INTRODUCTION TO MATERNAL CHILD NURSING
Maternity care has changed over the years to increase the emphasis on safety and quality of care.
Many expectant
... [Show More] mothers have other health concerns such as obesity, high blood pressure, and even
substance abuse. Their socioeconomic status can have an impact on their pregnancy, along with
their cultural preferences. Abuse and human trafficking may be other risks that these women face
during this period of their lives.
When planning maternal childcare for a client, nurses and providers must take into
consideration the specific needs of the client.
A client should be cared for at a facility that promotes safety and bases their care on the latest
evidence. The client should be involved in their care and discussing options with their provider. In
maternal care, Level III provides the highest level of care, whereas a home birth or birthing center
typically has fewer interventions and less care for lower-risk clients.
Level I, II, III are designations given to inpatient hospital facilities.
Evidence-based
practice
The care is provided based on the latest research and recommendations to
promote safety and positive health outcomes.
Level I facility Low-risk clients, in a hospital setting
LDR room Mom labors, delivers and recovers in the same room, but is transferred to a post
partum unit.
Birth centers Tub births and births may not require as much medical monitoring.
Home births Specialized physicians and midwives deliver within a client’s residence.
Level II facility Typically, care is provided for clients 32 weeks gestation in a hospital setting.
LRDP room Mom labors, delivers, and recovers in the same room and stays for 2-4 days.
Level III facility Highest-risk moms and their infant(s), in a hospital setting
Most families now recognize that they have choices in the childbirth experience. What are the
basic principles of family-centered care?
Nurses must support their clients and provide family-centered care. Nurses should involve the clients
whenever possible. The health and safety of the client and baby are the top priority. If there are no
health risks or financial barriers, clients should have the opportunity to have family/support persons
present at the birth, select the type of provider and decide on the birth setting. Usually, childbirth is
considered a normal, healthy process. Family dynamics will be impacted by childbirth.
Which factors will help to reduce maternal mortality in the United States? Select all that apply.
Availability of high-risk, maternal-infant care centers
Use of a specialized antepartum maternity clinic
Increased use of hospitals and specialized health care personnel, such as a certified nurse
midwife (CNM)
Home deliveries can provide a safe birthing experience, but have not improved the mortality rate.
Birthing plans have provided client involvement in their care, but they have not been a factor in
decreasing maternal mortality.
CJANGES IN MATERNITY CARE OVER TIME
Prior to the twentieth century (before 1901)
Deliveries happened at home; “granny midwives” were in attendance
High rates of maternal and infant death, both at home and in hospitals
Postpartum hemorrhage, postpartum infection, toxemia, prematurity, dehydration r/t diarrhea,
contagious diseases
20th century developments
Increase in physician assisted births in hospitals
By 1960, 90% of all births in the U.S. were in hospitals
Lay midwifery became increasingly illegal
Women’s role in delivery became passive; doctors delivered
Twilight sleep; narcotic and scopolamine
Continued problems with poor maternal nutrition, infection, inadequate prenatal care & cost
issues
When reviewing nursing history, which factors led to increased mortality rates and negative
pregnancy outcomes? Select all that apply.
All of these factors increased the mortality rates and increased the risk for mothers and their
newborns.
Short hospital stays sent women home before they were physically and emotionally stable.
Women were passive in the delivery process, often medicated and not able to have any voice
in the process.
Maternal nutrition resources were not always accessible and women sometimes didn’t know
the importance of their nutrition or didn’t have the financial means to buy it.
Risk of hemorrhaging post-delivery and communicable diseases were caused by factors such
as untrained delivery support personnel and unclean equipment. [Show Less]