Purpose for the Program
The Survivor Services program is designed to facilitate a positive birth experience for survivors of childhood sexual abuse. These survivors are at increased risk of a traumatic birth experience, which has been documented to increase the risk of postpartum depression and posttraumatic stress disorder in new mothers. Women who experience postpartum depression and posttraumatic stress disorder have an increased risk of costly postpartum care, hospital readmissions, and increased rates of perpetrating child abuse and neglect. They also may avoid or delay medical care for themselves and their children. Prenatal counseling and planning for labor can have a positive impact on how women perceive childbirth.
To create a nursing intervention with the goal of helping to facilitate a positive birth experience for this population. Participants come to the unit during their pregnancies and receive a tour, verbal education about labor and birth, and a written resource list. The participant fills out a brief intake form that asks about her fears/concerns about childbirth and her typical ways of coping with stress. Common posttraumatic stress disorder triggers are reviewed and coping strategies are discussed. The resource nurse creates a nursing care plan that addresses each woman's specific concerns and outlines planned strategies. The plan is reviewed/revised by the patient and distributed to her provider and her labor nurse.
Implementation, Outcomes, and Evaluation
Current literature was reviewed and a need identified. A proposal that included the risks for this population, the desired outcomes, and projected costs of the program was presented to leadership. It was agreed that the opportunity for increased quality and patient satisfaction justified the need for this program. Education in the region about this high-risk population was facilitated by securing a grant to fund a regional conference with nationally recognized experts in the field. Focus then shifted to educating individual providers about the program. A dedicated phone line and an intake and interview process were established. Patient, physician, and nurse feedback about the intervention have been very positive. Still in process is a quantitative and qualitative evaluation system to track outcomes and a formal education program for the resource nurses.
Implications for Nursing Practice
This program is an example of how nurses can implement an evidence-based program for a high-risk population with the potential to improve patient satisfaction.