Holistic Risk Assessment and Ethics in Community Birth

There is little agreement on what constitutes an “appropriate candidate” for community birth (home or birth center) in the United States. In this workshop, Dr. Cheyney will review the latest science on risk assessment overthe course of care for birthing people planning a community birth with a midwife. 

Next, she will present a clinical ethics framework for person-centered decision making, including a skill called complex care planning. Together we will apply the approach to case scenarios that have emerged from a qualitative research project designed to examine why a small percentage of people choose community birth even with medically complex pregnancies. 

This workshop will equip midwives with the skills needed to navigate holistic risk assessment across an array of social, clinical and institutional risks.

Learning Objectives:

1)Summarize the existing body of literature that addresses relative and absolute risk of negative outcomes for mother and baby by prenatal risk factor;
2)Explain the difference between absolute and relative risk and describe how to read outcomes of statistical analyses using these measures;
3)Define adjusted odds ratios and confidence intervals;
4)List and define all exposures and outcomes analyzed to inform risk assessment;
5)Summarize findings for the following exposures: breech, twins, older than average pregnant people, women of size, GDM, PE, postdates, primips, labor after cesarean;
6)Explain the difference between population-and individual-level risk, including the role of mitigating and exacerbating factors;
7)Explain the clinical significance of findings and critically debate implications for practice;
8)Describe the “four boxes approach” to ethical review of individual cases;
9)List the tenets of shared decision-making (SDM) and person-centered care (PCC);
10)Integrate the four boxes approach, SDM and PCC during scenario discussion;
11)Demonstrate the ability to support diverse clients through evidence-informed, holistic decision making to create a complex care plan.

This pre-recorded webinar is available only to members of CALM.

Upon completion of all online components, participants will receive a CE Certificate for 2 hours of CE approved by the Californians for the Advancement of Midwifery in collaboration and supervision of California Association of Licensed Midwives.