Care of the Mother and Fetus

Lesson
during the Prenatal period 3
What is this lesson all about?
Prenatal care is the foundation of a healthy pregnancy, labor and delivery. Early
and regular prenatal care is very important to the health of the baby and mothers
health during pregnancy. Studies also show that compared with babies whose mothers
get prenatal care, those who don't have a greater risk of low birth weight and of death.

Intended Learning outcomes: After studying this lesson you should be able to:

1. Define the terminologies used in maternal nursing.

2. Differentiate presumptive signs of pregnancy from probable signs to
positive signs of pregnancy.

Let’s study

Assessing and admitting a pregnant woman

Terminologies used in Maternal Nursing:
1. Ante – before
2. Antepartum – time before delivery
3. Gestation – pregnancy or maternal condition of having developing fetus in the
body.
4. Embryo – human conceptus up to 10th week gestation until delivery
5. Fetus – human conceptus from 10th week gestation (8th week post conception)
6. Viability – capability of living, usually accepted as 24 weeks although survival
rate is rare.
7. Gravida (G) – a woman who is or has been pregnant, regardless of pregnancy
outcome.
8. Nulligravida – a woman who is not now and never has been pregnant.
9. Primigravida – a woman pregnant for the first time.
10. Multigravida – woman who has been pregnant more than once.
11. Para (P) – refers to past pregnancies that have reach viability.
12. Nullipara – woman who has never completed pregnancy to a period of viability.
The woman may or may not have experienced an abortion.
13. Primipara – a woman who has completed 1 pregnancy to the period of viability
regardless of the number of infants delivered and regardless of the infant being
live or stillborn.
14. Multipara – woman who has completed two or more pregnancies to the stage of
viability.
15. Living children – refers to the number of living children a woman has delivered
regardless of whether they were live births or stillbirths.
16. Postterm or postdate pregnancy – one that extends beyond the end of week of
gestation, or 294 days from the first day of the last menstrual period.
 17. Preterm labor – cervical changes and uterine contractions occurring between 20
– 37 weeks of pregnancy.
18. Preterm birth – any birth that occurs before the completion of 37 weeks of
pregnancy.
19. Labor – a series of processes by which the fetus and placenta is expelled from
the uterus.
Pregnancy can be broken down into three periods:
 The antepartum period/antepartal/prenatal refers to the period from
conception to the onset of labor.
 The intrapartum period/intrapartal period extends from the onset of
contractions that cause cervical dilation to the first 1 to 4 hours after the birth of
the neonate and delivery of the placenta.
 The postpartum period/postpartal/puerperium refers to the 6 weeks after
delivery of the neonate and the placenta. Also known as the puerperium, this
stage ends when the reproductive organs return to the nonpregnant state.
Always remember that Duration of Pregnancy averages 280 days or 40 weeks (10 th
Lunar months; 9 calendar months) from the first day of the last normal
menstrual period.
Duration of pregnancy may also be divided into 3 equal parts, or trimesters. Of
slightly more than 13 weeks or 3 calendar months each.
PHYSIOLOGICAL CHANGES/ADAPTATIONS IN PREGNANCY
Terminologies of Pregnancy
Gravida – number of times pregnant, regardless of duration, including the
present pregnancy.
a. Nulligravida – a woman who is not now and never has been pregnant.
b. Primigravida – pregnant for the first time
c. Multigravida – pregnant for second or subsequent time.
Para – number of pregnancies that lasted more than 20 weeks, regardless of
outcome.
a. Nullipara – a woman who has not given birth to a baby beyond 20 weeks
gestation.
b. Primipara – a woman who has given birth to one baby more than 20 weeks
gestation.
c. Multipara – woman who has completed two or more pregnancies to the
stage of viability
 Physiologic and Psychologic Lesson
Changes in Pregnancy 4
What Is This Lesson About?
During pregnancy, a woman undergoes many physiologic and psychosocial
changes. Her body adapts in response to the demands of the growing fetus while her
mind prepares for the responsibilities that come with becoming a parent.
Physiologic changes initially indicate pregnancy; these changes continue to
affect the body throughout pregnancy as the fetus grows and develops. Psychosocial
changes occur in both the mother and father and may vary from trimester to trimester.

