Vulnerability of Young Mothers Essay Example

about another.

I chose these questions because I wanted to see from their impression if being in a vulnerable category affected their care. The questions I asked were: 1. What was your first thought when you found out you were going to have a baby? 2. What was your biggest concern during your pregnancy? 3. Do you feel you had adequate access to healthcare during your pregnancy? Why or why not? 4. Do you feel that there was something more that could or should have been done for you either during the pregnancy or during the time after the baby was born? Please explain. 5. What was the worst part of your experience? The best? Overall, I think the questions were adequate but not extraordinary. In hindsight, I probably could have gotten them to talk more about their perception of care with better questions. Some of the common things that I found were that both felt that they had good care. Each had their own issues such as bad morning sickness or high blood pressure, but overall they felt that they were treated well (Green) (Johnson). Neither felt that their insurance status affected their level of care (Green) (Johnson).

Both of them said that they did not feel that the nurses even acknowledged their insurance statuses while they were in the hospital (Green) (Johnson). They both found out they were pregnant at work. That was strange to me, but they both did their tests at work and both were thrilled with the results. Both of them also took a second test at home later to confirm that they actually did have a positive test (Green) (Johnson). From

there things differ, Sara’s biggest concern was whether she could have a vaginal delivery or would she require surgery. She hurt her hips while cheerleading in high school and was afraid that the remnants of that injury would affect her delivery (Green). Chelsea on the other hand states, “My biggest concern during pregnancy was am I still pregnant. There were times throughout my pregnancy where things would be completely fine but I was scared that our son wasn't okay or that I had lost him without even knowing. My concern I feel like was a pretty general one but like I said it had taken us so long that I felt it was my biggest worry to not be pregnant all of a sudden” (Johnson). Sara felt that her doctor was very thorough with answers to questions and was very comforting with any concerns (Green). Chelsea states, “.

I felt my health Care was pretty general during my pregnancy. I went to normal doctor's appointments without any fight from our provider. I had to go to a hospital in a bigger City for a more detailed ultrasound twice because Dominick was a little stubborn and moved where you couldn't see him. The insurance did not deny us that ability, so I would say it was pretty adequate” (Johnson). In regards to whether more could have or should have been done for them Sara states, “I feel as if my doctor could have went ahead and put me on blood pressure medicine when it started to go up and stay up instead of doing it after. I feel if he would have I would have been able

to continue to work and maybe even went full term with him or longer” (Green). She had to take her maternity leave three weeks early due to blood pressure problems, which affected the family finances some (Green). Chelsea had twenty-four hours of labor and her son was born at thirty-six weeks and six days. She felt that although she had a long labor and Dominick was born with breathing difficulties that there was nothing more that could have been done for her. She had nothing but praise for the labor and delivery staff and doctor. Dominick was transferred within an hour to a specialty hospital and the staff was adamant that Chelsea know what she would need to do to take care of herself once she was out of the hospital (Johnson).

Chelsea was discharged eight hours later to go to the specialty hospital. Her statement specifically was, “. She showed complete concern for my well being even after being discharged. So no nothing more needed to be done my son and I were beyond taken care of” (Johnson). The final question for them also differed in answers. Sara stated, “Being stuck at home after and not being able to go anywhere because I wasn’t allowed to get Grant out for a month after he was born. I was so used to getting up and doing. I had some postpartum depression because of that. The best part was to be able to hear his cry the moment he entered the world. I never thought I would ever get that experience and it was the best feeling in the world” (Green). While Chelsea said, “The best part

of my experience being pregnant was the attachment you share with your baby. I loved feeling my son move around and knowing he was with me. After pregnancy, the best part has been being a mother to my crazy little boy. He has been the best gift my husband and I could've ever asked for.

