Assistant professor awarded collaborative UMNursing grant for research into birth preferences adoption and implementation.
The University of Maryland School of Nursing’s Rachel Blankstein Breman, PhD '18, MPH, RN, assistant professor, has received a one-year, $15,000 UMNursing grant, a joint venture between UMSON and the University of Maryland Medical Center (UMMC), for the project “Implementation Study of the Birth Preferences Worksheet in Prenatal and Intrapartum Care at the University of Maryland Prenatal Clinics and Birthing Unit.” Breman has partnered with Amy Brown, BSN, RN, CPST, childbirth education coordinator at UMMC Women's and Children's Health - Maternal Child Outreach, to conduct the research.
Improving maternity care is a national priority, as the United States lags behind peer nations on both maternal morbidity and mortality indicators. At UMMC, obstetrical and family medicine practices provide prenatal and intrapartum care. In 2019, an interdisciplinary team decided to enhance clinical communication with pregnant and birthing people through a shared decision-making (SDM) process that starts during prenatal care and continues through labor and childbirth. SDM is an essential part of effective communication between the patient and health care team; through this process, the care preferences and personal values of the patient are integrated into the clinical decision-making process with the health care team.
A Birth Preferences Worksheet, an aspect of SDM, contains care-specific options available at UMMC for labor, birth, and initial newborn care, as well as a place to specify preferences. The information in the worksheet is discussed during prenatal visits, and during intrapartum care, the birth preferences are revisited, discussed, and implemented as appropriate to labor progression.
The purpose of Breman and Brown’s observational mixed-methods implementation study is to evaluate the adoption and implementation of the Birth Preferences Worksheet by postpartum people and the health care staff at UMMC. They hypothesize that when the Birth Preferences Worksheet is used, patients will report higher levels of SDM and respect.
To gather data, Breman and Brown will survey postpartum people prior to hospital discharge in addition to providers, including nurses, to evaluate the adoption and integration of the Birth Preferences Worksheet into clinical practice. The study will provide an initial evaluation to understand the barriers and facilitators of the worksheet for health outcome improvement. The collaborators also anticipate the findings from this study will be used to optimize implementation of the Birth Preferences Worksheet and will serve as a baseline for future implementation research on interventions addressing SDM during labor and birth.