Patient testimonials
The following testimonials were obtained from a TeamBirth survey that patients in participating Massachusetts hospitals completed in the postpartum unit prior to discharge.
According to one patient, “TeamBirth is great, feels like all obstacles are covered by multiple people with many talents, expertise. Feels like mom is part of the process, much different than my delivery 2 years ago when I felt like things were decided for me/I was ‘told’ what we were doing and questioned if I felt uneasy about it…. We felt safe and like all things were covered no matter what may happen.”
Another patient, also at a Massachusetts hospital, offered these comments about TeamBirth: “The entire staff was very genuine and my experience the best it could be. They deserve updated whiteboards in every room. I found them to be very useful.”
The clinician perspective
To be certain, clinician workflow must be a consideration for any practice change. The feasibility, acceptability, and safety of the TeamBirth model to clinicians was validated through a study at 4 community hospitals across the United States in which TeamBirth had been implemented in the 8 months prior.9
The clinician response rate was an impressive 78%. Ninety percent of clinicians, including physicians, midwives, and nurses, indicated that they would “definitely” (68%) or “probably” (22%) recommend TeamBirth for use in other labor and delivery units. None of the clinicians surveyed (n = 375) reported that TeamBirth negatively impacted care delivery.9
Obstetricians also provided qualitative commentary, noting that, while at times huddling infringed on efficiency, it also enhanced staff fulfillment. An obstetrician at a Massachusetts hospital observed, “Overall I think [TeamBirth is] helpful in slowing us down a little bit to really make sure that we’re providing the human part of the care, like the communication, and not just the medical care. And I think most providers value the human part and the communication. You know, we all think most providers value good communication with the patients, but when you’re in the middle of running around doing a bunch of stuff, you don’t always remember to prioritize it. And I think that at the end of the day…when you know you’ve communicated well with your patients, you end up feeling better about what you’re doing.”
As with most cross-sectional survey studies, selection bias remains an important caveat; patients and providers may decide to complete or not complete voluntary surveys based on particularly positive or negative experiences.
Metrics aside, obstetricians have an ethical duty to provide dignified and safe care, both physically and psychologically. Collectively, as a specialty, we share the responsibility to mitigate maternal mistreatment. As individuals, we can prevent perpetuation of birth trauma and foster healing and empowerment, one patient at a time, by employing tenets of TeamBirth.
For more information
To connect with Delivery Decisions Initiative, visit our website: https://www.ariadnelabs.org/deliverydecisions-initiative/ or contact: deliverydecisions@ ariadnelabs.org
To connect with Delivery Decisions Initiative, visit our website: https://www.ariadnelabs.org/deliverydecisions-initiative/ or contact: deliverydecisions@ ariadnelabs.org
Steps for implementing the TeamBirth model
To incorporate TeamBirth into your practice:
- Make patients the “team captain” and center them as the primary decision maker.
- Elicit patient preferences and subjective experiences to develop a collaborative plan on admission and when changes occur in clinical status.
- Round with and utilize the expertise of the full care team—nurse and midwife or obstetrician, as well as support person(s) and/or doula, learners, interpreter, and social worker as applicable.
- Ensure that the patient knows the names and roles of the care team members and provide updates at shift change.
- If your birthing rooms have a whiteboard, use it to keep the patient and team informed of the plan.
- Delineate status updates by maternal condition, fetal condition, and labor progress.
- Provide explicit permission for patients to call for a team huddle at any time and encourage support from their support people and/or doula. ●
Funding and partnership acknowledgements
This project is supported by:
- The Oklahoma Department of Health as part of the State Maternal Health Innovation Program Grant, Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services.
- The Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award to the Oklahoma State Department of Health. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
- The Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant T76MC00001 and entitled Training Grant in Maternal and Child Health.
- Point32 Health’s Clinical Innovation Fund.
Data included in this article was collected and analyzed in partnership with the Oklahoma Perinatal Quality Improvement Collaborative, Department of OB/GYN, University of Oklahoma Health Sciences Center, Oklahoma City.