Maternity NursingWeek 1

Chapters 1, 2

By

Catherine Ramos Marin, MSN/Ed(C), WHCNP, RN

Obstetrics- care of women during childbirth MCN - the care of childbearing and

childrearing families.◦ Primary goal

promotion and maintenance of optimal family health to ensure cycles of optimal childbearing and childrearing.

Goals and Philosophies

Antepartum Intrapartum

Postpartum

Newborn Nursery

Family-centered Community-centered Evidence-based Advocate to protect the rights of all

family members, including the fetus Health promotion and disease prevention

Philosophy of MCN

Advanced-practice Options in Maternal-

Newborn Nursing Certified Registered Nurse (RNC)- national certification examination

Nurse Practitioner (NP): expanded role as women’s health NP or family NPClinical Nurse Specialist (CNS)

Certified Nurse Midwife (CNM)- certified by the American College of Nurse-Midwives (ACNM)

Health promotion ◦ client education on the importance of health

maintenance◦ importance of prenatal care compliance and

neonatal care

Phases of Health Care

Health restoration ◦ prompt diagnosis and treatment on complications

of pregnancy Health rehabilitation

◦ prevention of further complications, ill client back to optimal health or helping a client to accept inevitable death (molar pregnancy to continue therapy)

Phases of Health Care

Healthy People 2010

Defines health care priorities Guide progress toward the ultimate goal of

optimal health Goals:

◦ To increase the quality and years of healthy life◦ To eliminate health disparities within America’s

population

Healthy People 2010 (cont’d)

Comprehensive set of 467 measurable disease prevention and health promotion objectives

28 focus areas Leading health indicators

Three Levels of Prevention

Primary prevention◦ Health promotion

Secondary prevention◦ Early identification and prompt treatment

Tertiary prevention◦ Restore health

Be mindful of the following:◦ Standards of Care◦ Institutional Policies◦ Ethical Implications◦ Nurse Practice Acts in your State

Legal and Ethical Issues in OB

“Unseen client” Emancipated minors

◦ clients who are not of legal age who are considered mature minors (age 11 to 17)

Patient Confidentiality Considered “normal events”

Legal Considerations

Wrongful birth ◦ the birth of disabled child when parents would

have chosen to end the pregnancy if they had been informed about the disability during the pregnancy.

Wrongful life- ◦ a claim that negligent prenatal testing on the

part of the health care provider resulted in the birth of an un-perfect child.

Legal….

Rights of mother vs. Rights of fetus Heroic measures vs. Comfort care High risks behaviors Methods of resolving infertility Human stem cell research Health of the mother and fetus @ risk

Controversial Issues in OB

Smaller families Single parents Working mothers Domestic Violence Sexual Abuse More health conscious

Trends in MCN

Cost containment Uninsured and

underinsured families

Trends

Have the right to refuse to assist Qualified replacement is available Maternal rights supersede those of the fetus

prior to viability and the reverse is true after viability

Nursing Responsibility

Freebirthing ◦ refers to women giving birth without any health

care provider supervision AKA: unassisted birth or couples birth Sources of knowledge:

◦ from books and internet and then arrange to give birth at home in complete privacy

Freebirthing

Birth is a normal function of women An orgasmic experience Increase the ability to bond with the

newborn Lack of health insurance Lack of information about patient rights

Reasons for Unassisted Birth

Care of the Family

Traditional Family Definition of Family

◦ Emotional closeness◦ Defined membership◦ Joined together by marriage, blood, adoption, or

residence in the same household

Care of the Family

Traditional Family

Dyad Family◦ two people together without children (newly

wed couple) Cohabitation Family

◦ heterosexual couples with children but unmarried

Nuclear Family◦ traditional, Married with children

Types of Family

Polygamous Family◦ marriage with multiple wives

Extended Family◦ multigenerational family

Single Parent Family Blended Family-

◦ remarriage or reconstituted family

Types of Family

Communal Family◦ formed by groups of people who choose to live

together Gay or Lesbian Family

◦ same sex living together

Types of Family

Single Parent Household

To help provide care to the grandchildren As a peacemaker to resolve conflicts

between grandchildren and parents To maintain involvement in family life

Grandparent Role Function

Grandparent Role

Stage 1: Beginning families Stage 2: Childbearing families Stage 3: Families with Pre-School

Children Stage 4: Families with School-aged

children

Duvall’s Eight Stage Family Life Cycle 1979

Stage 5: Families with Teenagers Stage 6: Families Launching Young Adults Stage 7: Middle-aged Parents Stage 8: Retirement and old age

Duvall’s Eight Stage Family Life Cycle 1979

Taking a Sexual history1. Explain purpose of interview2. Use direct eye contact unless it is culturally

unacceptable3. Ask open ended questions4. Clarify terminology5. Proceed from easier to more difficult topics

Taking Care of Women

6. Be alert to body language7. Listen and react in a non-judgmental manner8. Use teachable moments to educate9. Do not assume the women is heterosexual10. Be respectful

Taking Care of Women

Questions?????