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.

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

Certified Registered Nurse (RNC)- national certification examination Nurse Practitioner (NP): expanded role as women’s health NP or family NP Clinical 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

 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)

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

 “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”

 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.

 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 risk

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

 Cost containment  Uninsured and underinsured families

 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

 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

 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

 Traditional Family  Definition of Family ◦ Emotional closeness ◦ Defined membership ◦ Joined together by marriage, blood, adoption, or residence in the same household

 Dyad Family ◦ two people together without children (newly wed couple)  Cohabitation Family ◦ heterosexual couples with children but unmarried  Nuclear Family ◦ traditional, Married with children

 Polygamous Family ◦ marriage with multiple wives  Extended Family ◦ multigenerational family  Single Parent Family  Blended Family- ◦ remarriage or reconstituted family

 Communal Family ◦ formed by groups of people who choose to live together  Gay or Lesbian Family ◦ same sex living together

 To help provide care to the grandchildren  As a peacemaker to resolve conflicts between grandchildren and parents  To maintain involvement in family life

 Stage 1: Beginning families  Stage 2: Childbearing families  Stage 3: Families with Pre-School Children  Stage 4: Families with School-aged children

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

 Taking a Sexual history 1.Explain purpose of interview 2.Use direct eye contact unless it is culturally unacceptable 3.Ask open ended questions 4.Clarify terminology 5.Proceed from easier to more difficult topics

6. Be alert to body language 7. Listen and react in a non-judgmental manner 8. Use teachable moments to educate 9. Do not assume the women is heterosexual 10. Be respectful