The worst part of my experience was being sick so much. I had so much morning sickness I thought would never leave. It was horrible not knowing what would make you sick that day. But it was all worth it in the end” (Johnson). I think regardless of their insurance statuses, neither were too concerned with anything other than the health of their child. The policy that I associate most with pregnancy and deliver is only a law in Alabama but I think should be carried to other states. It is a law that was passed after the death of a friend, Rose Church. She was discharged prematurely and died from complications of childbirth. On autopsy, the examiner found placental fragments in her uterus. Her husband fought to bring this law to fruition. It requires insurance companies that provide maternity coverage to cover all medically necessary inpatient care for a mother and her newly born child as determined by the doctors. It also stipulates that a complete blood count on both admission and prior to discharge is a medical necessity for the mother. It requires them to cover forty-eight hours of stay for a normal vaginal delivery, and ninety-six hours of care for a cesarean section. It does have a provision for early discharge if the mother is informed of the

risks and benefits in writing, the mother consents in writing, and the doctor agrees to the early discharge ('Alabama Code Title 27. Insurance § 27-48-2 | FindLaw', 2018).

This law only protects insured patients and needs to be extended to all women after childbirth. I learned that each journey is different, and that each result is also different. I learned that the health and well-being of the child far outweighs the worry of insurance issues. I also learned that I would like to work with younger populations at some point in my career. I also learned that young mothers generally do not consider themselves vulnerable. They feel strong and ready to take on the world. One of the positive points in my interviews was that Sara was able to deliver Grant vaginally. The negative in my interview was that Chelsea was immediately separated from Dominick because he had to have a higher-level care and further testing. Dominick was in the neonatal intensive care unit for nearly thirty days. I am not sure how much this will change my practice in the near future, but I am sure that further down the road I will be working with this population from time to time. There are a lot of options for policies and procedures for this population. I honestly do not have anything particular in mind as of yet.

Although I normally deal with the elderly, for this project, I wanted to step outside of my comfort zone and learn some things about another vulnerable population. I chose this population because I knew that I had two very good candidates and I interview the elderly frequently doing assessments

in home health so I wanted a change of focus. I asked two young mothers who work outside the home and were either uninsured or underinsured to share with me their experiences with prenatal care and delivery of their children. It was a very enlightening experience. Although I know both of these young women personally and knew some of the trials that they went through the questions brought out information that I did not know previously. Both Sara and Chelsea are family members. One is my niece and one is my daughter.

Prior to the start of the interviews, we discussed the importance of being candid and understanding that there would be no judgement on my part. They had free reign to say anything that they felt needed to be said. I also set aside my views of them as family members and my prejudices about their care experiences because I am protective of both of them and I acknowledge that. Each interview was conducted separately to insure comfort in discussing their care. I did not exactly follow the guidelines on the questions. I was supposed to choose three but once we got started, I just kept asking until they each had answered all five. I am glad I did though because one would be more candid about one question while the other had more to say about another.

I chose these questions because I wanted to see from their impression if being in a vulnerable category affected their care. The questions I asked were: 1. What was your first thought when you found out you were going to have a baby? 2. What was your biggest

concern during your pregnancy? 3. Do you feel you had adequate access to healthcare during your pregnancy? Why or why not? 4. Do you feel that there was something more that could or should have been done for you either during the pregnancy or during the time after the baby was born? Please explain. 5. What was the worst part of your experience? The best? Overall, I think the questions were adequate but not extraordinary. In hindsight, I probably could have gotten them to talk more about their perception of care with better questions. Some of the common things that I found were that both felt that they had good care. Each had their own issues such as bad morning sickness or high blood pressure, but overall they felt that they were treated well (Green) (Johnson). Neither felt that their insurance status affected their level of care (Green) (Johnson).

Both of them said that they did not feel that the nurses even acknowledged their insurance statuses while they were in the hospital (Green) (Johnson). They both found out they were pregnant at work. That was strange to me, but they both did their tests at work and both were thrilled with the results. Both of them also took a second test at home later to confirm that they actually did have a positive test (Green) (Johnson). From there things differ, Sara’s biggest concern was whether she could have a vaginal delivery or would she require surgery. She hurt her hips while cheerleading in high school and was afraid that the remnants of that injury would affect her delivery (Green). Chelsea on the other hand states, “My

biggest concern during pregnancy was am I still pregnant. There were times throughout my pregnancy where things would be completely fine but I was scared that our son wasn't okay or that I had lost him without even knowing. My concern I feel like was a pretty general one but like I said it had taken us so long that I felt it was my biggest worry to not be pregnant all of a sudden” (Johnson). Sara felt that her doctor was very thorough with answers to questions and was very comforting with any concerns (Green). Chelsea states, “.

