1. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Family Nursing with Childbearing Families By Nataliya Haliyash, MD,PhD,MSN

2. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Lecture Objectives: Upon completion the lecture students will be able to: Give definition to ‘childbearing family nursing’ and differentiate it from obstetrical nursing. Discuss nursing theories that contribute to nurses’ understanding of families’ growth, development, functioning, and changes during childbearing. Understand the developmental tasks for childbearing families. Guide health promotion activities in the childbearing families. Recognize possible threats to health during childbearing and plan activities for maintaining and preserving family health.

3. Mosby items and derived items © 2005, 2001 by Mosby, Inc. HISTORICAL PERSPECTIVE Late 1800s – Industrialization –Families moved to more urban areas; household size and functions diminished. –Traditional networks of women were not always available, and mothers needed to replace care previously carried out in the home. –Childbearing still occurred at home for many middle-class families (Leavitt, 1986; Wertz & Wertz, 1989).

4. Mosby items and derived items © 2005, 2001 by Mosby, Inc. HISTORICAL PERSPECTIVE First Third of the 20th Century –The hospital became the place for labor, birth, and early postpartum recovery for middle-class families. –Many immigrant and working-class urban families continued to have babies at home with their traditional care providers. –An impetus to the development of public health nursing was concern for the health of urban mothers and babies. –Realizing that the health needs of all the family members were intertwined, early public health nurses considered families, not individuals, as their clients.

5. Mosby items and derived items © 2005, 2001 by Mosby, Inc. HISTORICAL PERSPECTIVE 1930s through the “Baby Boom” of the 1950s With the dramatic shift of births to hospitals, family involvement with childbearing diminished (Leavitt, 1986). Concerns about infection control contributed to separation of family members. Family members were forbidden to be with women in the hospital. Babies were segregated into nurseries and brought out to their mothers only for brief feeding sessions. Nurses focused on the smooth operation of postpartum wards and nurseries through the use of routine and orderliness. Despite these inflexible conditions, families tolerated them because they believed that hospital births were safer for mothers and babies.

6. Mosby items and derived items © 2005, 2001 by Mosby, Inc. HISTORICAL PERSPECTIVE 1980s to the Present –The research of Klaus and Kennell (1976) served as the impetus for the growth of family-centered care (American College of Obstetricians and Gynecologists & Interprofessional Task Force on Health Care of Women and Children, 1978). –Today promotion of family contact is becoming the hallmark of childbearing care. –Many hospitals have renamed their obstetrical services, using names such as Family Birth Center to convey the importance of family members in childbearing health care even though obstetrical care is becoming more dependent on technology. –With the trend for shorter hospital stays after birth, postpartum care is becoming family-based with nursing guidance.

7. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Childbearing Family Nursing Childbearing family nursing considers the family as client and/or the family as context for the care of its members. Family nursing with childbearing families covers the period before conception, pregnancy, labor, birth, and the postpartum period. It focuses on health and wellness rather than on procedures and medical treatment.

8. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Theories applicable to childbearing family nursing General Systems Theory –is especially effective for childbearing family nurses when they consider that a family, while in a state of change and readjustment, has more-permeable boundaries or is more open to the outside environment because the family becomes aware of resources beyond itself. Duvall’s Developmental Theory –In this theory, the family childbearing stage is defined as the period from the beginning of the first pregnancy until the oldest child reaches 18 months of age.