Current trends in Maternity and Newborn Health Nursing


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Current trends in Maternity and Newborn Health Nursing
Introduction
In the changing scenario of health care system of today’s world, the trends in midwifery and obstetrical nursing are also changing. There are new advancements in care being provided, parenthood planning, national maternal health policies etc.
History
Midwifery is as old as the history of human species. Archaeological evidence of a woman squatting in childbirth supported by another woman from behind demonstrates the existence of midwifery in 500BC.
Hippocrates (460BC) the father of scientific medicine, organized trained and supervised midwives. Hippo-crates believed that the foetus has to fight its way out of the womb and the membranes. The midwives did not appreciate the efforts of Hippocrates. Aristotle, the father of embryology, described the uterus and the female pelvic organs. He also discussed the essential qualities of the midwife.
Leonardo da vinci made anatomical drawings of pregnant uterus. Ambroise Pare laid the foundation of modern obstetrics He performed internal podalic version and skilfully delivered women. Louise Pasteur in 1879 wrote a thesis on puerperal sepsis demonstrating the presence of streptococci in the Lochia, blood. There is much advancement in obstetrical nursing.
Current Trends
In our mothers and grandmothers days, an untrained woman, neighbours, relative or friend delivered most babies at home. All the changes started in 29th century, when parturition moved into the hospital setting. At that point, child bearing became far from a family affair.
The mother and newborn remained isolated from the family for a week to ten days, when family had only visiting privileges.
• Nursing was separated into three specialities, with one nurse caring for the mother during labour, and delivery, another handling postpartum mothers and third caring for the baby.
• In the year 1940s, ‘rooming in’ concept was devised.
• The advantages of the system included a reduction in neonatal infection from crosscontamination, increased confidence and independence for the mother and greater breastfeeding success.
• In 1960s, the focus changed from the person giving care to the recipient. With that change, came a change in terminology and obstetrical care became Maternity care.

• WHO offers definition of maternity care-‘the object of maternity care is to ensure that every expectant and nursing mother maintains good health, learns the art of child care, has a normal delivery and bears healthy children.
Technological Advances
As the technology has revolutionized and increasingly sophisticated computers in today’s world, it has become necessary for the nursing personnel to have thorough knowledge of the new technology being used.
• Due to this advancement, ‘the hands on care’ of the client is reduced, so also is the, quality nursing care.
• Today foetal monitoring has progressed from the use of fetoscope to electronic foetal monitors. It can be used both, directly and indirectly.
• Experts believe that in coming years, births are going to be by high-tech innovations, resulting in low prenatal mortality and morbidity.
• In future, there are challenges for nurses, as they will provide care in the world of high technology.
1. Increased Cost of High- Tech Care As the high and sophisticated technology is being introduced into today’s world, the costs are also increasing. For the procedures such as ultrasound, foetal monitoring etc, the couple has to pay good amount of money. Gradually, obstetric care is becoming a business for the care providers.
2. Changing Patterns of Child Birth
• There are increasing numbers of working women, until they are in there thirties.
• As early marriage practices still continue, both ends, the older and younger mothers face increased risks of complications during pregnancy, such as preterm delivery, LBW etc.
3. Family Centered Care Maternity care today has enhanced to family centered care. Definition of health include physical, social, psychological and economic dimension. Family centered approach is basic unit of society. Thus emphasis on his aspect is must that fosters family unity. Integration and bonding takes high priority and much anticipatory counselling is offered. 4. Rising Caesarean Birth Rates With the use of foetal monitoring and ultrasound for prenatal monitoring and ultrasound for prenatal evaluation of foetal condition, has come and increased rate of caesarean birth rates. 5. Early Discharge In earlier days, women were hospitalized for longer duration and physical activity was increased very gradually. Over the years now, however, health care personnel have realized that early return to normal activities is the best course for uncomplicated births. 6. Role of Fathers With increased societal emphasis on shared parenting and the recognition of parental bonding, many fathers are active in care giving and enjoy the closeness it brings.

7. Delayed umbilical cord clamping after birth Delayed cord clamping means waiting anywhere from 30 seconds to a few minutes to clamp and cut the umbilical cord instead of immediately following delivery. By delaying cord clamping, baby will get additional blood from mom, which contains oxygen-carrying iron stores. Although this is something that many midwives and doctors have been doing for a long time, it isn't universally practiced. ACOG has recently recommended that in healthy infants, cord clamping should be delayed at least 30-60 seconds.
8. Laboring in water(Water Birth)
Immersion in water can help decrease the need for an epidural or other pain medications in women with healthy, uncomplicated pregnancies. However, once it's time to begin pushing it's best to get out of the tub because delivering baby in the water hasn't been well studied and there have been reports of serious complications.
9.Cell-free DNA genetic screening
Cell-free DNA screening is the newest way to screen for genetic problems in the baby. This is a simple blood test that can detect pieces of the baby's DNA in mom's blood to determine if there may be a problem with the pregnancy.
10. Immediate postpartum IUD insertion
An IUD is one of the most reliable methods of birth control available. In the past, you would need to return to the office a few weeks postpartum to get an IUD. However now, immediately following birth, an IUD can be inserted, eliminating the need for an extra visit and an extra procedure.
11. Limiting interventions during low-risk labor
Physicians have gotten a bad reputation for unnecessary interventions during labor and delivery. While there are definitely times that interventions are needed for a safe delivery, limiting unnecessary interventions can also be beneficial. They are encouraging the use of doulas, changing positions during labor, intermittent monitoring and non-pharmacologic methods of pain control in conjunction with women's birth plans.

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Current trends in Maternity and Newborn Health Nursing