Maternity 6-1 Flashcards
Anesthesia introduced - what year?
1847
1940′s
Women labored in large maternity wards and told to keep quiet.
Women delivered in sterile delivery rooms with only staff present.
Routine enema/pubic shaving
10-day hospital stay on bedrest
Lithotomy position (stirrups lying on back) routine/Forceps use frequent
Mothers were separated from their babies to prevent infection.
1942 : Grantley Dick-Read published Childbirth Without Fear.
affordable care act
Requires all qualified health plans to cover maternity care and childbirth
Covers 22 preventative services for women
Health insurance plans must provide breastfeeding support, counseling, and equipment for the duration of breastfeeding
The Affordable Care Act amended the Fair Labor Standards Act (FLSA) requiring employers to give allow sufficient break time for a mother to pump in a place that is not a bathroom
native american, native alaskan, black
have the worst mortality rates
Maternal
Maternal: number of deaths of any cause during pregnancy/100,000 live births
Fetal (you’re a fetus at 20)
Fetal: number of fetal deaths (over 20 weeks) in 1,000 live births
Neonatal
Neonatal: number of infant deaths (in first 28 days) in 1,000 live births
Infant
Infant: number of infant deaths (in first 12 months) in 1,000 live births
Causes of Maternal Mortality
- Heart disease and stroke
Heart disease and stroke caused more than 1 in 3 deaths overall
Causes of Maternal Mortality
- Obstetric emergencies (most common at time of birth)
Obstetric emergencies, like severe bleeding and amniotic fluid embolism (amniotic fluid enters a childbearing person’s bloodstream), caused most deaths at delivery.
Causes of Maternal Mortality - cardiomyopathy (cardio after birth)
Cardiomyopathy (weakened heart muscle) was the leading cause of deaths 1 week to 1 year after delivery
Opioid overdose now
leading cause of infant mortality in some states.
trends in family centered care
Patients empowered to make own decisions regarding pain management
Doulas
Choice of provider
Choice of where to deliver
Breastfeeding
Options and culture around birth varies regionally and among hospitals
length of hospital stay
24-48 hours for a vaginal birth
48-72 hours for c/s
Focus on Outpatient education
healthy ppl 2030
Reduce the rate of fetal and infant deaths
Reduce the rate of maternal mortality
Reduce preterm births
Reduce cesarean births among low risk birthing people.
family
two or more persons joined by a common bond of sharing and emotional closeness
culture
beliefs or guidelines shared by a group which dictate how individuals relate to larger society
Not static, ongoing
cultural humility
To practice cultural humility is to maintain a willingness to suspend what you know, or what you think you know, about a person based on generalizations about their culture
SRE
Infant discharged to the wrong person
Infant abduction
Maternal death or serious disability associated with labor or birth in a low risk pregnancy while being cared for in a health care facility
Death or serious disability (kernicterus) associated with failure to identify and treat hyperbilirubinemia in neonates
Circumcision without pain relief measures
Missed administration of RhoGam
Standard of Care
Standard of Care: that level of practice that a reasonably prudent nurse would provide in the same or similar circumstances.
national safety patient goals (the nation identifies communication w/ medicine to prevent infection for safety and surgery)
Identify patients correctly
Improve staff communication
Use medicines safely
Prevent infection
Identify patient safety risks
Prevent mistakes in surgery