Introduction to Maternity Care

Overview

• Instructor: Dr. Beth Mueller
• Course: Nursing 432, Topic 1.1
• Focus: Planning nursing care for childbearing families
• Key Themes:
  • Contemporary issues and trends
  • Family-centered nursing
  • Health considerations for female reproductive needs
  • Concepts of contraception, infertility, and family planning

Key Topics in Maternity Nursing

• 21st-century Maternity Care:
  • Covers preconception, conception, prenatal (antepartum), intrapartum (labor and birth), and postpartum periods.

Advances in Maternal Child Health

• Early 1900s:
  • Standardized childbirth care, childbirth classes, first milk bank, and advancements in birth control and feminine products.
• Mid-1900s:
  • Lamaze education, birth control pill, research on birth defects (e.g., thalidomide tragedy).
  • Introduction of mammograms, and NAGOG (Nurses Association of American College of Obstetricians and Gynecologists).
• Late 1900s:
  • Home pregnancy kits, Family Medical Leave, Newborns and Mother's Health Act, and emergency contraception.
• 2000s to Present:
  • Affordable Care Act, removal of pregnancy as a pre-existing condition, introduction of HPV vaccine.

Health Disparities

• Vulnerable Populations:
  • Women, racial/ethnic minorities, adolescents, older women, incarcerated individuals, immigrants, refugees, homeless, and rural communities.
• Maternal Mortality:
  • U.S. has high maternal mortality rates compared to other developed countries.
• Efforts to Reduce Disparities:
  • HERSA grants, Office of Minority Health, National Institutes of Health, CDC, and Department of Health and Human Services initiatives.
• Programs:
  • WIC program and Healthy People 2030 goals.

U.S. Health Care System

• Challenges:
  • Fragmented care, high costs, limited access to care, refusal of Medicaid by providers.
• Health Reform:
  • Affordable Care Act improving insurance accessibility.
• Contemporary Issues:
  • Low birth weight, pre-term birth, disparities in infant mortality, high obesity rates impacting pregnancy.

Birthing Practices

• Care Providers:
  • MDs, OBGYNs, certified midwives, doctors of osteopathy.
• Birth Options:
  • Hospital birth centers, standalone birthing centers, home births.
• Family-Centered Care:
  • Inclusion of family, skin-to-skin contact, rooming-in practices.

Trends in Nursing Practice

• Standards and Legal Issues:
  • Efforts to prevent errors, Joint Commission investigations.
• Sentinel Events and Failure to Rescue:
  • Emphasis on surveillance and identification of complications.
• Ethical Issues:
  • Advanced fertility treatments and associated ethical questions.

Family and Cultural Considerations

• Family Organization:
  • Evolving family structures, including diverse family forms.
• Theoretical Approaches:
  • Health promotion model, structural and functional family aspects.
• Genetics and Social Relationships:
  • Family genograms and ecomaps to assess family history and support systems.
• Cultural Context:
  • Providing culturally competent care, respect for personal space, communication, and family roles.

Conclusion

• Course Progression:
  • Deep dive into topics as the course progresses.
• Student Support:
  • Encouragement to reach out with questions.