Maternity Nursing

Introduction:

The aim of maternity nursing care is to

have an ideal pregnancy result in a

healthy mother, baby and family unit

(drugs & tobacco, AIDS, STD,

violence.

Maternity nsg focuses on the care of

childbearing women and their families

through all stages of pregnancy and

childbirth, as well as the 1st 4 weeks

after birth.

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Definitions

Obstetric

It is the surgical specialty, branch of

medicine, dealing with the care of women and

their children during pregnancy (prenatal

period), childbirth and the postnatal period.

Midwifery is the non-surgical equivalent.

Gynaecology

Gynecology is coming from the Greek

word gynaikos, meaning woman. It is the

medical practice dealing with the health of the

female reproductive system (uterus, vagina,

and ovaries) as well as the male reproductive

organs. Literally, outside medicine, it means

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"the science of women". It is the counterpart to

andrology, which deals with medical issues

specific to the male reproductive system.

Almost all modern gynecologists are also

obstetricians.

Maternity Nursing

It is a delivery of nursing care to women

and their families during pregnancy and

parturition and through the first days of

the puerperium.

Maternity nursing includes extensive

instruction of mothers in the usual

behavior and needs of a newborn,

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expected patterns of G&D of the infant

during the first week.

It is concern with all aspects of maternity

care and focused on helping pregnant

women and families to meet health needs

associated with child bearing experience,

Maternal needs are those associated with:-

1) Avoiding and achieving pregnancies

by supported mother to make informed

decision.

2) Maintaining, Monitoring, or

Interrupting pregnancy

3) Pregnancy-related problems such as

gestational diabetes mellitus.

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4) The normal anatomic, physiologic and

psychological adaptation to pregnancy

and childbirth.

5) The care of mothers in labour and

delivery, as well as emotional support in

labor and delivery.

6) Ongoing observation for the onset of

abnormal signs or symptoms.

Maternity nurses are influencing:

- Quality and cost of care

- Environment in which care is given

- Social issues that affect the health &

welfare of clients and their families

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Maternity nursing includes prevention,

cure and rehabilitation. Nurses

interventions are directed toward:

a. promoting and maintaining health

b.early Dx and effective Rx

c. minimizing maternal and infant disability

d.encouraging and enabling clients and their

families to make informed decision

(counselling, teaching).

Roles of maternity nurse

1) Care Giver: holistic concept includes

creating an appropriate climate therapeutic

relationship for helping pregnant women.

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2) Teacher and Counsellor: maternity

preventive approach by teaching and

counselling; maternal self care and infant

care, BF, SBE, nutrition, ---

3) Advocator: The nurse encourages the

mothers to become aware of her health

care rights and responsibilities. Nurse is in

a position to explain, interpret, defend and

protect patient's rights according to

holistic approach of nursing health care

delivery (bio-psychosocial and spiritual

aspect).

4) Manager:

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The nurse participates in the management

of nursing care by:

Prioritizing patient’s needs

Directing the goals and intervention

toward prioritized patient’s needs

Organizing the delivery of care to

maximum benefit and minimum

expenses in time and material (cost

effectiveness).

5) Researcher:

Nursing research can improve the

quality of care that resulting provision

of efficient nursing care with a

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minimum cost to patient. Evidence

Based practice; evaluate findings.

Nurse-Patient Relationship:

Establishing an open, interactive and

therapeutic nurse-patient relationship is

essential for delivery of maternity nursing care

through application of nursing process as the

following:-

1. Assessment Stage:

Assessing patient health status

(physical and emotional health)

accurately. 9

Assessing women response to the

anatomical, physiological and

psychological changes associated with

pregnancy

Pregnancy status

Determining the women’s perceptions

and present level of adaptation to

pregnancy, childbearing and

parenthood.

Influence of life experience, value,

and beliefs of pregnancy related

behaviours.

2. Nursing Diagnosis Stage:

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Identifying client's level of

knowledge, actual and potential

individualized client needs and

problems in order to accomplish

mutual goals; accuracy of Dx depends

on the comprehensiveness of the

available data base.

3. Planning Stage:

Maternity nurse collaborates with the

client to establish mutual patient-

center goal.

Essential steps of planning phase are

prioritizing the nursing diagnosis and

selecting nursing intervention that will 11

be help the patient to achieve the

goals.

4. Implementation Stage:

This is the stage of put the plan into

action (goal directed care)

The maternity nurse initiates and

completes the intervention designed to

help patient to achieve the goals and

demonstrate the specified outcome

criteria

5. Evaluation Stage:

This stage involves reassessing client

status and behavior to determine the

progress toward the goals.12

To evaluate the progress and the effect

of nursing intervention, the maturity

nurse should compare the current

status, abilities and knowledge with

the previous assessment.

Terms related to pregnancy

Gestation: refers to the period of time

between conception and birth during

which the fetus grows and develops inside

the mother's womb.

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Gestational period: the time interval of a

gestation plus 2 weeks

Gestational age is calculated using

mothers’ date of the last normal menstrual

period (LMP) to estimate the length of

pregnancy at the time of infants’ born. To

calculate this, according to Nägele’s Rule,

add 7 days and then subtract 3 months

from LMP after adding one year.

Subsequently gestational age reflects the

length of time gestation plus 2 weeks that

the baby has spent developing in the

womb.

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Trimesters: A pregnancy is also counted in

terms of trimesters roughly divided into 3-

month segments: First trimester: First day

of LMP through 12 completed weeks;

Second trimester: 13 weeks through 27

completed weeks; Third trimester: 28

weeks through 40 completed weeks.

Multiple gestation: A pregnancy with

more than one fetus

Gravida (refers to pregnancy): a women

who is pregnant regardless of the outcome

of pregnancy

Nulligravida: a woman who is not now

and never has been pregnant.

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Primigravida: a woman pregnant for the

first time.

Multigravida: a woman who has had two

pregnancies or more.

Grand multigravida: a women that has

been pregnant for 5 or more times

Para (refers to delivery): the number of

times a woman has given birth

Nullipara: A woman who has not

completed a pregnancy with a

fetus/foetuses who have reached the stage

of viability (20/24 weeks of gestation;

500g).

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Primipara: A woman who has given birth

after 20 weeks of gestation one time.

Multipara: A woman who has had 2 or

more pregnancies.

Grand multipara: a woman who has given

birth 5 or more times.

1) Examples:

1.A woman pregnant for the first time is a

primigravida and is described as Gravida

1 Para 0.

2.A woman who has two abortions and

has no viable children is described as

Gravida 2 Para 0.

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GTPAL acronym: is a more

comprehensive system for notation of

obstetrical history. This system goes

further and designates numbers of term

infants, preterm infants, abortions, and

living children using the acronym GTPAL

as follows:

G= gravida

T = number of term infants born (after

37 weeks’ gestation)

P = number of preterm infants born

(between 20 weeks’ gestation and 37

weeks’ gestation)

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A = number of pregnancies ending

before 20 weeks’ gestation, either

spontaneous or induced (abortion)

L = the number of children currently

living.

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