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Introduction to Nursing Care of the Childbearing Family

Molloy College

Division of Nursing

Ann Marie Paraszczuk

04/21/23

Maternity nursing

Maternity nursing focuses on women and their infants and families during childbearing cycle

Nurses play an active role in shaping health care systems to be responsive to needs of contemporary women

Tremendous advances in the care of mothers and infants

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RNs in a Variety of Settings

Inpatient and outpatient maternal-newborn facilities – nurses play major role in minimizing psychologic and physical distress associated with reproductive issues Client teaching

Collaborative care – function as part of multidisciplinary health team (NPs, CNM)

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Basic Principles of Family-Centered Care Childbirth is considered a normal, healthy

event in the life of a family Childbirth impacts the entire family and

relationships will change Families are capable of making decisions

about their own care if given adequate information and professional support

Flexibility, quality and individualized care for all family members (Phillips, 2003)

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Past Trends in Childbirth 1700’s: birth at home attended by midwives 1800’s: shift from using midwives to doctors among

middle class women 1900s: twilight sleep used on birthing women;

nurseries started to care for newborns 1970’s and 1980’s: growing trend to return to non-

medicated non-interventive childbirth Late 1900’s: homebirths/ birthing centers decline

due to creation of LDRPs, short stays are the norm 2000’s: 48 to 96 hour stays are legislated

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• Various setting for delivery –hospital most common

• Induction of labor is common practice

• One in 3-4 women undergo a surgical birth (cesarean) some by maternal request

• Childbirth classes abound in most communities

Current Trends in Childbirth

Current Problems

Problems with U.S. health care delivery system Structure of the system Medical errors occur High cost of health care Limited access to care Significant health disparities exist

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Barriers to Accessing Healthcare

Financial barriers Transportation Language barriers Cultural barriers Clinical hours Poor attitudes of healthcare workers

Need for Culturally/Spiritually Sensitive Care

Contemporary Issues and Trends Trends in fertility and birth rate Low birth weight and preterm birth Infant mortality in the U.S. Maternal mortality trends Increase in high risk pregnancies High technology care International concerns

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Care during pregnancy and birth

Involving consumers and promoting self-care Health literacy Breastfeeding in the workplace Culturally competent Care

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Statistical Data

Birth rate # of live births/1000 Maternal mortality rate: related death 42 days

after delivery - # per 100,000 Increasing

Infant mortality rate: deaths ↓1 yr - # per 1000 Unchanged with White lower than Black infants

Adolescent pregnancy:fluctuating Infertility issues: Involve 20% of all women

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Legal/Ethical Scope of practice Standards of nursing care Patient safety, privacy Informed consent _emancipated minors Maternal –fetal conflict Abortion Intrauterine fetal surgery Reproductive Assistance- Embryonic Stem cell research Cord blood banking

Social Issues

Fetal injury – maternal substance abuse Access to healthcare or rationing Poverty/homelessness Domestic violence Teenage pregnancy

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Evidence-based Practice Nursing interventions supported by current,

valid research – emerging as a force in health care

It provides a useful approach to problem solving/decision making; self-directed, patient-centered, life-long learning

Builds on actions necessary to transform research findings into clinical practice

Evidence-based Practice

Practice is evaluated issues are identified and addressed

Outcomes improved as a result of quality improvement initiatives

Nurses need to recognize which practices have conflicting findings as to their effect on client outcomes

Market pressures also a force in use of evidence-based practice

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Cultural Concepts Culture and Ethnicity Acculturation and assimilation Religion vs Spirituality

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Culturally Influenced Responses Biological predisposition Values and beliefs Communication Patterns

Language Personal space,touch

Time orientation Family orientation

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Cultural Influences

Family Structure Childbearing & Childrearing

Children’s importance and ideas re: pregnancy, health and infant feeding practices

Developing cultural competence Self-awareness and accepting diversity Childbearing and child rearing practices

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