Multifetal Pregnancy Reduction:
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MULTIFETAL PREGNANCY REDUCTION
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Multifetal Pregnancy Reduction:
Conflicting values or beliefs about the right or best course of action often form the basis for moral dilemmas (Simmonds, 2012). Moral distress is associated with how the nurse perceives her role (Burston & Tuckett, 2012). The advanced practice nurse may experience moral distress when faced with an instance of knowing the correct course of action; however, not being able to pursue it. Ethical justification for choices and actions are based on the principles of autonomy, beneficence, nonmaleficence, and justice.
Relatively recent developments in assistive reproductive technology …show more content…
Screening for the explicit purpose of sex selection for social reasons is not appropriate. However, information should not be withheld from parents if they request it.
Reduction to a singleton pregnancy from a twin or greater pregnancy remains controversial and some physicians may offer this option depending upon the woman’s circumstances and her values. To ensure the principle of autonomy, the decision ultimately rests with the parents of the fetuses. Benefits and Risks Associated with Higher-Order Pregnancies and MFPR
Maternal risks associated with multifetal pregnancy are the increased incidence of (a) hypertension, (b) preeclampsia, (c) gestational diabetes, and (d) postpartum hemorrhage
(American College of Obstetrics & Gynecologists, 2013). Additional complications may include maternal depression, severe parenting stress, child abuse, and an increased divorce rate.
Significant medical costs and adverse economic consequences are associated with multiple pregnancy. Infants born to multiple pregnancy may have an increased risk of prematurity, low birthweight, cerebral palsy, learning disabilities, delayed language development, behavioral difficulties, chronic lung disease, and …show more content…
One could also argue that justice could be applied in the case of which fetuses will be spared during the procedure and how the costs of health care are distributed.
Standard of Care and Scope of Practice Issues
The advanced practice nurse practicing in the area of women’s health or nurse-midwifery may practice in a diverse range of settings, including obstetrician or maternal-fetal medicine offices (American College of Nurse-Midwives, 2011). Contained within the scope of practice statement of the American College of Nurse-Midwives (ACNM) is the provision to form a partnership with women and their families in a shared decision-making model. This includes listening, providing information, guidance, and counseling. The standards of practice for nursemidwifery care include the support of individual rights and self-determination within the
MULTIFETAL PREGNANCY REDUCTION
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boundaries of safety. This standard addresses autonomy and beneficence. The provision of information in the context of current science is necessary for the woman to provide informed consent. CNMs are required to provide referral to other providers if necessary when the