Perinatal midterm review questions(Correctly solved)
1. Name the universal rights of childbearing women correct answers 1. Every woman has the
right to be free from harm and ill treatment
2. Every woman has the right to information, informed consent and refusal, and respect for her
choices and preferences, including companionship during maternity care
3. Every woman has the right to privacy and confidentiality
4. Every woman has the right to be treated with dignity and respect
5. Every woman has the right to equality, freedom from discrimination, and equitable care
6. Every woman has the right to healthcare and to the highest attainable level of health
7. Every woman has the right to liberty, autonomy, self-determination, and freedom from
coercion
2. Define 'obstetrical violence'. What forms does it take? Name at least five examples. correct
answers Obstetric violence is mistreatment of women and birthing people in the childbirth
setting, often delivered verbally and normalized as routine care. ALL women, in ALL countries,
are vulnerable to obstetrical violence.
Some examples of obstetrical violence include invasive practices physical violence, forced
medical interventions, disregard of women's pain and verbal humiliations.
3. Identify at least five populations at particular risk of obstetric violence? correct answers -
Adolescents and unmarried women (negative stereotypes about teens as bad mothers and that
early motherhood ruins lives, this causes them to be humiliated into dropping out of school. We
not consider how societal factors such as poverty and childhood adversity lead to teens
undergoing unprotected sex)
- Indigenous women and ethnic minorities (involuntary sterilizations and forced birth travel have
been brought among indigenous women Black women in the USA experience racism still today
and receive disrespectful perinatal care. Black mothers have more postpartum hemorrhage, more
primary cesarean sections, more postpartum depression.)
- immigrants; refugees and internally displaced women;
- women living in poverty; women living in informal urban settlements; women living in fragile
states; and women affected by humanitarian crises
-Women who are incarcerated also experience trauma during post partum care, such as shackling
during labor, solitary confinement for mental distress (versus mental health help) separation of
mothers from infants and young children and inadequate prenatal/postpartum care.
5. Define 'reproductive justice' according to Loretta Ross and her colleagues correct answers
Loretta Ross and her collegues argue that much discussion about reproductive rights focuses on
binary pro-choice/pro-life arguments in r/t abortion. Such focus is narrow, divisive, and fails to
address common structural societal problems faced by all women and marginalized women in
particular.
,Some women have limited choice about reproductive choice ... because of societal circumstances
(poverty, racism, misogyny) that no one would logically choose
Reproductive justice means the human right to:
• Personal autonomy
• The right to not have children
• The right to have children
• The right to parent those children in dignity and in safe communities.
6. Review evidence-based foundations of baby-friendly breastfeeding support correct answers
STEP 1. Have a written breastfeeding policy that is routinely communicated to all health care
staff
STEP 2. Train all health care staff in skills necessary to implement the policy
STEP 3. Inform all pregnant women about the benefits and management of breastfeeding
STEP 4. Help mothers initiate breastfeeding within a half-hour of birth
STEP 5. Show mothers how to breastfeed and how to maintain lactation, even if they should be
separated from their infants
STEP 6. Give newborn infants no food or drink other than breast milk, unless medically
indicated
STEP 7. Practice rooming-in - allow mothers and infants to remain together - 24 hours a day
STEP 8. Encourage breastfeeding on demand
STEP 9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding
infants
STEP 10. Foster the establishment of breastfeeding support groups and refer mothers to them on
discharge from the hospital or clinic
7. mother-baby-friendly birthing facilities? correct answers • Offer all birthing women the
opportunity to eat, drink, walk, stand, and move about during the first stage of labor and to
assume the position of her choice for the second stage, unless medically contraindicated.
• Provide all mothers with privacy.
• Allow at least one person of her choice to be with her
• Provides culturally competent care respecting customs, nonharmful practices, and values.
• Does not allow physical, verbal, emotional, or financial abuse
• Does not routinely employ practices and procedures that are not evidence-based, such as
routine episiotomy, induction of labor, and separation of mother and baby.
• Teaches, counsels, and encourages staff to provide both pharmacological and
nonpharmacological pain relief as necessary
• Promotes immediate skin-to-skin mother/baby contact and actively supports all mothers to hold
and exclusively breastfeed.
8. Compare and contrast 'too little too late' (resource scarcity) and 'too much too soon'
(overmedicalization) as contributing to complications during pregnancy and childbirth nationally
and globally. correct answers Too little too late:
• Lack of evidence-based guidelines
• Lack of equipment, supplies, and medicines
, • Inadequate numbers of skilled practitioners
• Women delivering alone
• Lack of emergency medical services and delayed interfacility transfers
However, even in richer countries, we commonly see "too little too late" supportive prenatal and
postpartum care, nutritional counselling, lactation support.
