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Best Possible Childbearing Outcome

Finding the best possible outcome for every family

The Best Possible Childbearing Outcome is the highest level of health a given family can achieve with the limitation they face.

The Optimal Childbearing Outcomes are the ideals for perfectly healthy pregnancies, births, and infants.

What are best childbearing outcomes?

It is obvious that not all families can achieve all aspects of the 20 factors of optimal childbearing outcomes. In fact few, if any, families would perfectly achieve the ideals contained in these 20 factors. That is almost tantamount to saying there is no such thing as a perfect family.

We aren't looking for perfection, but for the best possible childbearing outcome for each family. The best possible outcome is the closest that family can come to the optimal childbearing outcome given their current situation.

Obviously, the best outcome will be different for each mother and baby.

Consider the 20 different factors listed for the optimal childbearing outcome as threads in a rope. It is possible to have threads that are frayed or broken and still have a functioning rope. However, as more threads are broken, the rope weakens.

It has long been the goal of maternity care to maximize the physical outcome when physical risks or complications arise. The same can be done with psychological or social risks. Families and professionals together should understand and facilitate all the factors that contribute to an optimal outcome.

Reality of Imperfect Outcomes

All Positives Are Not Always Present

It is not always possible to have all factors positive. For instance:
  • Some pregnant women may not get quality nutrition due to nausea.
  • A mother may not have adequate social support.
  • A heavy work schedule may interfere with breastfeeding.
  • A colicky baby may be challenging for new parents to respond to.

Negative Factors May Be Present

Some negative risk factors may be unavoidable.
  • Mother has a chronic illness prior to pregnancy.
  • Labor complications may arise
  • Fear of labor
  • Separation of mother and baby due to pre-term delivery.
Some negative risk factors, such as the decision to avoid labor or not to breastfeed, may be a choice a mother makes as her best way of coping with events in her life. Physical complications, stress, trauma, fear, inadequate support, and time constraints are some of the factors that may create a situation where all the optimal outcomes are less feasible for a woman.

Others, including family, friends, and health care workers, should recognize the mother is the greatest expert on her life and respect the decisions she makes to cope with negative factors to improve her families outcomes.

Finding the best outcome for an individual family

No matter what level of physical/emotional health, the goal is to work for the best possible childbearing outcome for each mother/baby.

This is true even in the most difficult of situations. Even when the baby is not healthy or does not survive, the goal remains to achieve the best outcome.

When bad outcomes occur, healthcare professionals do not respond, "This baby is not healthy; there's nothing we can do." Instead they work diligently to insure the best possible outcome for this family.

Caring for the emotional and social needs of these families is of paramount importance. It is now understood that the care the family receives in these difficult situations will impact them for the rest of their lives. It will influence any future pregnancies and color their relationship with other healthcare givers they ever interact with in the future.

More Than Physical Health

It is not just poor physical outcomes of the infant that may lead to long-term negative outcomes for the family. Cesareans, for instance, have preserved the health of infants who might otherwise not have survived.

In spite of the value of this procedure, cesareans have been correlated with higher incidence of postpartum depression and postpartum trauma in mothers.

Maternal depression, in turn, has been associated with decreased maternal - infant attachment and decreased social development of the infant.

This should not be surprising considering the impact each phase of childbearing has on the next. It does not indicate that cesareans should be stopped; but that everyone should understand the long term potential impact and take measures to provide the best possible outcome for each family.

An Agenda

The time has come to critically examine the long-held supposition of the medical community that the physical health of the infant is paramount, but the emotional experience is dispensable.

Consider the number of news articles where women have given birth alone and unattended. In the majority of these situations, both mother and baby are physically healthy. But usually a woman who has delivered alone without others to offer support has significant emotional stress regarding that birth.

While medical care can be of tremendous value to many women, emotional support is needed by every woman. We need to recognize that the long term physical, psychological, social, and spiritual health of this new member of society has its foundation in the psycho/social, physical, and spiritual aspects of childbearing. Indeed, we need to reclaim the ancient code of medicine, the Hippocratic Oath that states, "First, do no harm."

A challenge is being issued to care for both the physical and emotional health of mothers and babies. One should not be set against the other. When physical complications arise that require procedures to be done that statistically diminish the probability that the mother will be able to birth, breastfeed, or bond with her baby, other steps may be taken to strengthen her possibility of successfully achieving the different factors of the optimal childbearing outcome. In that way, we can achieve the best possible childbearing outcome for each family.

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By Karen Newell Copyright 2003 - 2012 Better Childbirth Outcomes - All Rights Reserved
Camp Hill, Pennsylvania, USA