Intended Learning Outcomes: After studying this lesson you should be able to:
1. Describe the common physiologic and psychologic changes that occur with
pregnancy and the relationship of the changes to pregnancy diagnosis.

Let’s Study
Psychological Changes in Pregnancy -is always associated with changes in
psychological functioning of pregnant women.
It is usually associated with ambivalence, frequent mood changes, varying from
anxiety, fatigue, exhaustion, sleepiness, depressive reactions to excitement.
Pregnancy is such a huge change in a woman’s life that it brings about more
psychological changes than any other life event besides puberty (Rojas, Wood, &
Blakemore, 2007)
Assessment:
Social Influences
 Before, conveyed the idea that pregnancy was a 9-month-long illness.
 Today, health care settings view pregnancy as a time of health.
 Nurses plays a major role.
 instead of coming alone for prenatal care, women now bring their families.
Cultural Influences
 A woman’s cultural background may strongly influence how active a role she
wants to take in her pregnancy, because certain beliefs and taboos may place
restrictions on her behavior and activities (Andrews & Boyle, 2007).
 To learn about the beliefs of a particular woman and her partner.
 Every culture circulated entails explanations about what people thought caused
complications of pregnancy.
Individual Influences
 A woman’s ability to cope with or adapt to stress plays a major role in how she
will resolve conflict and adapt to the new life contingencies that are coming.
Family Influences
 The family in which a woman was raised can be influential to her beliefs about
pregnancy because it is part of her cultural environment.
Common Psychosocial Changes That Occur with Pregnancy
First Trimester
Task: Accepting the pregnancy
 Woman and partner both spend time recovering from shock of learning they are
pregnant and concentrate on what it feels like to be pregnant.
 A common reaction is ambivalence, or feeling both pleased and not pleased
about the pregnancy.
Second Trimester
Task: Accepting the baby
 Woman and partner move through emotions such as narcissism and introversion
as they concentrate on what it will feel like to be a parent.
 Roleplaying and increased dreaming are common.
 As soon as fetal movements can be felt, psychological responses of both
partners are apt to change
Third Trimester
Task: Preparing for the baby and end of pregnancy
 Woman and partner prepare clothing and sleeping arrangements for the baby but
also grow impatient with pregnancy as they ready themselves for birth.
 A good way to measure the level of a woman’s acceptance of the coming baby is
to measure how well she follows prenatal instructions.
Pregnancy produces several types of physiologic changes that must be evaluated
before a definitive diagnosis of pregnancy is made. The changes can be:
 Presumptive (subjective)
 Probable (objective)
 Positive.
Neither presumptive nor probable signs confirm pregnancy because both can be
caused by other medical conditions; they simply suggest pregnancy, especially when
several are present at the same time

Memory jogger
To remember the three categories of pregnancy signs, think of the three Ps:
Presumptive—Think of a presumptive sign as one that suggests, “If I had to guess, I’d
say yes!”
Probable—Think of a probable sign as one that means, this lady is most likely going to
give birth!
Positive—Think of a positive sign as one that confirms, in about 9 months, this woman
is going to have a baby!
PHYSIOLOGICAL CHANGES/ADAPTATIONS IN PREGNANCY
Terminologies of Pregnancy
Gravida – number of times pregnant, regardless of duration, including the
present pregnancy.
a. Nulligravida
b. Primigravida
 c. Multigravida
Para – number of pregnancies that lasted more than 20 weeks, regardless of
outcome.
d. Nullipara
e. Primipara
f. Multipara
Presumptive Signs of Pregnancy – more subjective signs cannot be
used to diagnose pregnancy. Recall FANS BVQUW
 F-
 A-
 N-
 S-
 B-
 V-
 Q-
 U-
 W–

Probable Signs of Pregnancy – objective signs results of vascular congestion

in pelvis. Recall PH CAB BUG
 P–
 H-
 C-
 A-
 B-
 B-
 U-
 G-

Positive Signs of Pregnancy – absolute indicators of pregnancy, recall FFUX

 F-
 F-
 U-
 X-