Grace, 25 years old, pregnant with her first child at 38 weeks, is currently being admitted into the Labor & Delivery unit at Mercy Hospital. Her water broke at home, she called up to the unit and was advised to come in. Current protocol for the hospital is to have the patient tested for COVID-19 within a week of their scheduled induction. Since Grace’s water broke before her scheduled induction, she has not completed her testing. Mercy’s current Labor & Delivery’s rooms specifically for COVID patients are full, so with Grace’s status being unknown, she was placed in a regular room. Once Grace is settled into her room, as a part of her labs, she will be tested for COVID-19.
After an hour, after Grace’s labs were drawn, her test came back positive for COVID-19. There are specific protocols in place at the hospital for patients who are positive for COVID-19, those precautions specific to Labor & Delivery, involve wearing appropriate Protective Personal Equipment (PPE), not allowing skin-to-skin and placing a clear, plastic barrier to separate mom from baby and their partner.
After 12 hours, Grace delivers a healthy baby girl. After everyone is cleared out of the room, she tells her nurse that she is aware of the benefits that skin to skin provides for baby, she wants baby to breastfeed skin to skin and also sees no reason for the barrier to be in the room since her, her partner and baby will all be going home together once discharge from the hospital. She pleads with the nurse to allow her the freedom to do as she wishes. The nurse is reluctant to respond.
STEP 1: Get the story straight — gather relevant information.
Clinical Indications questions: What major medical risks are present for the baby if Grace chooses to do skin to skin? What medical risks are present for the baby and her partner if she does not use the plastic barrier? Why is Grace adamant about skin to skin, what are the benefits?
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