Achieving Healthy Mother, Baby, and Family Unit

INTRODUCTION TO MATERNITY NURSING

Providing care to childbearing families is aimed at the ideal of having every pregnancy result in a healthy mother, baby, and family unit. The nurse today faces many evolving and challenging issues in achieving this goal. Such advances as in vitro fertilization and embryo freezing have afforded people opportunities once thought impossible. An increasing number of high-risk pregnancies result from such factors as drug abuse, acquired immunodeficiency syndrome, late or no prenatal care, teenage pregnancies, and pregnancies in women older than age 35. Technologic advances in high-risk obstetric units, fetal monitoring, sonography, and neonatal intensive care units are now providing the means to improve maternal health and save fetuses and infants who would not have survived years ago.

Today's childbearing families have many options. The planned birth may take place in the traditional hospital setting, a birthing center, or at home. The primary care provider may be a physician, a certified nurse-midwife, or a lay midwife. Birth-related choices commonly include the use of labor, delivery, and recovery rooms or labor, delivery, recovery, and postpartum rooms; various birthing positions and analgesic methods; alternative pain-relief strategies such as hydrotherapy; and the decision to allow children and others to be present during labor and delivery. Regionalization of obstetric services has provided childbearing families with access to the technologic advances and skilled personnel capable of managing pregnancy or neonatal complications.

Economic changes in the health care climate have dramatically affected the practice of nursing as cost-containment considerations have shortened the hospital length of stay. Many hospitals have adopted a practice of 12- to 24-hour discharge after delivery coordinated with home health care follow-up.

This combination of advancing technology, pregnancy risk factors, and changing economics challenges the nurse to be a highly skilled clinician and outstanding communicator.

 

TERMINOLOGY USED IN MATERNITY NURSING

• Gestation—pregnancy or maternal condition of having a developing fetus in the body.
• Embryo—human conceptus up to the 10th week of gestation (8th week postconception).
• Fetus—human conceptus from 10th week of gestation (8th week postconception) until delivery.
• Viability—capability of living, usually accepted as 24 weeks, although survival is rare.
• Gravida (G)—woman who is or has been pregnant, regardless of pregnancy outcome.
• Nulligravida—woman who is not now and never has been pregnant.
• Primigravida—woman pregnant for the first time.
• Multigravida—woman who has been pregnant more than once.
• Para (P)—refers to past pregnancies that have reached viability.
• Nullipara—woman who has never completed a pregnancy to the period of viability. The woman may or may not have experienced an abortion.
• Primipara—woman who has completed one pregnancy to the period of viability regardless of the number of infants delivered and regardless of the infant being live or stillborn.
• Multipara—woman who has completed two or more pregnancies to the stage of viability.
• Living children—refers to the number of children a woman has delivered who are living.

A woman who is pregnant for the first time is a primigravida and is described as Gravida 1 Para 0 (or G1P0). A woman who delivered one fetus carried to the period of viability and who is pregnant again is described as Gravida 2, Para 1. A woman with two pregnancies ending in abortions and no viable children is Gravida 2, Para 0.