Reflection Paper For Antepartum

The experience I will reflect on occurred during my fourth clinical shift. I was assigned a 32-year-old woman who was gravida 1, para 0 (nulliparous) and the fetus was at a gestational stage of 38 weeks and 2 days. Her husband was at the bedside, always supporting her throughout the whole process. Her estimated due date was on March 27, 2016, but she came into antepartum with more frequent and longer contractions on March 16, 2016. Her membranes ruptured around 0400 the next morning, with no noted blood or meconium. She was dilated at 4cm, effacement of 60-70% and stationed at -2. The nurse and I brought her over from antepartum at 0800 and started an IV on her to begin her antibiotic treatment. She was confirmed group B Streptococcus (GBS)

A GBS positive mother in the second phase of labor (birth of the newborn), puts the newborn at risk for the bacterium to cross over. If a newborn becomes GBS positive, the infection can cause neonatal morbidity and mortality; through respiratory distress, meningitis, sepsis, and heart and blood pressure instability (Noar, Blumenfeld, Merzbach, Timor-Trisch, & Zeltzer, 1982). It is vital that we prevent this cross-over of GBS through antibiotic administration of Penicillin G, as per RUH protocol. Penicillin G is the first-line of treatment and is usually administered IV at least 4 hours before birth to reduce the risk while the mother delivers and it’s important to monitor mother for any severe allergic reactions because they can occur rapidly (Chow et al., 2013). The nurse managed to start the Penicillin G at 0830 and then Syntocinon shortly after the antibiotic was done. She had no past medical history with no complications other than the GBS positive. We strapped on the Electronic Fetal Monitor (EFM) to get some readings of the fetal heart rate in relation to her contractions. The FHR was baselining at 145 with moderate

This could help ease any concerns she, or her husband, has with still feeling sensations at various times. The last thing you want is added stress during pregnancy and not knowing what’s going on can definitely increase anxiety for a nulliparous woman. I wasn’t really involved with assisting the woman in breathing and pushing patterns, and I noticed the nurse I was with was quite involved and encouraging towards the patient. It made me realize that the woman in labor has built a stronger relationship with the nurse rather than the resident that isn’t there as often. For next time, I want to be more involved and looked for as a support to a mother in all stages of labor, especially the second stage. It’s a rewarding feeling knowing you are going to be that person that they remember helping them throughout it all. Being more involved shows you care, and a human’s driven instinct is to care for one another and make a difference!