I felt my health Care was pretty general during my pregnancy. I went to normal doctor's appointments without any fight from our provider. I had to go to a hospital in a bigger City for a more detailed ultrasound twice because Dominick was a little stubborn and moved where you couldn't see him. The insurance did not deny us that ability, so I would say it was pretty adequate” (Johnson). In regards to whether more could have or should have been done for them Sara states, “I feel as if my doctor could have went ahead and put me on blood pressure medicine when it started to go up and stay up instead of doing it after. I feel if he would have I would have been able to continue to work and maybe even went full term with him or longer” (Green). She had to take her maternity leave three weeks early due to blood pressure problems, which affected the family finances some (Green). Chelsea had twenty-four hours of labor and her son was born at

thirty-six weeks and six days. She felt that although she had a long labor and Dominick was born with breathing difficulties that there was nothing more that could have been done for her. She had nothing but praise for the labor and delivery staff and doctor. Dominick was transferred within an hour to a specialty hospital and the staff was adamant that Chelsea know what she would need to do to take care of herself once she was out of the hospital (Johnson).

Chelsea was discharged eight hours later to go to the specialty hospital. Her statement specifically was, “. She showed complete concern for my well being even after being discharged. So no nothing more needed to be done my son and I were beyond taken care of” (Johnson). The final question for them also differed in answers. Sara stated, “Being stuck at home after and not being able to go anywhere because I wasn’t allowed to get Grant out for a month after he was born. I was so used to getting up and doing. I had some postpartum depression because of that. The best part was to be able to hear his cry the moment he entered the world. I never thought I would ever get that experience and it was the best feeling in the world” (Green). While Chelsea said, “The best part of my experience being pregnant was the attachment you share with your baby. I loved feeling my son move around and knowing he was with me. After pregnancy, the best part has been being a mother to my crazy little boy. He has been the best gift my husband

and I could've ever asked for.

The worst part of my experience was being sick so much. I had so much morning sickness I thought would never leave. It was horrible not knowing what would make you sick that day. But it was all worth it in the end” (Johnson). I think regardless of their insurance statuses, neither were too concerned with anything other than the health of their child. The policy that I associate most with pregnancy and deliver is only a law in Alabama but I think should be carried to other states. It is a law that was passed after the death of a friend, Rose Church. She was discharged prematurely and died from complications of childbirth. On autopsy, the examiner found placental fragments in her uterus. Her husband fought to bring this law to fruition. It requires insurance companies that provide maternity coverage to cover all medically necessary inpatient care for a mother and her newly born child as determined by the doctors. It also stipulates that a complete blood count on both admission and prior to discharge is a medical necessity for the mother. It requires them to cover forty-eight hours of stay for a normal vaginal delivery, and ninety-six hours of care for a cesarean section. It does have a provision for early discharge if the mother is informed of the risks and benefits in writing, the mother consents in writing, and the doctor agrees to the early discharge ('Alabama Code Title 27. Insurance § 27-48-2 | FindLaw', 2018).

This law only protects insured patients and needs to be extended to all women after childbirth. I learned that each journey is

different, and that each result is also different. I learned that the health and well-being of the child far outweighs the worry of insurance issues. I also learned that I would like to work with younger populations at some point in my career. I also learned that young mothers generally do not consider themselves vulnerable. They feel strong and ready to take on the world. One of the positive points in my interviews was that Sara was able to deliver Grant vaginally. The negative in my interview was that Chelsea was immediately separated from Dominick because he had to have a higher-level care and further testing. Dominick was in the neonatal intensive care unit for nearly thirty days. I am not sure how much this will change my practice in the near future, but I am sure that further down the road I will be working with this population from time to time. There are a lot of options for policies and procedures for this population. I honestly do not have anything particular in mind as of yet.