Show:
Physiology and Pathophysiology
Nursing Implications
Nursing Cares
Measureable nursing outcomes
Take home message
100
When is the most likely time (and most dangerous time) for a mother to hemorrhage during the birthing process
What is After the baby is born and when the placenta is being delivered.
100
This common method of pain management is unavailable to the laboring woman outside the hospital setting.
What is epidural
100
What may have a role in reducing pain, increasing satisfaction with pain relief, and reducing the rate of assisted vaginal delivery
What is Lamaze breathing and relaxation techniques.
100
The percentage of successful home births among amish people over a 25 year period by CNMs
What is 94%
100
Noncephalic presentation, desire for pharmacological pain relief, meconium stained fluid, need for labor augmentation, eclampsia, prolapsed cord multiple fetuses, previous cesarean section, previous postpartum hemorrhage, maternal medical conditions (high blood pressure, diabetes)
What are risk factors that may disqualify a woman from having an outside of hospital birth?
200
What is the main cause of post partum hemorrhage?
Ineffective uterine contraction.
200
There is an increased risk of this for the baby, who has no immune system at birth
What is an infection
200
Person of differing genders, class, and sociocultural groups interpret what terms differently
Physical activity, exercise and leisure
200
The category of women who have the best outcomes with delivery assisted by midwives
low risk women had lower rates of medical intervention compared to hospital births
200
Lower rates of episiotomy, cesarean section, operative vaginal delivery, lacerations and maternal infection.
What are the benefits of outside of hospital births?
300
Out of hospital births is only an available option for who?
What is healthy women with normal pregnancies.
300
Giving birth in the home setting means that the midwife has no access to this, which helps her assess the baby.
What is electronic fetal monitoring
300
To avoid listeriosis pregnant women should not eat these items made from milk & cheese
What is Mexican style queso blanco, queso fresco, feta, camembert, blue cheese, brie, or if the cheese is made with unpasteurized milk.
300
Outcome of planned home births by a registered midwife compared to hospital births
low perinatal death ( 1in 1000 births) and reduced rate of obstetric interventions
300
Planned Birth Center Births, Planned Home Births, Unplanned Out of Hospital Births
What is three types of outside of hospital births?
400
A physiological birth
What is the term used for a completely natural birth?
400
A seizure experienced by a laboring woman may be caused by this, and is a serious complication that would be a cause of intrapartum transport in the hospital setting.
What is Preeclampsia
400
Risk of this increases 5 fold in women with BMI greater than 40
What is uterine rupture
400
The conditions of neonates in planned home births
Less frequency of LBW & prematurity compared to hospital births in low risk women
400
What is greater risk associated with home births?
Multiple studies have shown a two to three times greater risk of neonatal death associated with planned home births when compared to hospital births in the United States. Still, overall risk is low and risk to the mother is equivalent to in hospital births. This increased risk does not seem to be present in Birth Centers.
500
How long after birth does it take for the placenta to naturally be expelled
What is It can take anywhere from immediately after the infant’s birth to hours.
500
A breech birth is a complication that could be cause for this, a surgical procedure that is specific to child birth.
What is a cesarean section?
500
What is significantly related to martial status and infant weight of greater than 9 lbs in nulliparous (a woman who has never given birth) women.
What is episiotomy (relieve pain or risk of tearing and protect the perineum)
500
The two common non-pharmacological methods of pain management used by midwives during labor
paced breathing (55%) and activity (mobility) and position change (42%)
500
While the ACOG states that they support the right of women to choose where they will give birth and support planned Birthing Center births, they have strongly recommended against home births. The ACOG sites concerns about increased risk for neonatal mortality as well as a lack of randomized controlled trials (RCT) studying safety. However, some midwifes point out that RCTs would be difficult to obtain since most women would likely not be interested in their birth location being randomized. Midwives also point to several studies including a retrospective, nationwide, cohort study conducted in the Netherlands (where approximately 30% of births are at home) that found no difference in perinatal mortality between home births and hospital births.
What is the American College of Obstetrics and Gynecologists’ stance on outside of hospital births?