maternity and women's health care
today & chapter 2: social, ethical, and
legal issues
historical perspective on childbearing: before 20th century
Before 20th century "Granny" midwives - childbirth in home. Apprenticed
historical perspective on childbearing: emergence of medical management
-late 19th century people moved to hospital births because of developments avail in hospitals.
-Doctors had resources in the hospital so people wanted to give birth in a hospital.
-By 1960, 90% of births were happening in the hospital
-Lay midwifery became illegal
-affluent families could have prenatal care: poor could not
-consumer demands: 1950's women began to be more involved in their pregnancy
historical perspective on childbearing: why government involvement? act? current resources?
distribution?
-Federal funding: because of poor outcomes for low income women
-The Shepard Towner act was developed for moms and kids.
-Currently: WIC, Head Start, etc.
-Inequitable distribution of health care: still not equitable.
antepartum
-before onset of labor
-other things we need to worry about such as hypertension
-not worried about labor yet, not giving birth YET
intrapartum
-time of labor and birth
-birth sometimes will not have labor such as a C-section
postpartum
,-first 6 weeks after birth
-after labor
What does -partum mean?
childbirth, giving birth
historical perspective on childbearing: effect of consumer demands
-Consumers involvement
-New childbirth methods
-Benefits of extended parent-newborn contact
historical perspective on childbearing: traditional hospital setting
-labor, delivery, recovery rooms (LDRs)
-labor, delivery, recovery, postpartum rooms (LDRPs)
historical perspective on childbearing: birth centers
-Freestanding
-Do not have epidurals or nacrotics
-Less volume, less lazy, less protocols, more water
historical perspective on childbearing: home births
do not want interventions
historical perspective on childbearing: insurance provider
Insurance provider may limit choice of health care provider or setting
where does the first part of recover take place after birthing a baby? how many patients does
the nurse have?
-First part of recover happens in labor and delivery room
-when mom is in active labor the ratio is one nurse 1 to 1 patient, Sometimes its 1 nurse to 2 pts
(mom and baby)
how many patients does a nurse have in the postpartum unit?
1 nurse to 4 patients or 1 to 8 patients (cuplets)
Historical Perspectives on Childbearing: family-centered maternity care
, -Physical and psychosocial needs of the family
-Fosters the family unit
Historical Perspectives on Childbearing: principles of family- centered care
-Childbirth is usually a normal, healthy event
-Childbirth affects the entire family
-Families making decisions about care
-Family and other support
who is the main focus on during labor? can then nurse do it all?
-Center and focus on the mom
-How to support the mom in labor (ask other family members, every family member can help
the mom)
-Nurse can not take care of all the things, such as comfort
Choices in Childbirth: Support and Education- Support person
-Father of baby
-Relative or friend
-Doula (trained labor support)
Who is a doula?
-A caregiver who provides continuous physical, emotional, and educational support for the
mother before, during, and after childbirth.
-Not a medical professional
-Not a doctor or nurse
who pays doulas?
CA (the government) pays ppl to be doulas and can be very effective
Choices in Childbirth: Support and Education- Siblings
-Presence of children at birth is controversial.
-Some children may attend all or part of labor and birth.
-Will not see children most of the time in this hospital setting
Choices in Childbirth: Support and Education- Education
Importance of perinatal education
Current Trends in Perinatal and Women's Health Care: Healthy People 2030
today & chapter 2: social, ethical, and
legal issues
historical perspective on childbearing: before 20th century
Before 20th century "Granny" midwives - childbirth in home. Apprenticed
historical perspective on childbearing: emergence of medical management
-late 19th century people moved to hospital births because of developments avail in hospitals.
-Doctors had resources in the hospital so people wanted to give birth in a hospital.
-By 1960, 90% of births were happening in the hospital
-Lay midwifery became illegal
-affluent families could have prenatal care: poor could not
-consumer demands: 1950's women began to be more involved in their pregnancy
historical perspective on childbearing: why government involvement? act? current resources?
distribution?
-Federal funding: because of poor outcomes for low income women
-The Shepard Towner act was developed for moms and kids.
-Currently: WIC, Head Start, etc.
-Inequitable distribution of health care: still not equitable.
antepartum
-before onset of labor
-other things we need to worry about such as hypertension
-not worried about labor yet, not giving birth YET
intrapartum
-time of labor and birth
-birth sometimes will not have labor such as a C-section
postpartum
,-first 6 weeks after birth
-after labor
What does -partum mean?
childbirth, giving birth
historical perspective on childbearing: effect of consumer demands
-Consumers involvement
-New childbirth methods
-Benefits of extended parent-newborn contact
historical perspective on childbearing: traditional hospital setting
-labor, delivery, recovery rooms (LDRs)
-labor, delivery, recovery, postpartum rooms (LDRPs)
historical perspective on childbearing: birth centers
-Freestanding
-Do not have epidurals or nacrotics
-Less volume, less lazy, less protocols, more water
historical perspective on childbearing: home births
do not want interventions
historical perspective on childbearing: insurance provider
Insurance provider may limit choice of health care provider or setting
where does the first part of recover take place after birthing a baby? how many patients does
the nurse have?
-First part of recover happens in labor and delivery room
-when mom is in active labor the ratio is one nurse 1 to 1 patient, Sometimes its 1 nurse to 2 pts
(mom and baby)
how many patients does a nurse have in the postpartum unit?
1 nurse to 4 patients or 1 to 8 patients (cuplets)
Historical Perspectives on Childbearing: family-centered maternity care
, -Physical and psychosocial needs of the family
-Fosters the family unit
Historical Perspectives on Childbearing: principles of family- centered care
-Childbirth is usually a normal, healthy event
-Childbirth affects the entire family
-Families making decisions about care
-Family and other support
who is the main focus on during labor? can then nurse do it all?
-Center and focus on the mom
-How to support the mom in labor (ask other family members, every family member can help
the mom)
-Nurse can not take care of all the things, such as comfort
Choices in Childbirth: Support and Education- Support person
-Father of baby
-Relative or friend
-Doula (trained labor support)
Who is a doula?
-A caregiver who provides continuous physical, emotional, and educational support for the
mother before, during, and after childbirth.
-Not a medical professional
-Not a doctor or nurse
who pays doulas?
CA (the government) pays ppl to be doulas and can be very effective
Choices in Childbirth: Support and Education- Siblings
-Presence of children at birth is controversial.
-Some children may attend all or part of labor and birth.
-Will not see children most of the time in this hospital setting
Choices in Childbirth: Support and Education- Education
Importance of perinatal education
Current Trends in Perinatal and Women's Health Care: Healthy People 2030
