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Objective: To investigate current HCP stillbirth aftercare practices and use findings to inform suggestions for stillbirth aftercare guidelines. Study Design: Participants (n=18) were HCPs (MDs, DOs, or NPs) in the field of Obstetrics and Gynecology or Maternal Fetal Medicine. Focus groups and surveys were conducted. A phenomenological approach was used

Objective: To investigate current HCP stillbirth aftercare practices and use findings to inform suggestions for stillbirth aftercare guidelines. Study Design: Participants (n=18) were HCPs (MDs, DOs, or NPs) in the field of Obstetrics and Gynecology or Maternal Fetal Medicine. Focus groups and surveys were conducted. A phenomenological approach was used to explore and understand current stillbirth aftercare practices and thoughts about protocols for stillbirth aftercare. Descriptive statistics were used to analyze demographics of participants and prevalence of references to stillbirth aftercare topics. Results: Sixteen obstetric HCPs (medical doctors and nurse practitioners in the fields of obstetrics and gynecology and/or maternal and fetal medicine) participated in Focus Groups and two obstetric HCPs alternatively completed surveys. Current stillbirth aftercare practices and perceptions related to stillbirth aftercare protocols and guidelines were clustered around the following themes: recommendations made to mothers after stillbirth, subsequent pregnancy care, perceptions and use of protocols for stillbirth aftercare, and responsibilities of nurses and nurse practitioners after stillbirth. Conclusion: Findings were used to develop a list of stillbirth aftercare practice suggestions and may be used to help design future research related to HCPs' stillbirth aftercare practices and the need for training on existing guidelines and development of further protocols or guidelines.
ContributorsMartinez, Lauren Ann (Author) / Huberty, Jennifer (Thesis director) / Coursen, Cristi (Committee member) / Leiferman, Jennifer (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
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Description
Intake of alcohol, tobacco, and illicit substances such as marijuana and methamphetamine during pregnancy can have significant deleterious effects on a developing fetus and the resulting infant. The existence of substance-exposed newborns also has negative impacts on society as a whole; these include financial burdens placed on taxpayers and the

Intake of alcohol, tobacco, and illicit substances such as marijuana and methamphetamine during pregnancy can have significant deleterious effects on a developing fetus and the resulting infant. The existence of substance-exposed newborns also has negative impacts on society as a whole; these include financial burdens placed on taxpayers and the additional time and resources required by health care professionals, social workers, and law enforcement authorities to properly care for such infants. Existing literature show a strong correlation between prenatal care and improved birth outcomes, including abstinence from or reduction of prenatal substance abuse. The Health Start Program in the state of Arizona attempts to mitigate the incidence of substance-exposed newborns, among other goals, by employing community health workers who identify high-risk pregnant and postpartum women, inform these women about how to receive prenatal care services, educate them on appropriate prenatal and neonatal care, and provide program and referral services to both pregnant and postpartum women. Community health workers interact directly with women most at-risk for prenatal substance abuse and should be well-versed in the understanding of the complex issues related to substance-exposed newborns. In an attempt to discover, analyze, and compile those complex issues with which community health workers should be knowledgeable, this project explores existing federal regulations regarding substance-exposed newborns, compares Arizona’s regulations to Minnesota’s, Virginia’s, and Washington’s, and analyzes prevailing literature in the field about the various implications associated with screening and reporting substance-exposed newborns to law enforcement authorities. After an intensive literature review, this project concludes that the Health Start Program needs a comprehensive resource document which enumerates federal and select state policies, landmark cases involving substance-abusing pregnant women and the precedence set by each, and recommendations from medical and public health experts. The document should also provide clear guidelines by which each stakeholder should abide and why, and recommend potential best practices the state of Arizona could adopt into law based on other state policies which have proven to be effective.
ContributorsTantibanchachai, Chanapa (Author) / Maienschein, Jane (Thesis advisor) / Ellison, Karin (Thesis advisor) / Coursen, Cristi (Committee member) / Arizona State University (Publisher)
Created2015