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Lecture 1

A Framework for Maternal and Child Health Nursing

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Objectives

On completion of this part, the student will be able to:

Define each vocabulary and term listed
Identify the primary goal of maternal and reproductive health nursing.
Identify common maternal and child health nursing practice.
Define common statistical terms used in the field, such as Infant and

Maternal Mortalities.

Identify areas of care that could benefit from additional nursing research.
Identify the contemporary trends in maternal and family health care and implication for nurses.
Discuss socio-cultural and ethical considerations in the area of maternity and reproductive health nursing.

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Goal of Maternal and Child Health

Promotion, maintenance of optimal family health to ensure cycles of optimal childbearing, childrearing

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Maternal and Child Health Practice

Preconceptual health care
Care of women throughout pregnancy
Care of children during perinatal period
Care of children from birth through adolescence
Care in all settings

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Framework of Nursing Care

Health promotion
Health maintenance
Health restoration
Health rehabilitation

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The Nursing Process

Applicable for all health care settings

Assessment
Nursing diagnosis
Planning
Implementation
Evaluation

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Evidence-Based Practice

Use of research or controlled investigation of problem with clinical expertise as foundation for action

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Nursing Research

Controlled investigation of problems that have implications for nursing practice

Justification for implementing activities for outcomes
Results in improved, cost-effective patient care

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Nursing Theories

How nurses view clients
Goals of nursing care
Activities of nursing care

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Maternal and Child Health Nursing

21th century

Infant mortality rate >100 per 1,000

Today
in Jordan was reported (2017) at 14.2 deaths/1,000

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Trends in Maternal and Child Health Nursing Population

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Measurements of Maternal and Child Health

Birth rate
Fertility rate
Fetal death rate
Neonatal death rate
Perinatal death rate

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Measurements of Maternal and Child Health (cont’d)

Maternal mortality rate
Infant mortality rate
Childhood mortality rate
Childhood morbidity rate

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Birth Rate

Birth rate is the number of births per 1,000 population

Birth rate has gradually decreases in Jordan 23.9 births/1,000 population (2017 est.)

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Fertility Rate

Fertility rate is the number of pregnancies per 1,000 women of childbearing age

Fertility rate in Jordan decreased dramatically (was 5.6 in 1990, 4.4 in 1997, 3.7 in 2002, became 3.19 children born/woman (2017 est.)

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Fetal Death Rate

Fetal death rate is the number of fetal deaths (over 500gm, 20 wks or more gestation) per 1,000 live births.
It reflects the overall quality of maternal health and prenatal care.

Causes of fetal death:

Maternal factors (e.g. maternal disease, premature cervical dilatation, maternal malnutrition)
Fetal factors (e.g. fetal disease chromosome abnormality, poor placental attachment)
unknown

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Neonatal Death Rate

Is the number of deaths per 1,000 live births occurring at birth or in the first 28 days of life.
It reflects the quality of care for the women during pregnancy and childbirth as well as for infants
Number improved each year as prenatal care improved.

Causes of neonatal death:

Prematurity
Low birth weight
Congenital anomalies

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Perinatal Death Rate

Perinatal death rate is the number of deaths of fetuses more than 500 gm and in the 1^st 28 days of life per 1,000 live births

Is the sum of fetal and neonatal rates

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Maternal Mortality Rate

Maternal mortality rate (MMR) is the number of maternal deaths per 100,000 live births that occur as a direct result of the reproductive process
MMR in Jordan 58 deaths/100,000 live births (2015 est.)

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cont. �Maternal Mortality Rate

Dramatic decrease can be attributed to:

Improved preconceptual, prenatal, labor and birth, and postpartum care
Greater detection of disorders eg. Ectopic pregnancy
Increased control of complications associated with pregnancy induced hypertension
Decrease use of anesthesia with childbirth

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cont. �Maternal Mortality Rate

Most of 20^th century leading causes of death were: hemorrhage and infection
Now: the leading cause is the hypertensive disorders (pre-exiting hypertension and pregnancy-induced hypertension)

Nurses need to be alert to the signs and symptoms of hypertension during pregnancy to save women lives.

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Advanced Practice Nursing

Clinical nurse specialists
Case manager
Nurse-Midwife

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Advanced Practice Nursing (cont’d)

Nurse practitioner

Women’s health
Family
Neonatal
Pediatric

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Legal Considerations

Protection of clients’ rights
Accountability for nursing care
Identifying, reporting suspected child abuse
Scope of practice
Documentation

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Ethical Considerations

Conception issues
Abortion
Fetal rights
Resuscitation

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Ethical Considerations (cont’d)

Procedures
Quality of life
Research

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Maternal Rights

The pregnant woman has the right to:

• Information about her health

• Discuss her concerns, thoughts, and worries

• Know in advance about any planned procedure to be performed

• Privacy

• Express her views about the services she receives