Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy. She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information.

Reflective Questions

1. As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?

2. How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views?

3. With the influence of the recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy, how will maternity care change in the future?