The early postpartum is essentially the ONLY time to establish breastfeeding, which confers a
lifetime of health promotion benefits, but the 'window of opportunity' to do so closes without
effective support (by way of relevant health promotion, and by way of cultural and economic
policy that do or do not support new parents)
Too much too soon: correct answers • Unnecessary cesarean sections
• Routine induced or augmented labor
• Routine continuous electronic fetal monitoring
• Routine episiotomy
• Routine antibiotics postpartum
(Care not based on evidence,
though the evidence exists)
Particularly in highly-medicalized countries, the phenomenon of "too much too soon"
(McDougall et al, 2016) is common. This includes unnecessary interventions such as inductions,
episiotomies, vacuum and forceps extractions, cesarean birth. When unnecessary, these have
harmful consequences that do NOT outweigh benefits. Clinical wisdom means knowing the
clinical difference b/w physiology and pathology, and using invasive medical interventions like
these ONLY when necessary.
9. Using five examples relevant to perinatal nursing, discuss terminology/language that serves to
empower rather than disempower patients and families. correct answers A language focus on
deficits, failures, and ineffective forms of coping has a nocebo effect causing fear and distrust in
one's body and ability. A language rich in affirmation empowers. Words of praise and affirma-
tion effect positive imagery and calmness, and convey a message of respect and care for another.
For example telling them how strong and healthy they are , that you are there to support them,
encouraging them, that it is their body and their choice etc.
10. Discuss how the medicalization of childbirth was/is part of colonization, and how this has
impacted reproductive health of Indigenous people in Canada. correct answers Aboriginal
communities wish to restore a sense of power over birthing practices and maternity care. The
dominance of biomedicine created a situation where Aboriginal people were told that time-
honored midwifery practices and birthing traditions were unsafe, that they must turn to the
advances of 'modern' maternity care.
The loss of Aboriginal identity, traditions, and beliefs, in addition to health policies developed by
non-Aboriginal people, are key players contributing to poor health.
11. Discuss how Mi'kmaq women in Nova Scotia describe their experiences with gestational
diabetes. correct answers Indigenous women experience a higher incidence of maternal
complications compared with non-Indigenous women. Despite this, little is known about access
to prenatal care for Mi'kmaq women in Nova Scotia.
1. Name the universal rights of childbearing women correct answers 1. Every woman has the
right to be free from harm and ill treatment
2. Every woman has the right to information, informed consent and refusal, and respect for her
choices and preferences, including companionship during maternity care
3. Every woman has the right to privacy and confidentiality
4. Every woman has the right to be treated with dignity and respect
5. Every woman has the right to equality, freedom from discrimination, and equitable care
6. Every woman has the right to healthcare and to the highest attainable level of health
7. Every woman has the right to liberty, autonomy, self-determination, and freedom from
coercion
2. Define 'obstetrical violence'. What forms does it take? Name at least five examples. correct
answers Obstetric violence is mistreatment of women and birthing people in the childbirth
setting, often delivered verbally and normalized as routine care. ALL women, in ALL countries,
are vulnerable to obstetrical violence.
Some examples of obstetrical violence include invasive practices physical violence, forced
medical interventions, disregard of women's pain and verbal humiliations.
3. Identify at least five populations at particular risk of obstetric violence? correct answers -
Adolescents and unmarried women (negative stereotypes about teens as bad mothers and that
early motherhood ruins lives, this causes them to be humiliated into dropping out of school. We
not consider how societal factors such as poverty and childhood adversity lead to teens
undergoing unprotected sex)
- Indigenous women and ethnic minorities (involuntary sterilizations and forced birth travel have
been brought among indigenous women Black women in the USA experience racism still today
and receive disrespectful perinatal care. Black mothers have more postpartum hemorrhage, more
primary cesarean sections, more postpartum depression.)
- immigrants; refugees and internally displaced women;
- women living in poverty; women living in informal urban settlements; women living in fragile
states; and women affected by humanitarian crises
-Women who are incarcerated also experience trauma during post partum care, such as shackling
during labor, solitary confinement for mental distress (versus mental health help) separation of
mothers from infants and young children and inadequate prenatal/postpartum care.
5. Define 'reproductive justice' according to Loretta Ross and her colleagues correct answers
Loretta Ross and her collegues argue that much discussion about reproductive rights focuses on
binary pro-choice/pro-life arguments in r/t abortion. Such focus is narrow, divisive, and fails to
address common structural societal problems faced by all women and marginalized women in
particular.
