Case: Nancy is an experienced midwife who has great relationships with her patients. She works at a birthing center, and she has an association with the local hospital. One of her patients, Jen, would like to attempt a vaginal birth after cesarean (VBAC). Nancy thinks that this is a great idea for Jen. However, Nancy's hospital doesn't support VBAC plans because of safety and liability concerns. In their state, midwives cannot legally offer VBACs in birthing centers or in support of a home birth. Usually, the birthing center sends patients who experienced a cesarean directly to the hospital, but Jen says that if she is sent to the hospital, she will refuse surgery and refuse to sign a waiver. Nancy knows that this means that Jen may not be admitted in a timely manner, and she will likely be required to labor with minimal assistance in the ER. Knowing this, Nancy is considering disobeying the law in order to support Jen's birth plan. This involves telling Jen to come to the birthing center while in labor, with a plan to transfer to the hospital if complications arise. Her main reservation is that helping Jen could compromise her license and privileges to work with the hospital.
Group Work:
1- Identify the values that are at stake in this case.
2- Identify two options that a healthcare leader could choose in this case.
3- Make the best argument you can for the first option.
4- Make the best argument you can for the second option.
5- With your group, assign one person to defend the first option, one person to defend the second option, and one person to moderate the dispute. At least 5 minutes discussing the options. Then, after at least 5 minutes of listening, each participant should spend 1 minute communicating their decision to the group and spend at least 1 minute actively listening and engaging with disagreement.