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1. 2022-2023
Women’s Health Nursing
Introduction to Women’s
Health Nursing
Presenter(s):Dr. Nadia Eltohamy

2. Student Learning Outcomes (SLOs)
Topic: Student Learning Outcomes (SLOs)
2
 At the end of this lecture the students should be able to :
 Identify concepts related to Maternity.
 Mention the goals of maternal and child health nursing.
 Describe Philosophy of Maternal and Child Health Nursing
 Analyze Framework for MCH Nursing
 Define common statistical terms used in the field, such infant and
maternal mortality.

3. Introduction
• Women’s health care focuses on the physical, psychologic, and social needs of
women throughout their lives.
• Poverty, rape, family violence, and human trafficking are considered
sociocultural and occupational factors that are related to women’s health
problems
• Women’s health nurses specialize in and investigate conditions unique to women
(such as reproductive malignancies and menopause)
• They also provide care for women and their families during the childbearing
cycle.

4. Common terms relate to pregnancy and birth
Maternity Care
 Is the care, support, instruction, and health promotion
given by nurse to the expectant women, partner, and
family during pregnancy and labor and after birth .

5. Common terms relate to pregnancy and birth
 Antepartum - is the period from conception to the
onset of labor.
 Intrapartum - period from the onset of contraction
that cause cervical dilatation to the first 1- 4 hrs after
the birth of the neonate and placenta.
 Postpartum (Puerperium) - the 6-week period after
delivery of the neonate and placenta which ends when
the reproductive organs return to non pregnant state

6. Goal of Maternal-Neonatal Nursing
 Promotion and maintenance of optimal family health to
ensure cycles of childbearing.
 Provide comprehensive family-centered care to the
pregnant woman and her fetus or neonate during the
antepartum, intrapartum, and postpartum periods.

7. Philosophy of Maternal and Child Health
Nursing
 Maternal and child (MCH)health nursing is family centered
(assessment include individual family member).
 Maternal and child health nursing is community centered
(it depends and influence the community health).
 MCH is research oriented, because research is the means
whereby critical knowledge increases.
 A maternal and child (MCH) health nursing serves as an advocate
to protect the right of all family member including the fetus.
 MCH nursing includes a high degree of independent nursing
functions.
 Both nursing theory and evidence-based practice provide a
foundation for nursing care.

8. Framework for MCH Nursing
 MCH nursing can visualized within a framework in
which nurses, using nursing process, nursing theory,
and evidence-based practice.
 Care during childbearing can be through these phases:
1.Health promotion
2.Health maintenance
3.Heath restoration
4.Health rehabilitation

9. Phases of Health Care
Health Promotion
 Educating clients to be aware of good health through
teaching and role modeling
Example:
Teaching women the importance of rubella immunization
before pregnancy.

10. Phases of Health Care
Health maintenance
 Intervening to maintain health when risk of illness is
present
Example:
Encouraging women to come for prenatal care;

11. Phases of Health Care
Health Restoration
 Promptly diagnosing and treating illness using interventions that
will return client to wellness most rapidly
Example:
• Caring for a woman during a complication of pregnancy or a child
during an acute illness

12. Phases of Health Care
Rehabilitation
 Preventing further complications from an illness; bringing ill client
back to optimal state of wellness or helping client to accept
inevitable death
• Example:
• Encouraging a woman with vesicular mole disease to continue
therapy .

13. MCH Nursing Today
 In the past, the infant mortality rate in the USA was
greater than 100 per 1000.
 In response to effort to lower this rate, health care
shifted from a treatment focus to a preventive one
 e.g., early prenatal care, breast feeding, immunization
and injury prevention as well as technological advances

14. Maternal-Neonatal Nurses Practice in Various
Settings
 Community based health centers
 Private physicians' centers
 Hospital clinics
 Acute care hospitals
 Maternity hospitals
 Birthing centers
 Private homes

15. Providers of Maternity Care
 Certified Nurse-Midwives (CNMs): registered professional nurses who
have completed an advanced program approved by the American
collage of nurse – midwifes.
 Nurse Practitioners: clinical nurse specialists who completed a
master program in the area of woman’s health
 Obstetricians/gynecologists
 Pediatricians
 Neonatologists
 Lactation specialists

16. Function of Maternal & Neonatal Nursing
 Health Education (about childbirth and preventive
medicine)
 Physical examination
 Pregnancy history
 High-risk patient follow-up
 Patient care
 Delivery
 Neonatal assessment and examination
 Discharge planning

