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Old 05-16-2008, 01:23 PM
NW Sukosky RN NW Sukosky RN is offline
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Sounds like "communication" issues got in your way . . .

Some observations for you to consider:
1. It is important on your part to follow your OB/GYN's recommendations regarding prenatal vitamins and iron (as needed) and an iron rich diet to insure that your hemoglobin and hematocrit are within normal range and that you aren't "anemic" as you go through this pregnancy. This may need to be regularly "monitored" by your OB/GYN as you get closer to delivery.
2. Speak with your OB/GYN physician about your views and discuss with him/her what they would do in an OB delivery emergency. The MD is ultimately responsible in an emergency situation for the team's response.
3. Make sure that the facility has a way to identify you as a "no blood" program participant upon your arrival and you need to provide your properly filled out "no blood advanced directive" to the facility. Make sure you have a clear understanding of options like the cell saver, erythropoietin, albumin, etc. and that your choices are clearly indicated on your paperwork. Have "the talk" with your relatives who do not share your point of view so that they are also clear about your wishes.
4. Be aware that in many facilities (even "no blood" ones!) there are no special activities planned for the JW "no blood" OB patient other than having emergency equipment (like the cell saver or volume expanders) available "just in case". This is not significantly different for the individual who won't accept blood than the one who will. Many facilities follow blood conservation techniques for all patients and most recognize that the OB patient can tolerate much lower hemoglobins after delivery than med surg patients due to their increased fluid volume, youth, and rapid recovery.
5. After doing the above, again approach your "consultant" to see if he/she has any further recommendations for you. Make sure you have given written "permission" for the facility to speak with your HLC member about your condition should the need arise. Because of current regulations, the staff may not feel that they can speak with your representative without this written confirmation that they are free to discuss your case with the representative.

Best Wishes for a successful delivery.
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