2. Contemporary Maternity Nursing

3. Objectives To describe maternity nursling's scope To describe maternity nursling's scope To review the trends and issues in contemporary nursing. To review the trends and issues in contemporary nursing. To explore social issues in maternity nursing. To explore social issues in maternity nursing. To discuss ethical and sociopolitical issues. To discuss ethical and sociopolitical issues. To review Healthy People 2010 goals as they relate to maternity care. To review Healthy People 2010 goals as they relate to maternity care.

4. Nursing Care of Women and Infants Advances Advances Still discrepancies Still discrepancies –Access issues –Adolescent care –STI’s and AIDS – adversely affect reproduction

5. “Healthy People 2010” Goals - www.health.gov/healthypeople Goals - www.health.gov/healthypeoplewww.health.gov/healthypeople –Increase healthy life and quality of life –Eliminate the health disparities MCH MCH –“Improve the health and well-being of women, infants, children and families” see box 1-5

6. Millennium Development Goals 2015 target of UN Summit 2000 2015 target of UN Summit 2000 –www.un.org/millenniumgols/goals.html www.un.org/millenniumgols/goals.html Empower women Empower women Decrease child mortality Decrease child mortality Improve maternal health, and more Improve maternal health, and more

7. Integrative Healthcare Belief systems, values and desires Belief systems, values and desires Patient input Patient input

8. Options Alternative Healing Modalities Alternative Healing Modalities –Alternative medical systems –Mind- body intervention –Therapies- biologically based –Manipulative and body-based –Energy therapies Primary Care provider options Primary Care provider options

9. Choices Education – parenting and childbirth Education – parenting and childbirth Room choices Room choices Positioning Positioning Analgesia Analgesia Discharge Discharge

10. Problems Structure of US Health Care sytem Structure of US Health Care sytem Medical errors Medical errors High cost High cost Access Access Disparities Disparities

11. Terms Antepartum- prenatal Antepartum- prenatal Intrapartum- labor and delivery Intrapartum- labor and delivery Postpartum- first 6 weeks after delivery Postpartum- first 6 weeks after delivery

12. Mother-infant Terminology Infant mortality rate -#deaths/1,000 live births Infant mortality rate -#deaths/1,000 live births Maternal mortality rate – #deaths/100,000 live births Maternal mortality rate – #deaths/100,000 live births Neonatal mortality rate - #deaths/1,000 live births, first 28 days Neonatal mortality rate - #deaths/1,000 live births, first 28 days Perinatal mortality rate- # stillbirths & neonatal deaths /1000 live births Perinatal mortality rate- # stillbirths & neonatal deaths /1000 live births

13. Birthrate- # of live births /1000 population Birthrate- # of live births /1000 population Fertility rate - # births/1000 women between ages 15 &44 years Fertility rate - # births/1000 women between ages 15 &44 years Abortus- embryo/fetus removed or expelled at 20 wks or less Abortus- embryo/fetus removed or expelled at 20 wks or less Stillbirth- infant, who at birth, demonstrates no signs of life Stillbirth- infant, who at birth, demonstrates no signs of life

14. Other issues LBW and Preterm LBW and Preterm High risk pregnancy rate increase High risk pregnancy rate increase High technology care High technology care

15. Childbirth Practices Promotion of safe motherhood Promotion of safe motherhood Prenatal care- promote better pregnancy outcomes Prenatal care- promote better pregnancy outcomes – Early risk assessment –Promoting healthy behaviors –Community based care

16. Self management Self management Health Literacy Health Literacy Breast feeding in workplace Breast feeding in workplace International concerns International concerns

17. Nursing Trends Nursing Specialization Nursing Specialization Evidence-based Practice Evidence-based Practice Outcomes orientation to practice Outcomes orientation to practice Best Practices Best Practices

18. Legal Issues and Standards of Practice Procedure book – follow guidelines Procedure book – follow guidelines Risk Management – minimize risk of injury and subsequent lawsuits Risk Management – minimize risk of injury and subsequent lawsuits Ethical Issues Ethical Issues Nursing Research Nursing Research

19. Sentinel event- Sentinel event- Failure to rescue Failure to rescue

20. Useful web sites for Maternal Child Health Http://mchb.hrsa.gov Health and Wellbeing of Children in Rural Areas Women’s Health USA 2006 Child Health USA 2006 www.amchp.orgwww.amchp.org Association of MCH Programs www.ncemh.org National Center for Education in MCH Georgetown University www.engenderhealth.org great resource for monitoring prenatal care, pp, infertility, and post abortion www.mchpolicy.orgwww.mchpolicy.org Maternal and Child Health Policy specializes in issues affecting children, incl. special health care and low income families