Maternity Nursing

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Maternity Nursing

• Lisa Heelan, MSN, FNP-BC
• Family Health Promotion 1

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Learning Objectives

• Evaluate contemporary issues and trends in
  maternity nursing
• Examine the Healthy People 2010 goals related to
  maternal and newborn care outcomes
• Describe the main characteristics of contemporary
  family forms
• Be knowledgeable in the main components of what
  is needed in obtaining a family assessment

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• Relate the role of culture in caring for
  childbearing families
• Discuss cultural competence in relation to ones
  own nursing practice
• List the components of prenatal care
• Interpret the role benefits of a doula

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Birth in America

• 1900 95 of all births took place at home
• 1939 50 of all births at home
• 1955 95 of all births in the hospital
• Wolf, 2009

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Childbirth is the 1 reason for all
hospitalizations
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• 100 babies born in Pennsylvania
• 12 will be born preterm
• 3 will die before reaching their
• first birthday
• 4 will be born with a birth defects
• 8 will be born low birth weight
• 
  March of Dimes

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Report Card

• http//marchofdimes.com/aboutus/49267_62035.asp

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• http//www.healthypeople.gov/document/html/volume2
  /16mich.htm_Toc494699663

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What to expect during a prenatal visit.

• http//www.youtube.com/watch?vqZqGZLwDfdE

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Listening to Mothers Survey

• http//www.childbirthconnection.org/article.asp?ck
  10396

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Prenatal Care
Education
Treatment for medical conditions or risk
reduction
Risk Assessment
Each component can contribute to reductions
in perinatal illness, disability and death by
identifying and mitigating potential complications
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Frequency of Prenatal Visits
Every 4 weeks until 28 weeks gestation Every 2
weeks until 36 weeks gestation Weekly until
delivery
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Antepartal NursingInterventions

• Being knowledgeable in the normal changes of
  pregnancy
• Instructing in signs symptoms that indicate a
  problem may be developing
• Providing appropriate information for self care
  measures
• Referring when necessary

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Nursing in a Home Care Setting

• Can be used for women who have difficulty in
  accessing the healthcare system
• Most often used for women with prenatal
  complications that can be managed without
  hospitalization.

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Attitude about pregnancy
Exercise Rest
Smoking
Traveling
First Trimester Topics
Danger signs of spontaneous abortion
Employment
Fetal growth development
Early pregnancy classes
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Infants tend to have lower birth weights
Infants have a higher incidence of preterm birth
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The Faces of Fetal Alcohol Syndrome
Growth Retardation Facial Anomalies Major Cause
of mental retardation
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Even moderate alcohol intake is contraindicated

• Increased incidence of lowered birth weight
• Some neurologic effects such as Attention Deficit
  Disorder
• No Safe level of drinking during
• pregnancy has been identified

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• Live Viruses (like rubella) should not be given
  to pregnant women
• Vaccines using killed viruses may be used

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Exercise during pregnancy

• 30 minutes daily and stop when fatigued
• No balance activities
• No exercising in supine position
• Pulse rates lt 140/min

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Nursing Pearls of Wisdom

• At each prenatal visit, focus your teaching on
  changes or possible discomforts the woman might
  encounter during the coming month and the next
  trimester.

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The importance of support during labor---having a
doula

• http//www.youtube.com/watch?v16uFf02NYb4
• http//www.youtube.com/watch?vHfOBVPZg94Y

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We Are Family
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Types of Families

• Nuclear Cohabiting parent
• Married-parent Single-Parent
• Childless Married blended
• Extended Gay Lesbian
  

The primary institution in society that preserves
transmits culture.
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• What basic information should be included in
  a Family Assessment?

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Family Assessment

• Name, age, sex and family relationship of all
  people residing in the household
• Family type, structure roles and values
• Cultural associations
• Religious affiliations
• Language
• Support network

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Friedman Family Assessment Model

• Identifying data
• History of family
• Environmental data
• Family structure
• Family functions
• Family stress coping

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• Culture is not just something the client
  possesses it is something that all humans
  possess.

It is learned.
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Ethnocentrism

• Conviction that the values and beliefs of
  ones own cultural group are the best ones or the
  only acceptable ones

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Are there cultural influences on
childbearing and rearing?
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Beliefs regarding pregnancy
Amish
Appalachian
African- Amercan
Chinese
Mexican
Arab
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Taboos
Refers to behaviors or things that are avoided
What is avoided in your family?
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Ask not what disease the person has, but
rather, what person the disease has.
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• Develop cultural competence by becoming
  knowledgeable about the cultural practices of
  local groups where you work and live.

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Cultural Humility Lifelong process of self
reflection and awareness with a respectful
attitude toward diverse points of view.
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Its all about relationships..
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And Respectwhich comes full circle
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Questions to ask.
What do you think you should do to remain healthy
during pregnancy?
What healing methods have you tried?
What do you think will help?
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• Who do you want with you during your labor?
• How will family members participate in your
  pregnancy, childbirth parenting?
• What do you and your family expect from the
  nurses caring for you?

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• L Listen
• EExplain
• AAcknowledge
• RRecommend
• NNegotiate

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References

• Center for Disease Control, US Department of
  Health
• and Human Services. (2010). Healthy
  People 2010,
• 2nd edition. 16-62. Retrieved from
• http//www.healthypeople.gov/Document/HTML/V
  olume
• 2/16MICH.htmToc494699662
• Declercq, E., Sakala, C., Corry, M., Applebaum,
  S.
• (2006). Listening to mothers 11
  Report of the
• second national US Survey of womens
• childbearing experiences. Retrieved
  from
• http//www.childbirthconnection.org/pdf.asp?PDFDow
  nloadLTM11_report

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• Epstein, R. (2010). Get me out A history of
  childbirth.
• New York W.W. Norton Company
• Fadiman, A. (1997). The spirit catches you and
  you
• fall down A Hmong child, her American
  doctors
• the collision of the cultures. New
  York Farrar,
• Straus Giroux
• Lowdermilk, D. Perry, S. (2007). Maternity
  womens
• health care. (9th edition). St. Louis
  Mosby Elsevier
• Wolf, J. (2009). Deliver me from pain.
• Baltimore The John Hopkins University
  Press