Medical Family Therapy in Obstetrics and Gynecology

  • Angela Lamson
  • Kenneth Phelps
  • Ashley Jones
  • Rebecca Bagley
Chapter
Part of the Focused Issues in Family Therapy book series (FIFT)

Abstract

The combined disciplines of obstetrics and gynecology (Ob-Gyn) are committed to the reproductive physiology of women’s health throughout the lifespan and include an integration of medical and surgical care. Ob-Gyn providers attend to the social, physiological, environmental, and genetic factors that influence or exacerbate health conditions in women. As such, Ob-Gyns’ expertise in and attention to diverse factors that influence the physical health of women makes medical family therapists (MedFTs) a logical partner for integrated behavioral healthcare (IBHC). Both disciplines train providers to recognize and care for the unique biopsychosocial-spiritual (BPSS) health needs (Engel, 1977, 1980; Wright, Watson & Bell, 1996) of each patient over the lifespan and in the context of her family system. Furthermore, both disciplines include training in their respective areas across prevention, health education, assessment, diagnostics, and intervention.

Notes

Glossary of Important Terms for Care in Obstetrics and Gynecology

Breech presentation

When the fetus is positioned inside the uterus in a manner whereby its feet or buttocks would—without intervention—deliver first (instead of the head).

C-section (Cesarean birth)

A surgical delivery of a baby through incisions made in the abdomen and uterus.

Cervix

The opening to the uterus, located at the top of the vagina.

D&C (dilation and curettage)

A surgical procedure for removal of tissue from inside the uterus by opening the cervix and inserting an instrument into the uterus.

Ectopic pregnancy

Also known as a mislocated pregnancy; symptoms include unexpected vaginal bleeding and cramping. The fetus may grow enough to rupture the fallopian tube (typically after about 6–8 weeks), whereby a woman usually feels severe pain in her lower abdomen. If the tube ruptures later (after about 12–16 weeks), the risk of death for the woman is increased because the fetus and placenta are larger and lead to an increased loss of blood. In most women, the fetus and placenta from an ectopic pregnancy must be surgically removed.

Hysterectomy

A surgery for removal of the uterus. It is termed a “total hysterectomy” if the cervix is removed with the uterus.

Placenta previa

A condition that occurs in about one in every 200 deliveries; it refers to when the placenta is mostly or completely covering the cervix, in the lower (rather than upper) part of the uterus. Placenta previa can cause painless bleeding from the vagina that suddenly begins late in pregnancy necessitating emergent delivery. It is a risk for maternal and fetal death due to blood loss.

Preeclampsia

An illness that occurs in pregnancy or after delivery where a woman has high blood pressure and symptoms of organ injury or dysfunction. Some of these symptoms include an abnormal amount of protein found in the urine, abnormal liver or kidney function, vision changes, decreased number of platelets, upper abdominal pain, fluid found in the lungs, and severe headache. (note: Eclampsia is an extension of preeclampsia, resulting in maternal seizures.)

Preterm delivery

When a baby is born before week 37 of the pregnancy.

Preterm labor

Also called premature labor; it refers to when uterine contractions occur before 37 weeks of pregnancy.

Previable delivery

A delivery prior to 23 weeks (22 weeks in some facilities).

Sexually transmitted infections/diseases (STI/D)

Some women may not know that they are carrying an STI /D; this becomes an even more of complicated issue during pregnancy or at the time of delivery. Some STI /Ds are more dangerous for the fetus than others, especially when considering vaginal deliveries. Some hospitals are using rapid human immunodeficiency virus (HIV) testing during labor and delivery for pregnant women who were not tested previously during pregnancy. If a woman is found to be HIV-infected, providers are then able to begin antiretroviral therapy immediately to prevent perinatal transmission.

Thromboembolic disease

In the United States, thromboembolic disease is the leading cause of death in pregnant women. It occurs when blood clots form in blood vessels that travel through the woman’s bloodstream and block an artery. This disease most commonly occurs 6–8 weeks after delivery. The risk is much greater after a cesarean section than after vaginal delivery.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Angela Lamson
    • 1
  • Kenneth Phelps
    • 2
  • Ashley Jones
    • 2
  • Rebecca Bagley
    • 3
  1. 1.Department of Human Development and Family ScienceEast Carolina UniversityGreenvilleUSA
  2. 2.Department of Neuropsychiatry and Behavioral ScienceUniversity of South CarolinaColumbiaUSA
  3. 3.Department of Advanced Nursing Practice and EducationEast Carolina UniversityGreenvilleUSA

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