you believe she’s made the wrong decision. What do you do?
Ensure you’ve discussed the risks and benefits of the plan she’s chosen and of all reasonable alternative plans, and that she’s understood what you’ve told her. Then follow her decision, unless you feel this risks her out of your care, in which case begin the process of transferring care, explaining why you feel this is appropriate.
You have a student beginning phase 3/primary midwife under supervision who needs a continuity of care client. You tell him about a repeat client who you just heard is pregnant again, giving details of her previous pregnancy and birth. Your student is excited to meet her when she makes an appointment for the following week. What did you do wrong?
You should have obtained your client’s permission before disclosing details of her previous care with your student.
A local OB approaches you about a patient and her husband, who have requested that he perform a female circumcision on their neonate. The OB asks you whether he should agree to the procedure since it is in keeping with their cultural heritage. Which is the best response?
Whilst it is important to respect the culture of clients, Female Genital Mutilation can cause severe complications, including death. You recommend that the OB explain that he is unwilling to perform the surgery because of these risks, but without shaming the parents.
You’re at a homebirth, covering for a midwife who lives in a town an hour from you when a complication arises. You call 911 and request an ambulance, and then ask the client’s partner for the phone number for the nearest hospital so you can call to make report. What have you done wrong?
A midwife must be prepared for emergencies, including for transport, and even when covering for another midwife. You should have already had the contact details for the nearest hospital.
You’re delighted to be invited to a Christmas party with labor and Delivery staff from the local hospital. At the party, one of the nurses starts loudly discussing a client you transferred to them in derogatory terms. Do you…?
Quietly but forcefully request that the nurse stop talking about this. Not only is it inappropriate and unprofessional to discuss patients in this way, but it’s also a breach of patient confidentiality.
You’re caring for Caroline, a client from a religious group that you’ve never heard of. Caroline explains to you that women are considered ‘unclean’ for 30 days after birth and are not allowed in the presence of men during this time. Which of these is the best response you could give her?
You understand what she’s saying to you, and will look more into the religious beliefs and practices so that you can do your best to follow them when caring for her. If you do misstep, apologize and learn from the mistake.
An article has just been published in a peer-reviewed journal, proposing a ‘novel’ approach to something, but you’ve actually been doing this for many years and had been keeping track of the results with the thought of possibly publishing a paper on it yourself one day. You have a similar number of data points to the published study, but your results are very different to those reported, and you suspect a flaw in their work. What should you do?
Contact the editor of the journal and tell them of your own data and your suspicions that there may be an error in the published work.
At your 36-week home visit with Christa, you notice that the house is perfectly clean and the fridge is well-stocked. You help make up the spare bed for the birth, inflate her pool to check it, and connect the hot water tap to the hose. You’re happy for the physical work as it’s chilly in the house and there’s no heating. What do you still need to discuss?
Explain to Christa that it’s very important that the birth room be warm when the baby arrives, and ensure she has a heater there by 37 weeks.
At your 36-week appointment with Cho, you notice that her husband has several bruises, avoids eye contact with you, and agrees with everything Cho says. You think of domestic partner violence.
Domestic partner violence is perpetuated against all genders by all genders. You need to think carefully about how to approach this issue to ensure the safety of all.
A local midwife posts in a closed group to “warn everyone” that a woman who claims to be a man approached her for midwifery care. Which is the best response to her?
As midwives, our job is to care for pregnant people, not condemn them. If she is not comfortable caring for this client, that is her prerogative, however, she should treat everyone with respect, even if she does not ‘approve’ of their lifestyle. Suggest that she look into CEUs on being inclusive.
You’re collecting data on maternal mortality in your state in order to look for any recurring causes. For your first figure, you want to divide causes into ‘direct’ and ‘indirect’. Which of the following is the most accurate grouping?
Direct: PPH, eclampsia, sepsis from infection of cesarean wound, pulmonary embolism. Indirect: Seizure following cessation during pregnancy of epileptic medications, asthma, COVID-19, cardiomyopathy