,Some women have limited choice about reproductive choice ... because of societal circumstances
(poverty, racism, misogyny) that no one would logically choose
Reproductive justice means the human right to:
• Personal autonomy
• The right to not have children
• The right to have children
• The right to parent those children in dignity and in safe communities.
6. Review evidence-based foundations of baby-friendly breastfeeding support correct answers
STEP 1. Have a written breastfeeding policy that is routinely communicated to all health care
staff
STEP 2. Train all health care staff in skills necessary to implement the policy
STEP 3. Inform all pregnant women about the benefits and management of breastfeeding
STEP 4. Help mothers initiate breastfeeding within a half-hour of birth
STEP 5. Show mothers how to breastfeed and how to maintain lactation, even if they should be
separated from their infants
STEP 6. Give newborn infants no food or drink other than breast milk, unless medically
indicated
STEP 7. Practice rooming-in - allow mothers and infants to remain together - 24 hours a day
STEP 8. Encourage breastfeeding on demand
STEP 9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding
infants
STEP 10. Foster the establishment of breastfeeding support groups and refer mothers to them on
discharge from the hospital or clinic
7. mother-baby-friendly birthing facilities? correct answers • Offer all birthing women the
opportunity to eat, drink, walk, stand, and move about during the first stage of labor and to
assume the position of her choice for the second stage, unless medically contraindicated.
• Provide all mothers with privacy.
• Allow at least one person of her choice to be with her
• Provides culturally competent care respecting customs, nonharmful practices, and values.
• Does not allow physical, verbal, emotional, or financial abuse
• Does not routinely employ practices and procedures that are not evidence-based, such as
routine episiotomy, induction of labor, and separation of mother and baby.
• Teaches, counsels, and encourages staff to provide both pharmacological and
nonpharmacological pain relief as necessary
• Promotes immediate skin-to-skin mother/baby contact and actively supports all mothers to hold
and exclusively breastfeed.
8. Compare and contrast 'too little too late' (resource scarcity) and 'too much too soon'
(overmedicalization) as contributing to complications during pregnancy and childbirth nationally
and globally. correct answers Too little too late:
• Lack of evidence-based guidelines
• Lack of equipment, supplies, and medicines
, • Inadequate numbers of skilled practitioners
• Women delivering alone
• Lack of emergency medical services and delayed interfacility transfers
However, even in richer countries, we commonly see "too little too late" supportive prenatal and
postpartum care, nutritional counselling, lactation support.
The early postpartum is essentially the ONLY time to establish breastfeeding, which confers a
lifetime of health promotion benefits, but the 'window of opportunity' to do so closes without
effective support (by way of relevant health promotion, and by way of cultural and economic
policy that do or do not support new parents)
Too much too soon: correct answers • Unnecessary cesarean sections
• Routine induced or augmented labor
• Routine continuous electronic fetal monitoring
• Routine episiotomy
• Routine antibiotics postpartum
(Care not based on evidence,
though the evidence exists)
Particularly in highly-medicalized countries, the phenomenon of "too much too soon"
(McDougall et al, 2016) is common. This includes unnecessary interventions such as inductions,
episiotomies, vacuum and forceps extractions, cesarean birth. When unnecessary, these have
harmful consequences that do NOT outweigh benefits. Clinical wisdom means knowing the
clinical difference b/w physiology and pathology, and using invasive medical interventions like
these ONLY when necessary.
9. Using five examples relevant to perinatal nursing, discuss terminology/language that serves to
empower rather than disempower patients and families. correct answers A language focus on
deficits, failures, and ineffective forms of coping has a nocebo effect causing fear and distrust in
one's body and ability. A language rich in affirmation empowers. Words of praise and affirma-
tion effect positive imagery and calmness, and convey a message of respect and care for another.
For example telling them how strong and healthy they are , that you are there to support them,
encouraging them, that it is their body and their choice etc.
10. Discuss how the medicalization of childbirth was/is part of colonization, and how this has
impacted reproductive health of Indigenous people in Canada. correct answers Aboriginal
communities wish to restore a sense of power over birthing practices and maternity care. The
dominance of biomedicine created a situation where Aboriginal people were told that time-
honored midwifery practices and birthing traditions were unsafe, that they must turn to the
advances of 'modern' maternity care.
The loss of Aboriginal identity, traditions, and beliefs, in addition to health policies developed by
non-Aboriginal people, are key players contributing to poor health.
11. Discuss how Mi'kmaq women in Nova Scotia describe their experiences with gestational
diabetes. correct answers Indigenous women experience a higher incidence of maternal
complications compared with non-Indigenous women. Despite this, little is known about access
to prenatal care for Mi'kmaq women in Nova Scotia.
