: To explore and compare associations among demographics, childbirth-related stressors, depressive symptoms, gestational age, and psychological birth trauma (PBT) among adolescents.: This cross-sectional, descriptive, comparative study compared two groups of adolescents for PBT. From a larger study dataset, we identified all adolescents delivering prior to 38 weeks (n = 30) and randomly selected 30 adolescents delivering between 38 and 42 weeks gestation for comparison. PBT was defined via birth appraisal, assessed by a one-item rating scale, and trauma impact, assessed via the Impact of Event Scale. Surveys, including the Center for Epidemiological Studies-Depression Scale, were completed within 72 hours of birth. We used frequencies and percentages to describe the sample and Chi square, Spearman Rank-Order Correlation, and Pearson's Product Moment Correlation to determine relationships between variables. Chi square and ANOVA statistical tests determined group differences.: Adolescents were primarily Latina, single, primigravidas, and over 16 years of age. Adolescents delivering before 38 weeks experiencing cesarean births reported symptoms of depression and were highest risk for PBT. Additionally adolescents delivering before 38 weeks reported lack of pain control and unsupportive caregivers in labor.: Healthcare professionals cognizant of the potential risk factors for PBT can help vulnerable adolescents through caregiver support, adequate pain control in labor, education, and screening and treatment of depressive symptoms. Follow-up postdischarge, especially for high-risk adolescents, should be arranged to monitor for continued, delayed, or remitting symptoms of depression and PBT.

: The purpose of this process improvement project in a rural community hospital with a small volume perinatal service was to foster a cooperative working environment between the obstetric and medical-surgical nursing teams and promote quality nursing care by evaluating, revising, and clearly defining the obstetric float nurse role.: Members of the obstetric and medical-surgical nursing team were convened to evaluate the obstetric float nurse role and develop plans for improvement. Nurses from both units participated in a written survey before and after the project was completed. Based on issues identified from review of the surveys and group discussion, a guideline was developed that defined the expectations and responsibilities of the obstetric float nurse on the medical-surgical unit.: The redesigned obstetric float nurse role helped nurses of both units understand the expectations and responsibilities of the obstetric float nurse and promoted better working relationships. An additional benefit was improved communication regarding care and needs of the medical-surgical patients.: Clearly defined obstetric float nurse guidelines were successful in our small rural community hospital and may be of benefit to other similar volume perinatal units.

PURPOSE:

: The purpose of this study was to determine whether birth plans are associated with improved obstetric and neonatal outcomes. STUDY AND

DESIGN:

: This retrospective case-control study (N = 182) was conducted at a hospital in Córdoba, Spain, between August 2008 and September 2011. Obstetric and neonatal outcomes were compared between groups (women with and without birth plans). Chi-square statistics and Student's t-tests were used for statistical analysis.

RESULTS::

Women with birth plans were older and had a higher academic background than the control group. There were no significant differences between groups for any of the obstetric outcomes or 5-minute Apgar scores; however, there was a significant difference in umbilical artery cord blood pH values (p = .019). The percent of babies with umbilical cord blood pH < 7.24 among nulliparous women with birth plans (14.7%, n = 5) was lower than among babies of nulliparous women without birth plans (37.5%, n = 26).

CLINICAL IMPLICATIONS:

: Findings of this study provide evidence that birth plans may be helpful and are not associated with any negative obstetric or neonatal outcomes. Mothers with birth plans and their babies have at least as good outcomes as those without a birth plan. Babies of nulliparous women with birth plans had better umbilical cord blood pH values than babies of nulliparous women without birth plans. Healthcare professionals can promote the use of birth plans as a resource to enhance communication of women's desires for labor and birth.