Pregnancy

BunnyBunnyBSNRN, ASN, BSN · Aug 30, 2019

send a warning out to not drink the water

BrisketRN, BSN, RN · Aug 30, 2019

Read up on your state laws about pregnant minors! Maybe a little studying up on OB?

jnemartin, BSN, RN · Aug 30, 2019

I have not encountered this, but I would check in with the students and see how everything is going - physically and psychosocially. Find out when is the due date and what the plan for onset of active labor is (so that if it happens at school, everyone knows what the plan is). Discuss with them typical do's and don'ts of pregnancy (no ibuprofen, no roller coasters, no twisting at the waist, try to sleep on L side, limit caffeine, be careful about sushi and deli meats, no alcohol/smoking/marijuana, take a daily prenatal or you will be super tired and could affect baby's bone and brain development).

I'm currently pregnant and thought it was super strange that no one ever talked to me about pregnancy "basics." I hope with a teen pregnancy, they would take more time to go over things, but who knows. For typical pregnancies, at the 10 or 12 week mark they see you for the first time, confirm pregnancy with ultrasound, and give you a pamphlet about some basic info. You're almost done with the first trimester at this point, so damage could already be done if the pregnant person was not well informed or didn't have access to good information. And it's possible that they give teens the info early but don't review it with them.

I'd also ask what are the plans for after the baby comes, so they can start planning for that.

jnemartin, BSN, RN · Aug 30, 2019

Oh, and I would suggest they find a support system of other pregnant people and new moms if they plan to keep/raise the babies. They can connect to these support groups through the hospital where they are delivering or there are many local ones on social media. They will learn a lot and have back-up people other than parents who may not always be the easiest to come to about things. That being said, I would warn them about sites like "What to Expect" because there is a lot of misinformation on those forums that can be entertaining but really leaves me (as a nurse) shaking my head.

ruby_jane, BSN, RN · Sep 3, 2019

Been there - two pregnant students and more pregnant teachers than I could count.

Odds are - nothing is going to happen at school. Keep repeating that.

Make sure you have doctors' offices phone numbers for them. When they come in with a complaint (it's usually spotting, very rarely is it "my water broke") - call the doctor's office. If the office is not open, hand them a maxi pad to put in their undies and have them lie down (position of comfort, not back-lying). That way when the office does open you can describe the color, clarity, etc. of the discharge.

If it looks like real labor, send them along per the MD instructions (the MD may have given them some kind of laminated card, or you'll have to call). Odds are the EMT, not you, will deliver that baby if it happens on a school day.

Other thoughts: if the student is under 18 there may be different rules for who can know what about the pregnancy. Get the student to tell you with whom she wants you to communicate. If they're over 18 they are obviously adulting and you do not have to communicate with their parents without the student's consent.

Teachers may freak out about this. Pregnancy is not a disability. Any accommodations (like an elevator pass) would need medical documentation- at least that's my policy.

Does your district have a specific policy about pregnant students? Is there a designated social worker who works with them?

Good luck!

JenTheSchoolRN, BSN, RN · Sep 3, 2019

Check with your state about charting with pregnancy. In my state I cannot chart anything about the pregnancy in the student's health file because it is also the school file and FERPA vs HIPAA. I can keep my own notes (usually in a password protected word doc stored locally on my computer) and talk with student's doctor and parents about pregnancy once it have been disclosed to me.

I cannot talk to anyone at school about it without the student's permission. Does not matter if they are 18 or not. Only exception is in emergency health situation.

Saltines, no joke, are awesome to have on hand :).

I've seen pregnant students, but way more pregnant staff, including some high risk women. I don't ever pretend to be an OB nurse and immediately have them on the phone with their OBs office if needed, acting as emotional support to make the phone call more than anything.

NurseMom1972, RN · Sep 4, 2019

Both of my students were fairly far along before the school year started (due in Oct / Nov).

Thanks for the input, it brought up a lot of points that I will work out ASAP.

Fingers crossed labor begins at home ?

On 8/30/2019 at 3:42 PM, BunnyBunnyBSNRN said:
send a warning out to not drink the water

ABSOLUTELY!!! Students and Staff alike.

NutmeggeRN, BSN · Sep 9, 2019

After having a previously undislosed pregnancy crowning in my office....gah!!!

I ordered an emergency OB kit, depending on far away your EMS is.

JenTheSchoolRN, BSN, RN · Sep 9, 2019

35 minutes ago, NutmeggeRN said:
After having a previously undislosed pregnancy crowning in my office....gah!!!
I ordered an emergency OB kit, depending on far away your EMS is.

Well, that is a story!!

Lucky for me, firefighters are around the corner and respond within 2-3 minutes of my 911 call. Honestly they have more experience than I do in birthing babies lol.

But an emergency OB kit isn't a bad idea for the staff. We have usually have 4-8 staff members a year pregnant.

Flare, ASN, BSN · Sep 10, 2019

I had a pregnant student a few years ago (at the middle school level). By and large, there wasn't much for me to do. My main concerns were that the key people that should know what's going on know (namely me and guidance so that we could help her find resources, and the principal so that home instruction could be set up when appropriate). She dressed in baggy clothes for most of the time, so i don't think a lot of people knew what was up until the very end when it became very apparent and public knowledge (on her doing). My other concern was PE restrictions and return to school / PE as well as return to school after pp period. I was also concerned in trying to find her an appropriate place to pump her breast milk in.

JenTheSchoolRN, BSN, RN · Sep 10, 2019

3 minutes ago, Flare said:
I was also concerned in trying to find her an appropriate place to pump her breast milk in.

Excellent point. My school luckily has a small private pump room for staff members that was have also let a student that was nursing use.