Maternal and Neonatal Care

Because of its profound emotional implications for mother and child, maternal-neonatal care requires expertise that goes beyond clinical skills. Such care must combine clinical competence, sensitivity, and good judgment. It must consider the patient's sexuality and self-image and recognize changing social attitudes and values—especially those concerning conventional and alternative methods of conception and childbirth.

More than 4 million infants are born in the United States each year. Many are born with considerably less medical intervention than was customary in previous decades, and many were conceived with considerably more intervention. As a result, nurses today must be prepared to implement or assist with a wide range of procedures.

If you're working with a pregnant patient, you'll need to use your teaching skills. For instance, you may be called on to organize and direct natural childbirth classes or to teach the mother-to-be how to breathe and control pain during childbirth. You may teach fathers and other support persons to participate in childbirth by providing comfort and direction.

You may also be asked to give information about childbirth options. Although most births still occur in a hospital, many parents inquire about delivery in a birth center. Usually located on the maternity unit of a hospital or sponsored by a childbirth association, a birth center combines the advantages of a homelike setting with the emergency medical and nursing interventions available in a hospital. Today's nurse may staff or direct the birth center.

Historically, the midwife has been a fixture in remote or poor communities. Today's professional nurse-midwife, however, brings advanced technical skills and certification to diverse communities—urban center to country town alike. She may work in collaboration with—or be supervised by—a physician or a group. In some areas, she may even practice independently. In fact, several states permit insurers to make direct payment to the nurse-midwife for her services.

Accompanying the changes in maternity care are changes in neonatal care—thanks to advanced knowledge and techniques for improving fetal monitoring and promoting neonatal survival. New clinical evaluation methods, combined with new electronic and biochemical monitoring techniques, allow improved neonatal care. To make use of these advances, you must be familiar with neonatal physiology, procedures, and equipment.