Birthing setting & alternative method of delivery > Establishing pregnancy > Maternal adaptations to pregnancy Flashcards
Is a mother-friendly based on, though its practices, if the hospital expects that birth is a normal, natural, and healthy process
Hospital birth
Is a mother-friendly based on, though its practices, if the hospital expects that birth is a normal, natural, and healthy process and a woman has the opportunity to:
a. experience a healthy and joyous birth regardless of her age or circumstances
b. give birth as she wishes in an environment in which she feels nurtured and secure.
c. receive accurate and up-to date information about the benefits and risk of a all procedures, drugs, and tests suggested for use during pregnancy, birth and the postpartum period, with the right to informed consent and informed refusal
d. receive support for making informed choices about what is best for her and her baby based on her individual values and beliefs.
explain hospital birth
provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of intervention and outcomes.
3. provides culturally competent care-that is ccare that is sensitive and responsive to the specific beliefs, values, and customs, of the mother’s ethinicity and religion.
4. provides a birthing woman with the freedom to walk, move about and assume the positions of her choice during labor and birth and discourages the use of the lithotomy position
6. Educates staff in nondrug methods of pain relief and does required to not promote the use of analgesic or anesthetic drugs not specifically correct a complication,
7.Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions,
8. Discourages nonreligious circumcision of the newborn.
Has clearly defined policies and procedures for:
a. Collaborating and consulting
throughout the perinatal period
with other maternity services.
b. Linking the mother and baby to appropriate
community resources, including prenatal and post-discharge follow-up and
breastfeeding support
c. Does not routinely employ
practices and procedures that are unsupported by scientific evidence such as routine perineal shaving
Promotes breastfeeding by:
a. having a written breastfeeding policy that is routinely communicated to all health care staff
b. educating all health care staff in skills necessary to implement this policy
c. Informing all pregnant women about the benefits and management of breastfeeding
d. Helping mothers initiate breastfeeding within
a half-hour of birth
e. Showing mothers how to breastfeed and how
to maintain lactation even if they should be separated from their infants
f. Giving newborn infants no food or drink other than breast milk unless medically indicated
g. Practicing rooming in to allow mothers and infants to remain together 24 hours a day
h. Encouraging breastfeeding on demand
i. Giving no pacifiers to breastfeeding infants
j. Fostering the establishment of breastfeeding support groups
Advantages breastfeeding
a. A woman is encouraged to be prepared to
control the discomfort of labor through nonmedication measures such as controlled breathing although anesthesia
such as an epidural is readily available.
b. A woman is encouraged to be
knowledgeable about the labor process and make decisions about procedures
performed
C.A woman is encouraged to consider
breastfeeding to aid uterine contraction and infant bonding after birth.
d. Labor, birth, and immediate postpartal care can all be scheduled in a single room.
e. A woman is attended by skilled professionals during labor and birth and the postpartal period.
f. Emergency care and extended highrisk care are immediately available.
Disadvantages of breastfeeding
a. Separation of the family for at least one
night.
b. Mother may not feel as much in control of
the childbirth experience as she may wish
c. Care may be fragmented, particularly if a woman’s physician is not present during the entire labor and birth, or if labor nurses change shifts in the middle of labor.
DEFINITION
Are wellness-oriented childbirth facilities designed to remove childbirth from the acute care hospital setting while still providing enough medical resources for emergency care should a complication of labor or birth arise:
Alternative Birthing Centers
Are wellness-oriented childbirth facilities designed to remove childbirth from the acute care hospital setting while still providing enough medical resources for emergency care should a complication of labor or birth arise:
a. the birth attendants tent to be nurse-midwives
b. women who deliver in ABCs are screened for complications before being admitted
c. Like hospitals, ABCs have LDRP rooms
where a woman and her support person can invite friends and siblings
to participate in the birth
d. A minimum of analgesia and anesthesia is
provided, and she can choose a birth position
e She can bring her own music or distraction objects, and the partner can perform such tasks as cutting the
umbilical cord he or she chooses
f. Women remain in an ABC from 4 to 24 hours after birth
Advantages
a. A woman is encouraged to be prepared to control the discomfort of labor through nonmedication measures such
as controlled breathing
b. A woman is encouraged to be
knowledgeable about the labor process and to help care providers with decision making
c. A woman is encouraged to breastfeed to aid uterine contraction and infant bonding after birth.
d. Family integrity can be maintained because family members may accompany a woman to the birthing
center
e. A woman is attended by skilled professionals during labor and birth
f. Emergency care is immediately available. Extended High-risk care is easily arranged
disadvantages
a. Extended high-risk care is not immediately available
b. A woman may be fatigued after birth because of brief health care setting stay.
c. She must independently monitor her postpartal status because of brief health care setting stay
Refers to a women giving birth without any health care provider supervision also refer to it
a unassisted birth or couples birth
Free birthing
Are methods of childbirth delivery that avoids invasive modern medicine in favor of more natural and homely settings
Alternatives methods of birth
it is kept pleasantly warm, mot chilled. Soft music is played, or at least harsh noises are kept to a minimum. The infant is handled gently, the cord is cut late; and the infant is placed immediately after birth into a warm water bath.
