Complex Care Planning in the Community Setting

Mellisa Cheyney LM, PhD

The purpose of this presentation is to expose midwives to an approach called complex care planning used to help navigate instances when a client with a medically complicated pregnancy or risk factors that fall outside the typical scope of practice for community birth expresses a continued desire for a home or birth center birth despite attempts to refer to a higher level of care. During the first half of the presentation, I will review the principles of patient-centered care, shared decision making, risk perception, the LEARN model, the four boxes approach to clinical ethics, and tools for eliciting an explanatory model –all of which inform complex care planning. During the second half of the presentation, I will provide several case studies and participants will work in small groups to analyze the cases and create complex care plans. We will conclude by reporting back to the larger group and summarizing key “take-home” messages from the session.

Melissa Cheyney PhD CPM LDM is Associate Professor of Clinical Medical Anthropology at Oregon State University (OSU) with additional appointments in Global Health and Women Gender and Sexuality Studies. She is also a Licensed Midwife in active practice, and the Chair of the Division of Research for the Midwives Alliance of North America where she directs the MANA Statistics Project. Dr. Cheyney currently directs the International Reproductive Health Laboratory at Oregon State University where she serves as the primary investigator more than 20 maternal and infant health-related research projects in nine countries. She is the author of an ethnography entitled Born at Home (2010, Wadsworth Press) along with dozens of peer-reviewed articles that examine the cultural beliefs and clinical outcomes associated with midwife-led birth at home in the United States. Dr. Cheyney is an award-winning teacher, and in 2014 was given Oregon State University’s prestigious Scholarship Impact Award for her work in the International Reproductive Health Laboratory and with the MANA Statistics Project. She is the mother of a daughter born at home on International Day of the Midwife in 2009.