Don't Rush Me . . . Go the Full 40 As a Public Health Strategy to Promote Spontaneous Labor & Normal Birth
Title: Don't Rush Me . . . Go the Full 40 As a Public Health Strategy to Promote Spontaneous Labor & Normal Birth
- 1) Describe how promoting spontaneous labor and normal birth addresses national efforts to reduce perinatal morbidity and mortality while promoting healthy best practices for moms and babies when all is healthy and well.
- 2) Discuss the GotheFull40 campaign, its materials and resources and efforts to promote spontaneous labor, full term pregnancies and normal birth.
- 3) Understand via case studies how the campaign is being implemented in various states, facilities and regions, and the evaluation and measurement of the impact of the campaign.
AWHONN's GoTheFull40 campaign seeks to increase the percentage of women who complete at least 40 weeks of pregnancy and who wait for spontaneous labor, and to improve maternity care professionals' effectiveness to reduce elective inductions and cesarean births.
Proposed change:
Women and their babies benefit from an intricate cascade of endocrine events leading up to and facilitating labor and vaginal birth when labor occurs spontaneously (Lothian, 2006). The result: shorter hospital stays, lower infection rates, increased breastfeeding, and quicker recoveries with fewer complications (Ruhl, 2012). However, induction of labor rates have doubled in the U.S. in the last 20 years (Martin, et. al, 2012; Zhang, et. al, 2002), and the cesareab rate has increased 50% (Martin et. al, 2012). A significant number of labor inductions are not medically necessary. The overuse of labor interventions is a "public health problem" that "exposes women and infants to unnecessary risks in the perinatal period and long term," and which results "in considerable and unnecessary healthcare costs," leading experts say (Childbirth Connections, 2012; Lowe, 2013). Overuse of inductions increases both long and short-term maternal and neonatal morbidity including obstetric hemorrhage, neonatal ICU admissions, less breastfeeding, overuse of cesarean and infection (Zhang, et. al, 2012).
Into persistent prematurity, increasing labor interventions and rising perinatal morbidity and mortality, AWHONN in 2012 launched "Don't Rush Me . . . Go the Full 40" as a grassroots, public health campaign about the benefits of a full-term pregnancy and spontaneous labor (Clark et. al, 2009; Romano & Lothian, 2008).
Implementation, outcomes and evaluation:
GoTheFull40's goals are aligned with AWHONN's Nursing Care Quality Measures and complimentary to efforts in progress at the Joint Commission, AMA-PCPI, and the Centers for Medicaid and Medicare Services (CMS) to increase patient safety and quality of care. More than 4 states have implemented the campaign as a public health message, and CMS includes the campaign in its Strong Start tools to help reduce early and elective births. This poster presents the major components of the campaign and outcomes to date regarding the campaign's goals and objectives, resources and toolkits, 40 Reasons article, Spontaneous Labor Pledge, and the GoTheFull40 Champions group.
Implications for nursing practice:
This poster demonstrates how AWHONN's GoTheFull40 campaign promotes spontaneous labor to improve maternal and neonatal health by helping to reverse current trends in perinatal morbidity and mortality. This poster equips nurses to champion the GoTheFull40 campaign in their institutions and communities.
Keywords:
normal birth
cesarean
elective induction
spontaneous labor
overuse
perinatal morbidity & mortality