Contemporary Maternity Contemporary Maternity NursingNursing

ObjectivesObjectives

• To describe maternity nursling's scopeTo describe maternity nursling's scope

• To review the trends and issues in To review the trends and issues in contemporary nursing.contemporary nursing.

• To explore social issues in maternity To explore social issues in maternity nursing. nursing.

• To discuss ethical and sociopolitical issues. To discuss ethical and sociopolitical issues.

• To review Healthy People 2010 goals as To review Healthy People 2010 goals as they relate to maternity care.they relate to maternity care.

Nursing Care of Women and InfantsNursing Care of Women and Infants

• Advances Advances

• Still discrepancies Still discrepancies – Access issuesAccess issues– Adolescent careAdolescent care

– STI’s and AIDS – adversely affect STI’s and AIDS – adversely affect reproductionreproduction

““Healthy People 2010”Healthy People 2010”

• Goals Goals - www.health.gov/healthypeople- www.health.gov/healthypeople

– Increase healthy life and quality of lifeIncrease healthy life and quality of life

– Eliminate the health disparities Eliminate the health disparities

•MCH MCH – ““Improve the health and well-being of women, infants, Improve the health and well-being of women, infants,

children and families” see box 1-5 children and families” see box 1-5

Millennium Development Millennium Development GoalsGoals

• 2015 target of UN Summit 20002015 target of UN Summit 2000– www.un.org/millenniumgols/goals.htmlwww.un.org/millenniumgols/goals.html

• Empower womenEmpower women

• Decrease child mortalityDecrease child mortality

• Improve maternal health, and moreImprove maternal health, and more

Integrative Healthcare Integrative Healthcare

• Belief systems, values and desires Belief systems, values and desires

• Patient input Patient input

OptionsOptions

• Alternative Healing Modalities Alternative Healing Modalities – Alternative medical systemsAlternative medical systems– Mind- body interventionMind- body intervention– Therapies- biologically based Therapies- biologically based – Manipulative and body-basedManipulative and body-based– Energy therapiesEnergy therapies

• Primary Care provider options Primary Care provider options

ChoicesChoices

• Education – parenting and childbirthEducation – parenting and childbirth

• Room choicesRoom choices

• Positioning Positioning

• Analgesia Analgesia

• DischargeDischarge

ProblemsProblems

• Structure of US Health Care sytemStructure of US Health Care sytem

• Medical errorsMedical errors

• High cost High cost

• AccessAccess

• DisparitiesDisparities

TermsTerms

• Antepartum- prenatalAntepartum- prenatal

• Intrapartum- labor and delivery Intrapartum- labor and delivery

• Postpartum- first 6 weeks after Postpartum- first 6 weeks after delivery delivery

Mother-infant TerminologyMother-infant Terminology

• Infant mortality rate -#deaths/1,000 Infant mortality rate -#deaths/1,000 live birthslive births

• Maternal mortality rate – Maternal mortality rate – #deaths/100,000 live births#deaths/100,000 live births

• Neonatal mortality rate - Neonatal mortality rate - #deaths/1,000 live births, first 28 days#deaths/1,000 live births, first 28 days

• Perinatal mortality rate- # stillbirths & Perinatal mortality rate- # stillbirths & neonatal deaths /1000 live birthsneonatal deaths /1000 live births

• Birthrate- # of live births /1000 Birthrate- # of live births /1000 population population

• Fertility rate - # births/1000 women Fertility rate - # births/1000 women between ages 15 &44 yearsbetween ages 15 &44 years

• Abortus- embryo/fetus removed or Abortus- embryo/fetus removed or expelled at 20 wks or less expelled at 20 wks or less

• Stillbirth- infant, who at birth, Stillbirth- infant, who at birth, demonstrates no signs of lifedemonstrates no signs of life

Other issues Other issues

• LBW and PretermLBW and Preterm

• High risk pregnancy rate increaseHigh risk pregnancy rate increase

• High technology careHigh technology care

Childbirth Practices Childbirth Practices

• Promotion of safe motherhoodPromotion of safe motherhood

• Prenatal care- promote better Prenatal care- promote better pregnancy outcomespregnancy outcomes– Early risk assessmentEarly risk assessment– Promoting healthy behaviorsPromoting healthy behaviors– Community based care Community based care

• Self managementSelf management

• Health Literacy Health Literacy

• Breast feeding in workplace Breast feeding in workplace

• International concernsInternational concerns

Nursing TrendsNursing Trends

• Nursing SpecializationNursing Specialization

• Evidence-based PracticeEvidence-based Practice

• Outcomes orientation to practiceOutcomes orientation to practice

• Best Practices Best Practices

Legal Issues and Standards of Legal Issues and Standards of PracticePractice

• Procedure book – follow guidelinesProcedure book – follow guidelines

• Risk Management – minimize risk of Risk Management – minimize risk of injury and subsequent lawsuitsinjury and subsequent lawsuits

• Ethical IssuesEthical Issues

• Nursing Research Nursing Research

• Sentinel event- Sentinel event-

• Failure to rescueFailure to rescue

Useful web sites for Maternal Child HealthHttp://mchb.hrsa.gov

Health and Wellbeing of Children in Rural AreasWomen’s Health USA 2006Child Health USA 2006

www.amchp.org Association of MCH Programs

www.ncemh.org National Center for Education in MCHGeorgetown University

www.engenderhealth.orggreat resource for monitoring prenatal care, pp, infertility, and post abortion

www.mchpolicy.org Maternal and Child Health Policy specializes in issues affecting children, incl. special health care and low income families