1. Intro to Maternity Nursing
N316 Maternal Infant Nursing
2/23/2019

2. What’s it all about? “Wellness” Orientation Family-Centered Care
Scope of practice: Antepartum, Intrapartum, Postpartum, & Neonatal care of the childbearing family
Family-Centered Care
Focus on the “family” as the patient
“Empowering” the family to develop competence, confidence, and control over their own lives.
Nursing plays a key role in facilitating this process especially as it relates to holistic health!
2/23/2019

3. Contemporary Childbirth
Changing definitions of family
Nuclear, Dual-Career, Childless, Extended, Single-parent, Stepparent, Binuclear, Nonmarital heterosexual cohabitating family, Gay & Lesbian
Shortened hospital stays postpartum
Use of Complementary and alternative medicine
Nursing supports the concept of self-care
2/23/2019

4. Culturally Competent Care
In childbearing, the number of cultural and spiritual influences on pregnancy and labor and delivery are amazing!
It is essential to assess the client/family for specific requests they have, taboos, rituals, etc. that need to be integrated into the plan of care to foster cultural competence!
2/23/2019

5. Professional Options RN/ RNC Nurse Practitioners (NP)
Certified Nurse Midwife (CNM)
Clinical nurse specialist (CNS)
Professional Organizations
AWHONN~ Association for Women’s Health, Obstetrical, and Neonatal Nurses
Sets the STANDARDS OF CARE for maternity and gynecological nursing
ANA~ American Nurses Association
Also sets STANDARDS OF NURSING CARE but are more general in scope
2/23/2019

6. Ethical issues in Maternity Nursing
Informed Consent-will be discussed in more detail in peds
Right to privacy- HIPAA laws, modesty issues, etc.
Confidentiality-essential in maternal child nursing
Specific issues
Maternal fetal conflict
Abortion
Fetal research
Assisted Reproductive Technology
Embryonic stem cell research
Human Genome Project
2/23/2019

7. Maternity Nursing is a Multi-faceted Role
Role Model for Mother
Counselor
Role Model for Peers
Evidence-based Researcher
The Maternal Child Nurse
Teacher
Clinician
Diagnostician
2/23/2019

8. Healthy People 2020~
This Document is considered the single most important document regarding health in the U.S.
4 Overarching Goals
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death;
Achieve health equity, eliminate disparities, and improve the health of all groups;
Create social and physical environments that promote good health for all
Promote quality of life, healthy development, and healthy behaviors across all life stages
2/23/2019

9. Healthy People 2020— Maternal, Infant & Child Focus Areas
Fetal, Infant, and Child Deaths
Fetal and infant deaths
Child deaths
Adolescent and young adult deaths
Maternal Death and Illness
Maternal deaths
Maternal illness and pregnancy complications
2/23/2019

10. Healthy People 2020— Maternal, Infant & Child Focus Areas
Prenatal Care
Prenatal care
Childbirth Classes
Screening for STD’s
Obstetric Care
Very low birth weight infants born at Level III hospitals
Cesarean deliveries
2/23/2019

11. Healthy People 2020— Maternal, Infant & Child Focus Areas
Risk Factors
Low birth weight & very low birth weight
Preterm birth
Weight gain during pregnancy
Infants put to sleep on their backs
Developmental Disabilities and Neural Tube Defects
Developmental disabilities
Spina bifida and other neural tube defects
Optimum folic acid
2/23/2019

12. Healthy People 2020— Maternal, Infant & Child Focus Areas
Prenatal Substance Exposure
Prenatal substance exposure
Fetal Alcohol Syndrome
Counseling and Interventions to Prevent Tobacco Use
Breastfeeding, Newborn Screening, & Service Systems
Breastfeeding
Newborn bloodspot screening
Sepsis among infants with sickle cell disease
Medical home care for children with special health care needs
Service systems for children with special health care needs
2/23/2019

13. Infant Mortality HP2020 Goal—Reduce Fetal and Infant Deaths
Baseline (per 1,000 live births + fetal deaths)
2020 Target
20+ weeks gestation
6.2
5.6
Perinatal Period (28 weeks gestation – to 7+days after birth
6.6
5.9
2/23/2019

14. 2007-2009 Baseline (% of live births)
Prenatal Care—HP 2020 Goal:  Percentage of Women who Receive Early Prenatal Care
Baseline (% of live births)
2020 Target
Care beginning 1st trimester
70.8
77.9
Early & adequate prenatal care
70.5
77.6
2/23/2019

15. Breastfeeding—HP 2020 Goal:  the Proportion of Mothers who Breastfeed Their Babies
Baseline (% of mothers who breastfeed)
2020 Target
(stats from CDC from 2014)
In early postpartum period 74 81
6 months 43 60
1 year 22 34
2/23/2019

16. Cesarean Deliveries—HP 2020 Goal: Reduce Cesarean Deliveries
Baseline (% of mothers who undergo cesarean birth)
2020 Target
No prior Cesarean delivery
26.5
23.9
Prior cesarean deliveries 90 81
2/23/2019

17. 2007-2009 Baseline (% of babies)
Low & Very Low Birth Weights—HP2020 Goal:  the number of Low and VLBW Babies
Baseline (% of babies)
2020 Target
Low birth weight
8.2
7.8
VLBW
1.5
1.4
2/23/2019

18. Preterm Births—HP 2020 Goal:  Preterm births
Baseline (% of babies)
2020 Target
Total Preterm
12.7
11.4
Live births at 34-36
9.0
8.1
Live births at wks’ gestation
1.6
1.4
Live births at < 32 wks’ gestation
2.0
1.8
2/23/2019

19. SIDS—HP 2020 Goal:  the Percentage of Babies Put to Sleep on Their Backs
2007 Baseline (% of Babies)
2020 Target
Low birth weight 69
75.9
2/23/2019

20. 2007-2009 Baseline (% of pregnant women)
Substance Abuse in Pregnant Women—HP 2020 Goal:  Abstinence from Substance Abuse among Pregnant Women
Baseline (% of pregnant women)
2020 Target
Alcohol
89.4
98.3
Binge Drinking
95.0
100
Cigarette Smoking
89.6
98.6
Illicit drugs
94.9
2/23/2019

21. Women place much faith and trust in maternal and child health nurses, from whom they expect accurate and timely information that will lead to an uneventful and healthy pregnancy.
We challenge you to be promoters of optimal, holistic healthcare to women, infants, children, and their families!
2/23/2019