Emergency Childbirth Site Management Plan - Outline

Emergency Childbirth Site Management Plan - Outline

 

The Emergency Childbirth Site Management Plan Outline is a tool I developed to help emergency planners, especially community midwives, wrap their minds around what may be needed if circumstances require that healthy pregnant people unexpectedly need to birth in temporary, low resource, birthing facilities. This outline is not a complete plan, and should be thoroughly picked apart and scrutinized by each group in consideration of their unique situation, but it will be a helpful roadmap to any group starting down the path to making an Emergency Childbirth Site Plan.

Phase 1 - Identifying Resources

Assign Area Leader

  • An “area” is any geographic area that a group of midwives plan to serve, together.
  • The Area Leader should have the education and expertise to create/review training materials and to manage groups of people.

Identify available midwives/providers

  • Currently practicing CPM, CNM, LM, Internationally credentialed midwives
  • Retired CPM, CNM, LM, Internationally credentialed midwives
  • Retired “other providers”  MD, DO

Identify birthing location

  • Could be anywhere, preferably with power, running water, bathroom facilities, and beds/rooms

Create resources and instructions for volunteer midwives

  • Site-wide treatment protocols
  • Instructions for equipment/supply preservation
  • PPE requirements and instructions
  • Discharge instructions
  • Follow-up instructions
  • Emergency transport criteria and procedures

Identify available support personnel

  • Nurses
  • Doulas
  • Student midwives
  • Midwife assistants
  • Community volunteers

Establish official communication protocols

  • Charting system (consider paper charts)
  • Phone tree
  • Email/text list
  • Real-time messaging
  • FAX Capability (smartphones can effectively function as handheld scanners and fax machines.)

Create emergency OOH birth training materials

  • Job description - Midwives
  • Job description - Support
  • Procedure manual
  • Safety manual
  • Cleaning/sanitation manual
  • HIPPA compliance
  • Site-specific logistical and regulatory overview
  • Charting/record-keeping system

 

Phase 2 - Preparing for Operation

Hold mandatory training

Stock facility

  • Midwives/providers bring their own diagnostic and resuscitative equipment to their shift
  • Alternately, midwives pool diagnostic and resuscitative equipment at the location
  • Identify and obtain necessities
  • Absorbent underpads (newspapers will work)
  • Birth and suturing instruments
  • Sutures
  • Suction devices
  • Herbs
  • Lidocaine, as available
  • Anti-hemorrhagics, as available
  • Postpartum pads/undergarments
  • Peri-bottles
  • Immediate newborn needs

Create instructions for women arriving at facility

  • List of what to bring
  • Personal needs
  • Sheets
  • Towels
  • Two large trash bags
  • One for birth trash
  • One for laundry if they wish to carry their birth laundry home
  • Discharge instructions

 

Phase 3 - Accept Clients

Staff at least 1 midwife per 12 - 24hr shift, depending on volume, with at least one on-call who will answer phone calls and be available to come in if additional coverage is needed.

Staff at least 1 to 2  support persons per 12-24 hr shift with several on-call depending on volume.

 

Resources

https://iawg.net/resources

https://ranzcog.edu.au/news/ranzcog-launches-resource-for-covid-19-and-pregnan

 

Download Emergency Childbirth Site Management Plan - Outline PDF here

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