Collaborative in Midwifery

Practice
Sarjana Kebidanan
Institut Kesehatan Rajawali
What is midwifery collaboration?

In maternity care, collaboration is a

dynamic process of facilitating
communication, trust and
pathways that enable health
professionals to provide safe, woman
 centered care.
• As the name implies, collaborative care is the
collaboration of multiple healthcare providers on one
woman’s care plan. This relationship between providers
must be built on an understanding and respect between
disciplines with the goal of optimal outcomes for the
woman, the newborn(s), and the family.
• Each provider brings a unique skillset to the table, and
those skillsets complement each other and open up new
possibilities for a woman’s care plan.
The providers involved in collaborative pregnancy
care can include:

Midwives
 Obstetricians
Family Physicians
Nurse Practitioners

Nurses
• Depending on the specific needs and preferences
of the woman and her baby, other health
professionals that may be part of her care team
include physical therapists, dieticians,
 anesthesiologists, pediatricians, and/or
neonatologists. Lactation consultants, social
workers and doulas may also be involved.
The Principles that Guide the
Collaborative Model
The Boston Medical Center has laid out a
collaborative model that has ten basic principles
that the members of the care team must keep in
mind at all times. This is important for doctors and
midwives to stay on top of
Team Focused:
• Responsibility for the care of women in triage, during labor and delivery, and
during the postpartum stay, rests with a team of professionals rather than one
 provider.

Clarity of Responsibility:
• Supervising providers and responsible parties for each case should be clear to
all personnel at all times.

Citizenship:
• Interactions between care partners will be respectful and constructive.
Communication should focus on excellence in patient care.

Acceptable Case Load:

• Safe patient care is possible only if providers are responsible for a reasonable
number of women in labor and personnel are well rested.

Maximizing Continuity:
• f possible, the first option for the care provider group on labor and delivery
should be the one with whom the woman has an established relationship.
Frequent Communication:
• Frequent communication is key for providing safe care. Regular
interdisciplinary board rounds and updates can promote this.
Good Documentation:
• Clear and consistent documentation is necessary for all care delivered.
All co-management or transfer of care should be written in the chart.

High Efficiency:
• Healthcare providers should make the most of their skills by caring for
the women whose needs match their highest level of training.

Evidence-Based Care:
• Care will be based on the most current evidence that has been
standardized from one provider to another.

Excellence in Education:
• At teaching hospitals, all members of the care team should help educate
residents and students.

Positive Outcomes of
Collaborative Pregnancy Care
• Goals of collaborative pregnancy care is that the
woman has the ability to make informed
decisions about her own care.
• The collaboration should not just be between the
healthcare providers, but between the providers
and the patient as well. The aim is for prenatal
care, labor and delivery, and postpartum care to
be as safe, positive, and comfortable as possible
for mother, baby, and the rest of the family.
The specific benefits
of these
collaborations
include:
 preterm birth Lower costs of birth
Increased satisfaction
for patients and
Decreased infant with quality of care
insurers
mortality rates
Decreased risk of

Consulting
• Consulting is used to consult something that is
unclear or need more explanation
For example:
1. What do you think ?
2. Do you think it is a good idea ?
3. Do you have any doubts ?
4. Are you convinced?
5. What do you mean by that?
6. Any suggestions?
7. I need to clarify this matter
8. I’d like to crosscheck with you…
 9. Let’s get this straight…
10. Why do you think so?
EXAMPLE

(1) Consult with the doctor

N: Doctor I’ve been having this problem
It worries me
D: What is it ? Tell me
N: Yesterday when I went shopping…
I felt dizzy… things were movi ng. I
thought I was fainting.
D: Then what did you do ?
N: I sat down somewhere…
I had some fruit juice…
Then I felt better
D: Then what did you do ?
N: I went home and took an
Aspirin It bothers me..
D: Well…I’d better take a look
Let me check
 N: Thanks doctor

REPORTING
• Reporting purposes to report about activities that had
been occurred

For example:
1. To begin with, he offered me a cigarette
2. The next thing I knew, I was in The ER
3. I did not recognize him.
4. So then he was put in the detention
5. So, I fell over
Routine report
S : Ready for the reports?
N : Yes, Mrs. Ira. Ward B…all done
All patients seem to be alright. No emergency cases.
S : What about Mrs. Alit?
N1 : She’s been in the ICU
S : Good
N2 : Children Ward’s rather crowded today
New patients with hay fever…
S : Typical Spring epidemic?
N2 : Yes, but all under control
S : Very well
N3 : Day Patient Ward, all clear.
One patient went home rather late. She seemed to be in pain. But she was batter when
she left.
S : Minor surgery?
N3 : Yes, but with general anesthetic.
S : Whose patients?
N3 : Doctor Joni
S : You’d better put in the record
N3 : I will
S : Alright…Done for today. Thank you. Bye.

GIVING OPINION
• Giving opinion purposes to give opinion in order to solve
 a problem .

For example:
1. In my opinion, it’s worth considering
2. Not everyone will agree with me, but
3. I do believe he’s the person in command
4. I personally, believe we ought to discipline
the children
5. I think we should go
6. I feel that you should be present
7. I personally think so

THANK YOU