尽管分娩后产后阴道出血具有普遍性,并且在产后期间管理阴道出血以监测健康状况非常重要,对分娩者提供的信息或产品知之甚少。调查当前的做法可能会为制定更多支持性和公平的产后护理提供见解。
■评估在产后住院期间为分娩父母提供的阴道出血咨询的模式和内容。
■住院产后护理的观察性研究。出生的父母和他们的同伴同意自己的视频和音频记录,他们的婴儿,和医疗团队成员在产后单位逗留期间。
■经IRB批准,并与美国东南部一家三级医院的临床医生协调,数据收集了2020年8月至12月15个家庭的数据。一个多学科小组在出院前12小时对每个家庭的视频和音频数据进行编码。这项分析评估了阴道出血咨询时机的模式,内容,以及本次来文的语言一致性和主题内容。
■出生的父母参与者是自我识别的西班牙裔白人(n=6),非西班牙裔黑人(n=5),非西班牙裔白人(n=3),和非西班牙裔多种族(n=1)。六人说西班牙语,八人剖腹产。时间,内容,阴道出血沟通的语言一致性各不相同,这些主题主要在出院前一小时讨论。15个分娩父母中有12个就这些话题进行了2到5次交流,2有一次交换,1例没有观察到产后出血的咨询。六位讲西班牙语的分娩父母中有四位就这些语言不一致的话题进行了咨询。产后阴道出血管理涉及获取产品的主题,患者安全,有意义的咨询缺乏足够的通道,准确和尊重的护理的变化,以及繁忙的临床环境,提供了不同的信息。
■研究结果表明,有机会加强临床实践,积极主动,和语言一致的阴道出血和产后随后的月经护理。月经公平是有尊严和安全护理的重要组成部分。
视频分析了刚分娩的人与医院的医疗团队之间何时共享阴道出血的信息以及哪些信息。我们为什么要做这项研究?出生后,人们必须注意阴道出血。对于医院的人来说,识别出血过多的警告信号很重要,可以接触到垫子,在出院回家之前,感受到他们的医疗团队的支持。对于新父母,很少有关于产后阴道出血的住院咨询经验的研究-这是生殖生命周期的一部分。我们想在病房里观看和聆听,这样我们就可以考虑医疗保健提供者谈论阴道出血的最佳方法。我们做了什么?我们问了15个刚生孩子的人,和他们一起住在医院的人,和他们的医疗团队,如果我们能在他们的病房里录像和录音。他们可以随时开始和停止录制。我们只记录了同意参加研究的人。我们学到了什么?在每个家庭回家之前,我们在医院看了过去12个小时的录音。我们发现大部分时间,医护人员没有谈论阴道出血。说西班牙语的人并不总是有人翻译成他们的语言。有时家庭成员不得不翻译和要求垫。有些人没有足够的垫子或内衣,不得不在要求更多之后等待。这是什么意思?我们找到了改善有关出生后阴道出血的教学的方法。我们建议在需要时总是有口译员,给人们足够的垫子和内衣,包括教学中的同伴,并有足够的医护人员来回应请求。这些想法将改善咨询,并在分娩后为每个人提供所需的支持。
UNASSIGNED: Despite the universal nature of postpartum vaginal bleeding after childbirth and the importance of managing vaginal bleeding in the postpartum period to monitor health status, little is known about the information or products that birthing individuals are provided. Investigating current practices may offer insights to enacting more supportive and equitable postpartum care.
UNASSIGNED: To evaluate the patterns and content of vaginal bleeding counseling provided to birthing parents while on a postnatal inpatient unit.
UNASSIGNED: Observational study of inpatient postpartum care. Birthing parents and their companions consented to video and audio recording of themselves, their infants, and healthcare team members during their postnatal unit stay.
UNASSIGNED: Following IRB approval and in coordination with clinicians at a tertiary hospital in the southeastern United States, data were collected with 15 families from August to December 2020. A multidisciplinary team coded video and audio data from each family from 12 h before hospital discharge. This analysis evaluates patterns of vaginal bleeding counseling timing, content, and language concordance and thematic content of this communication.
UNASSIGNED: Birthing parent participants were self-identified Hispanic White (n = 6), non-Hispanic Black (n = 5), non-Hispanic White (n = 3), and non-Hispanic multi-race (n = 1). Six were Spanish-speaking and eight had cesarean section births. The timing, content, and language concordance of vaginal bleeding communication varied, with these topics mainly addressed in the hour preceding discharge. Twelve of the 15 birthing parents had communication on these topics between 2 and 5 times, 2 had one exchange, and 1 had no counseling on postpartum bleeding observed. Four of the six Spanish-speaking birthing parents had counseling on these topics that was not language concordant. Postpartum vaginal bleeding management involved the themes of access to products, patient safety, and meaningful counseling. There was a lack of adequate access, variation in accurate and respectful care, and a busy clinical environment with differences in information provided.
UNASSIGNED: Findings suggest that there are opportunities to strengthen clinical practices for more consistent, proactive, and language concordant vaginal bleeding and subsequent menstrual care postpartum. Menstrual equity is an important part of dignified and safe care.
Video analysis of when and what information on vaginal bleeding was shared between people who just gave birth and their healthcare team at the hospital.Why did we do the study? After birth, people must take care of vaginal bleeding. It is important for people in the hospital to recognize warning signs for too much bleeding, have access to pads, and feel supported by their healthcare team before discharging to home. There has been little research on experiences with inpatient counseling on postpartum vaginal bleeding—a part of the reproductive life cycle—for new parents. We wanted to watch and listen in hospital rooms so we could think about the best ways for healthcare providers to talk about vaginal bleeding. What did we do? We asked 15 people who just gave birth, people staying with them at the hospital, and their healthcare team if we could video and sound record in their hospital rooms. They could start and stop recording anytime. We only recorded people who agreed to be in the study. What did we learn? We watched recordings of the last 12 hours at the hospital before each family went home. We found that most of the time, the healthcare workers did not talk about vaginal bleeding. People who spoke Spanish did not always have someone interpreting into their language. Sometimes family members had to translate and ask for pads. Some people did not have enough pads or underwear and had to wait after asking for more. What does it mean? We found ways to improve teaching about vaginal bleeding after birth. We recommend always having an interpreter when needed, giving people enough pads and underwear in their rooms, including companions in the teaching, and having enough healthcare workers to answer requests. These ideas would improve the counseling and give everyone the support needed after giving birth.