Laboyer method
Reclining or sitting in warm water during labor can be soothing. The baby is born underwater and then immediately brought to the surface for a first birth
Hydrotherapy and Water birth
Potential difficulty for water birth
contamination of the bath water with feces expelled with pushing efforts during the second stage of labor could leat to uterine infection in the mother or aspiration of contaminated bath water by a newborn, which could lead to pneumonia.
Advantages of home birth
a. knowledgeable about the birth process and be an active participant in independently reducing the discomfort of labor
b. has the greates freedom for expressing her individuality
c. there is no seperation of the family at birth
d. a skilled professional can attend the birth
Advantages of home birth
a. knowledgeable about the birth process and be an active participant in independently reducing the discomfort of labor
b. has the greatest freedom for expressing her individuality
c. there is no separation of the family at birth
d. a skilled professional can attend the birth
Disadvantage of home birth
a. adequate equipment other than first-line emergency equipment is unavailable
b. an abrupt change of goals is necessary if hospitalization is required.
c. a woman and support person may become exhausted because of the responsibility placed on them
d. interference with the “taking-in-phase” may occur postpartally because a woman must take hold
e. a woman must independently monitor her postpartal status.
of pregnancy occur gradually but eventually affect all of a woman’s organ systems
Physiologic changes
Changes that are necessary to allow a woman to be able to provide oxygen and nutrients for her growing fetus as well as extra nutrients for her own increased metabolism during the pregnancy
Physiologic changes
of pregnancy occur in response not only to the physiologic alterations that are happening but also to the increased responsibility associated with welcoming a new and completely dependent person into a family
Psychological changes
Physiologic changes that occur during pregnancy can be categorized as:
local and systemic
Physiologic change confined to the reproductive organs
local
physiologic change affecting the entire body
systemic
Both symptoms (____) and signs (_____) of the physiologic changes of pregnancy are used to diagnose and mark the progress of pregnancy
subjective findings ; objective findings
are subjective and recorded under history of present illness
presumptive signs
of pregnancy are objective and recorded as physical assessment findings
probable and positive signs
Presumptive includes:
-amenorrhea
-breast changes-more erect
-ereolas darken and increase in diameter
-colostrum is formed
-montgomery gland become bigger
-skin changes: presence of choasma/melasma (due to hyperpigmentation in the face and armpit)
-linea negra and striae gravidarum
- there is morning sickness
- frequence of urination and
-dizziness can be the first sign of pregnancy
probable includes
enlargement of the abdomen-umbilicus push out.
-chadwick’s sign-deep purple/violet discoloration of the vagina due to increased vascularity
-goodell’s signs-cervix becomes more vascular and edematous (softening of cervix)
- hegar’s sign (softening of the lower uterine segment)
-braxton hick’s contraction, ballotment -( bounching back of the uterus)
- changes in the level of HCG
-quickening (1st uterine contraction during pregnancy)
-positive pregnancy test
(softening of cervix)
edematous
(softening of the lower uterine segment)
hegar’s sign
-( bounching back of the uterus)
ballotment
(1st uterine contraction during pregnancy)
quickening
-fetal heart tone can be heard or auscultated
-fetal movement felt by the examiner and outlining of the
-fetal body through sonography evidence
Positive
MATERNAL ADAPATATIONS TO PREGNANCY 1ST TRIMESTER
A. ambivelence, fear, fantasies, and anxiety
b. pregnant woman places main focus on self
MATERNAL ADAPATATIONS TO PREGNANCY 2ND TRIMESTER
a. tranquil period
b. acceptance of the reality of pregnancy
c. increased interest in fetus
MATERNAL ADAPATATIONS TO PREGNANCY 3RD TRIMESTER
a. anticipates labor and delivery; assumes mothering role
b. fantasies and dreams about labor common
c. nestling behaviors
Physiologic changes that occur during pregnancy can be categorized as local or systemic.
Development task of pregnancy
“I am pregnant”
Acceptance of the biological fact of pregnancy
” I am going to have a baby”
Acceptance of the fetus as a distinct individual and a person to care for
“I am going to be a mother”
prepare realistically for the birth and parenting of the child
includes an extensive health history, a complete physical examination, including a pelvic examination and blood and urin speciments for laboratory work. Manual pelvic measurements can be taken to determine pelvic adequacy
Screening
purpose of pelvic adequacy
- obtain history
- medical history
- obstetric history
- history of current pregnancy
- determine gravity and parity
- physical exam including pelvic exam
- calculate edc and aog
- vital signs
” if on subsequent visits a symptom is mentioned, establishing a baseline health picture at the initial pregnancy allows you to be able to verify that it is truly a new symptom and a woman is not just becoming more aware of it:
components of initial visit
chief concern for coming to the health care facility
history taking
Information about a woman’s current nutrition, elimination, sleep, recreation, and interpersonal interactions, can be elicited best by asking a woman to describe a typical day of her life. I f any of this information is not reported spontaneously as she describes her day, ask for additional details
Personal data
Below ___ are at risk for anemia, CPD, congenital deformity
15
Above ___ are at risk for HPN, DM, Placenta previa and Abruptions placenta, C/S, ectopic pregnancy, fetal growth retardation, macrosomia, down syndrom
35
Below ___ lb is at risk for prematurity, low birth weight infant, stillbirth and congenital defects
95
_____ prone to develope DM, HPN, and thrombophlebitis
Obese
