Antepartum 1 Issues and trends Flashcards
MATERNAL MORTALITY
- US: dramatic decrease over last century (long term)
- but trending increase over last several decades
- significant difference in maternal mortality rate of non Hispanic /black compared to non Hispanic whites
TRENDS IN BIRTH
BIRTH RATE: # of live births per 1000 people in a given population .
- 2014- 12.5 per 1000 population, number of births :3,988,076
- US in 2012 saw the most significant decrease in birth rate since early 1970’s small increase in 2014-1%
- US is #159 in the world as of 2016
- birth rates dropped in 2015 to record lows among women under age 30 and rose for those aged 30-44
GLOBAL REPORT CARD MATERNAL MORTALITY
-MATERNAL MORTALITY RATE: # of deaths from any cause related to or aggravated to or aggravated by IUP or IUP management (including 1st 42 days pp) per 100,000 live births
OUR REPORT CARD INFANT MORTALITY
- infant mortality rate -number of deaths of infants under 1yo per 1000 live births in a given population
- globally declining
- US: the infant mortality rate decreased 2.3% in 2014 from 2013 to a historically record low value of 5.82 deaths per 1000 live births
- US ranked 32nd among industrialized nations. total # countries studied= 34 important indicator for health of nation
- US high % of preterm births
TRENDS
cesarean birth rate (c/s) increase by almost 60% since 1997
currently 32.2%
THE 3 DELAYS
- delay in deciding to seek care
- delay in reaching care in time
- delay in receiving adequate treatment
ISSUES
- managed care organizations face challenge
- integrating essential community providers of unique services for women with special needs adolescents, women with disablilities, minorities
- 2011 1/5 of reproductive aged females were uninsured (21.3%)
EFFORTS TO DECREASE MMR AND IMR
- adequate/early prenatal care
- folic acid for women of childbearing age
- avoiding tobacco/alcohol
- regular physical activity/nutrition
- effective identification/referral of at risk patient
- decrease elective early delivery prior to 39 weeks
NURSES ROLE
Holistic: focus on care of childbearing women and families: pregnancy, childbirth and post partum,
-ambulatory clinics,hosp,birth center,homes
- prenatal/intrapartum/postpartal care
- teaching: preg,childbirth,breastfeeding, newborn care classes
- perioperative/ postoperative
- newborn/nicu care
NURSES RESPONSIBILITY
- bedside care,supervision, research
- patient education
- patient advocate
- consider all variables
- minimize psychological and physical stress
- maintaining competency and advancing skills
EDUCATION OF NURSES CARING FOR CHILDBEARING FAMILIES
- nurses of varying levels of education and specialization work together to provide care for childbearing families
- lifelong learning is a part of every nurse’s reality in today’s world
LEGAL CONSIDERATIONS
- functioning within scope of practice
- standards of care/practice in perinatal nursing:protect public and are used to judge quality of care
CLIENT RIGHTS
- informed consent:autonomy and self determination
- what is the nurse’s role?
- documentation: evidence that nurse adhere to acceptable standards of care,provided education, interventions, evaluation and reported client needs appropriately
OTHER CLIENT RIGHTS
RIGHT TO SAFETY:
QSEN standards in nursing education nursing awareness of and implementation of national safety goals
RIGHT TO PRIVACY HIPPA:
availability of technology and internet increased need for advocacy and communication by the nurse
ETHICAL ISSUES
-innovations and allocation of resources intrauterine fetal surgery fetoscopy therapeutic insemination genetic engineering stem cell research surgery for infertility surrogate childbearing treatment of very low birth weight babies
