1. Introduction to Nursing Care of the Childbearing Family
Molloy College
Division of Nursing
Introduction to Nursing Care of the Childbearing Family
Ann Marie Paraszczuk
4/23/2017

2. 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 12

3. 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)

4. 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)

5. 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

6. Current Trends in Childbirth
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

7. 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 6

8. Barriers to Accessing Healthcare
Financial barriers
Transportation
Language barriers
Cultural barriers
Clinical hours
Poor attitudes of healthcare workers
Need for Culturally/Spiritually Sensitive Care

9. 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 5

10. Care during pregnancy and birth
Involving consumers and promoting self-care
Health literacy
Breastfeeding in the workplace
Culturally competent Care

11. 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

12. 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

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

14. 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

15. 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

16. Cultural Concepts Culture and Ethnicity Acculturation and assimilation
Religion vs Spirituality

17. Culturally Influenced Responses
Biological predisposition
Values and beliefs
Communication Patterns
Language
Personal space,touch
Time orientation
Family orientation

18. 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 p