Nursing Care of Child Bearing Families Session 1+2:

Its the first session of OB! This is a great start to the class, and the first two sessions honestly started off somewhat slowly due to forces out of our control. The notes are short due to this, and there is a lot of information that is not a part of this, and it should only be supplemental for your studying.

-Peter

OB/GYN

Session 1

the U.S. is 50 out of 50 for industrialized nations for Maternal mortality

  • no consistent prenatal care

Labor induced is not the safest birth type

  • 50% increase in the chance of a c-section

39-42 weeks is the normal term of pregnancy

Childbirth in the U.S. is NOT safer now than ever before.

95% of deliveries in the 1800-1900 are at the home, and usually done by midwives.

1912 Flexnar report’s take power away from midwives, given to doctors.

1920’s medicated births

  • increase in infant mortality rates during/after this but due to birth injury and fever.

1935  antibiotics for fever

Session 2

Attendants

  • FOC is father of child
  • Doula – a medical information/positional/emotional resource that is on call 2 weeks before the due date up until the birth and some time after.

ethical issues –  maternal/fetal conflict, assisted reproductive tech, abortion, stem cell research, when to resuscitate a preterm on the edge of viability

The pregnancy related mortality ratio is going up in the US and is 31st in developed countries.

  • need access to prenatal care

A low birth weight baby can be full term or otherwise

Do not assume that a pregnant woman knows specific information about pregnancy

  • no drinking is ok during pregnancy

Morbidity and mortality

  • Maternal
  • Infection, Hemorrhage, HTN, Embolism
  • Neonatal/Fetal
  • Congenital anomalies, short gestation/low birthweight, SIDS, Consequences of maternal Dx, Unintentional injuries.

pre birth cervix looks like a doughnut with a dot/hole (os) in the middle. after pregnancy the hole tends to look like a slit.

effacement – the distance between the internal and external os decreases

Ligaments hold up the uterus (round ligament) and stretch to accommodate the weight and size

  • can cause pain.

retroverted uterus – uterus pointed backwards.

symphysis pubis – cartilage connection of the pelvis in the anterior

More than one ductal opening on the nipple. 15-20.

estrogen types

  • Estradiol
    • in the reproductive years
  • Estriol
    • only during pregnancy
  • Estrone
    • Menopause

Progesterone

  • hormone of pregnancy

FSH – stimulates the follicle and that allows the egg to mature

LH – Converts the empty follicle that produced the egg into the corpus luteum, which supports

Ovarian cycle

  • follicular Phase days 1-14
  • growth of follicle
  • estrogen dominance
  • LH surge releases the egg
  • variable amount of time
  • Luteal Phase 15-28
  • Progesterone dominance

Menstrual cycle

  • Menstrual cycle (bleeding)
  • Proliferative phase
    • estrogen dom
  • Secretory phase
    • Progesterone dom
  • ischemic phase if no pregnancy
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