Family-centered Maternity Care and Rooming-in - page 2

A thread in the Ob/Gyn nursing forum got me thinking about this. Family centered maternity care (FCMC) is a buzzword that's no doubt quite familiar to many in maternal/child nursing circles. In my almost-eight years as a nurse -... Read More

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    Most of my 17 years as a RN has been spent in a LDRP unit at two different hospitals. At the first hospital we had rooming in, allowed support person to stay, and we had visting hours for everyone else!
    The hospital I work in now allows rooming in, does not have any specific visting hours, allows as many people in the delivery as the patient wants ( if feasable). I am a huge supporter of family centered care. But by that I mean the family unit. Mom, support PERSON, and baby. It seems these days the birthing process is more a circus than an intimate family event. I long for the days of visiting hours. We have so much to do and teach the family unit in 2 days, its hard to fit it all in.

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    FCMC is great when mom is physically able to car for baby. One of my daughters delivered (c/s)-and was told that there was no nursery. In this case, "family centered" meant that you better hope and pray that you had someone with you to care for you and baby...scary part this was only 2yrs ago...
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    DSCRN, I see your point. There are some moms post c/s that can't physically care for their babies - but having a c/s doesn't automatically mean that she can't do it. I have plenty of new moms that want their babies in their rooms with them 24/7. They hold their babies in the crook of their arms to sleep, breastfeed, then go back to sleep. I check on them frequently enough and help change diapers etc. I make sure they have everything they need close at hand, and everybody does quite well!
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    I also see your point. I've cared for many c/s moms who had their babies room in. My concern was immediatly post op, when my daughter was dozing off a miserable labor, E/C/S. It had been an all nighter, and c/s due to fetal distress. With mom sleeping, my fear was that my grandson would have a fresh c/s choking episode. When I mentioned this to her nurse, she sai d"why would the baby choke"
    Elvish likes this.
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    Very true FCMC should not mean you are on your own. The focus is on the family unit keeping them together. Staff should be more attentive in these instances. Practically every moment is a teaching opportunity. The nurse should help the mother/support person gain confidence in caring for their newborn.
    Elvish likes this.
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    dscrn & LJMoats - I agree with both of you. Nurses shouldn't just be rolling the baby into the room and leave them on their own completely! It's a fine balance to strike sometimes - between making sure mom & baby are adequately 'checked on' and 'helped' and being an annoyance by being in there too much!
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    Your description sounds pretty much precisely what our hospital does. Rooming in is best, but I agree that respite care in a perfect environment would be available upon request. That we can't always do at night, if we are tight-staffed. But we do our best to honor requests if at all possible. Moms who are sick or have just had surgery CANNOT be expected to care for their newborn entirely right out post-op. We should make ourselves available to help. From what I see, though, so many hospitals are loading up 6 or more couplets to a nurse. That has to be hard to do unless there is a fulltime nursery to send the baby to, that is well-staffed.

    Great work, Elvish.
    Elvish likes this.
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    I just talked with my midwife today about what happens after the birth. She said it is a mandatory 24 hour stay with a normal vaginal birth. I will meet with a lactation consultant and learn how to breast feed and if I want to stay an additional day, that is fine with them. My baby will stay in the room with me and I will have the care of a nurse to walk me through everything. That is very exciting to me since I have absolutely NO IDEA what to expect or even how to embark on this journey that is about to take place this fall.
    LJMoats and
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    6 couplets are a lot. Usually a post partum assignment is 3-4 couplets. We have LDrp'S so at times a nurse will have a labor and and an "old" mommy/baby couplet. A lot of times if that happens I will try to assign the labor nurse a patient with a baby in NICU. Sometimes the dollars and cents gets to us all.
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    Citi-Kat congratulations on your upcoming adventure! It seems you have great resources in place, get the most of them while you can! If possible stay for the second day, you never know what may come up and the questions you will have. Being a first time mom it my help you feel a little better about having someone around, just in case!

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