CHANGING CONCEPTS IN MATERNAL-HEALTH CARE

 Maternity care has changed dramatically throughout the years as attitudes and opinions have
altered.
 Historically, maternity care was a function of lay midwives, and most birth occurred in the home
setting.
 As knowledge increased about birth interventions and physicians develop methods of infection
prevention, the family physician become the provider of choice for prenatal care and hospitals
instead of homes, became the accepted place to give birth.
 In today’s society, as the health care consumer has become more knowledgeable, two different
trends can be noted on one hand, as lawsuits have become more common with large judgments
being leveled against practitioners, maternity care has become increasingly specialized.
 Obstetricians often provide routine prenatal and delivery care.
 The at-risk clients are frequently followed by a perinatologist, a physician who specializes in the
care of women with high-risk pregnancies.
 Neonatologist provide expert with specialized care to at-risk newborns.
 On the other hand, the consumer movement has pushed for birth to be viewed as a natural process
in which little intervention is required.
 Therefore, the midwife has once again come to be accepted as a provider of maternity care, and
some women elect to deliver at home or in birthing centers, which provide a home-like
atmosphere.

MATERNAL-CHILD HEALTH TODAY

 One way to measure health status of a nation is to determine mortality rates of childbearing
women, infants and children.
 Mortality rates are statistics recorded as the ratio of deaths in a given category of the population.
 The statistics that are of interest to the maternity and pediatric nurse are maternal, fetal, neonatal,
perinatal (the period surrounding birth from conception throughout pregnancy and birth), infant
and child mortality rates.
 Morbidity refers to the number of persons afflicted with the same disease condition per certain
number of population.

Statistical Terms Used to Report Maternal and Child Health

 Birth rate: Number of births per 1000 population.
 Fertility rate: Number of pregnancies per 1000 women of childbearing age.
 Fetal death rate: Number of fetal deaths (weighing more 500 g) per 1000 live births.
 Neonatal death rate: Number of deaths per 1000 live births occurring at birth or in the first 28 days
of life.
 Perinatal death rate: Number of deaths of fetuses weighing more than 500 g and within the first 28
days of life per 1000 live births.
 Maternal mortality rate: Number of maternal deaths per 100,000 live births that occur as a direct
result of the reproductive process.
 Infant mortality rate: Number of deaths per 1000 live births occurring at birth or in the first 12
months of life.
 Childhood mortality rate: Number of deaths per 1000 population in children, 1 to 14 years of age.
THE NURSES CHANGING ROLE IN MATERNAL-CHILD HEALTH CARE
 The image of nursing has changed, and the horizons and responsibilities have broadened
tremendously in recent years.
 The primary thrust of health care is towards prevention.
 In addition in the treatment of disease and physical problems, modern maternal-child care
addresses prenatal care, growth and development and anticipatory guidance on maturational and
common health problems.
 Teaching also is an important aspect of caring for the child bearing and child-rearing family.
 Clients are educated on a variety of topics from follow up and immunization to other more
traditional aspects of health.
 Nurses at all levels are legally accountable for their actions and assume new responsibilities and
accountability with every advance in education.
 Nurses practicing in maternity and pediatric settings at all levels must keep up to date with
education and information on how to help their patients and where to direct families for help when
other resources are needed.
 When the nurse functions as a teacher, adviser and resource person, it is important that the
information and advice provided be correct, pertinent and useful to the person in need.
 Health teaching is one of the most important aspects of promoting wellness.
 Nurses are often in a position to do incidental teaching, as well as more organized formal teaching.
 Nurses also must be aware that they serve as role models to others in practicing good health habits.