NUR 406 Exam 5
- What were the colonial practices (1600s) for childbirth?
Women cared for women in childbirth
Woman and fetus viewed as being at the mercy of God with possible death for either or both Birth was both a cultural and social event
- What are the trends for maternity nursing during the 1700s?
Europe - lying-in hospitals for poor women popularized and a mysterious disease prevailed
Women who delivered at home, however, were immune to the disease White recommended the following
Clean linens Few visitors Keep child in another room Abolish belly binding Nursing child 4-5 times/day Check drinking water not tainted Stool everyday Ox's bladder filled with cold water applied to belly to help uterus contract
*Contanimation occured often due to doctors and staff not washing their hands
- What are the trends for maternity nursing during the 1800s?
Physicians gained popularity as techniques and instruments for complicated deliveries im- proved
Ether and chloroform used during labor - considered 1st anesthesia
Widely used but controversial until used by Queen Victoria (1853) during birth of 7th child - became the "ladylike" way to give birth
End of century obstetrics began to separate into its own department while nurses began to receive special training 1 / 4
- What are the trends for maternity nursing during the 1900s?
DeLee - 1920s, advocate for routine intervention for normal birth - urged sedation, outlet forceps, ether & episiotomy
Local & regional anesthesia implemented 1940s - began to restrict food & drink during labor Twilight sleep (comb morphine, scopolamine, ether and/or chloroform) gained pop- ularity in 1950s.
Early feminists campaigned every woman's right to give painless birth Perinatology & neonatology regionalized for specialized care those at high risk
Improved diagnostics
ultrasound, amniocentesis, CVS, stress testing, fetal scalp testing, continuous fetal monitoring
Improved resuscitative techniques, advanced ventilatory & nutritional therapy and newborn (& fetal) surgery
Family Centered Maternity Care is current philosophy
- What are the trends for midwifes in the 1900s?
Mary Breckinridge - 1st nurse-midwife in US.Trained in Europe, developed standardization for midwifery, the 1st midwifery school in US-Frontier Nursing Service, and encouraged further need for midwifery schools/education
Early 1900s, 50% of all American births attended by midwives.
The number of CNM/CM-attended births has risen nearly every year since 1989, which is the first year that CNM-attended birth statistics were reported. That year, CNMs attended 132,286 births, or 3.2% of all US births. In 2006, CNMs/CMs attended 317,168 births—a 33% increase since 1996.
In 2006, certified nurse-midwives (CNMs) and certified midwives (CMs) attended 317,168 births—a record number. This represents 7.4% of all US births or 10.8% of all vaginal births. 2 / 4
Many states ban the practice of lay midwifery (non-education based)
Now
*nurse midwives deal with low-risk patients. OB/GYN deal with high risk patients
- What are the trends of maternity nursing in the 2000s?
In 2006 nurse mid- wives and certified midwives attended births in
Hospitals - 97% Birth Centers - 2% Homes - 1%
Caesarean deliveries in 2006, a record high of 31.1 percent Inductions of Labor According to the National Center for Health Statistics, the rate of inductions was 9.5% in 1990.In 2006, the rate more than doubled to reach 22.5%. May currently be closer to 40%.
Family centered cared
- What is family centered care?
A model of care based on the philosophy that physical, sociocultural, spiritual, and economic needs of the family are combined and considered collectively when planning care for the childbearing family
- What are some of the trends in family centered care?
Hospitals have birthing rooms - single rooms where the woman and family will stay for labor, delivery, recovery and sometimes postpartum
Atmosphere more relaxed than traditional hospital rooms Specialized birthing beds 3 / 4
Fathers and other family members encouraged to be involved
- What are Birth Centers?
A place that gives you a caring, warm and homelike setting where you are supported and respected as well as safe and secure.
You will have a private room for giving birth where you can
make yourself comfortable ...
wear your own clothing...
have nourishment when yo feel hungry...water birth.soak in a tub... and even have a
A Birth Center welcomes your children, your parents, and friends so you can decide who will be with you or near you as you give birth.
It is a place that gives you continuing support and information on infant care, breastfeeding, parenting, and family planning.National Birth Center Study 1989 published in New England Journal of Medicine 11,814 women admitted for labor and delivery to 84 free-standing birth centers 70.7 percent had only minor complications or none 7.9 percent had serious emergency complications during labor and delivery or soon thereafter, such as thick meconium or severe shoulder dystocia
One woman in six (15.8 percent) was transferred to a hospital 2.4 percent had emergency transfers 29 percent of nulliparous women and only 7 percent of parous women were trans- ferred, but the frequency of emergency transfers was the same.The rate of cesarean section was 4.4 percent. There were no maternal deaths. The overall intrapartum and neonatal mortality rate was 1.3 per 1000 births.
- What are the regulations for home birth?
In Indiana, Certified Professional Midwives are not regulated
2006, midwife Jennifer Williams was charged with practicing medicine without a license (a
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