17. Critical Thinking Challenges
• Which of the following is the best statistical indicator of the
adequacy of prenatal care?
A. Fertility rate
B. Maternal mortality rate
C. Infant mortality rate
D. Abortion rate

18. Critical Thinking Challenges
• Rationale: Maternal mortality rate is the best indicator of a country’s
prenatal care. Increases in prenatal care result in a decrease in
maternal mortality

19. Sentinel Events
• Sentinel event as an unexpected occurrence involving death or
serious physical or psychological injury.
• Seriou's injury specifically includes loss of limb or function.
• These events are called sentinel because they signal a need for an
immediate investigation and response.

20. Sentinel Events
Reportable sentinel events in perinatal nursing include :
• Any maternal death related to the process of birth; any perinatal death
unrelated to a congenital condition in an infant having a birth weight
greater than 2500 g.
• Severe neonatal hyperbilirubinemia (bilirubin greater than 30 mg/dl).
• Infant discharge to the wrong family
• Blood group incompatibilities.
• Leaving a foreign body (e.g., sponge or forceps) in a client after
surgery.
• Falls that result in death or major permanent loss of function

21. Complications in pregnancy
 Complications in pregnancy can result from conditions that are specifically
linked to the pregnant state as well as conditions that commonly arise or occur
incidentally in women who are pregnant.
 Include miscarriage, preterm labor or premature rupture of membranes,
premature birth, stillbirth, low birth weight, macrosomia, birth defects, and infant
and maternal morbidity or death.
 Complications affecting mother and fetus may arise at any stage of pregnancy,
during labor, or postpartum.
 Prenatal care is a key component of a healthy pregnancy.
 Regular prenatal care helps to identify and treat complications and to promote
healthy behaviors.

22. ETHICAL CONSIDERATIONS OF PRACTICE
 Ethical issues are increasing in frequency in health care today.
 Some of the most difficult decisions in health care settings are those that involve
children and their families.
 The following are just a few of the major potential conflicts:
 Conception issues, especially those related to in vitro fertilization, embryo
transfer, ownership of frozen oocytes or sperm, cloning, stem cell research, and
surrogate mothers
 Abortion
 Fetal rights versus rights of the mother
 Use of fetal tissue for research
 Resuscitation (for how long should it be continued?)
 The balance between modern technology and quality of life

23. Measuring Maternal and Child Health
Nursing
 A number of statistical terms are used to express the
outcome of pregnancies and births and describe maternal
and child health.
 Statistics for these terms require accurate collection and
analysis so the nations health can describe accurately.
 Such statistics are useful for comparison and planning of
future health care needs .

24. Common Statistical Terms
 Birth rate
 Fertility rate
 Fetal death rate
 Neonatal death rate
 Perinatal death rate
 Maternal mortality
 Infant mortality

25. Common Statistical Terms
 Birth rate is the number of births per 1000 population,
also known as the crude birthrate.
• Fertility Rate
 It the number of births per 1000 women aged 15 – 44
years .
 The term fertility rate is reflected what proportion of
women who could have babies are having them

26. Common Statistical Terms
Fetal Death Rate
 Is defined as the fetus death in uterus weighing 500g or more of 20 weeks
or more gestation per 1000 live births per year.

 It may occur because of maternal factors:
1. maternal disease
2. premature cervical dilatation
3. maternal malnutrition
•
 Fetal factors:
a. fetal disease
b. chromosome abnormality
c. poor placental attachment

27. Common Statistical Terms
Fetal Death Rate (cont.)
• The fetal death rate is important in evaluating the health of
the nation because it reflect the over quality of maternal
health and prenatal care

28. Common Statistical Terms
Neonatal Death Rate
 The number of deaths of infants younger than 28 days per 1000
live births per year.
 The first 28 days of life are known as the neonatal period,
and an infant during this time is known as a neonate.
 It reflects not only the quality of care available to women
during pregnancy and children birth but also the quality of
care available to neonate during the first month of life.

29. Common Statistical Terms
Perinatal Death Rate
 Statistically, the period is defined as the time beginning
when the fetus reaches 500g (about week 20 of pregnancy)
and ending about 4 weeks after birth.
 The perinatal death rate is the sum of the fetal death rate
and neonatal death rates .

30. Common Statistical Terms
Maternal Mortality
 Is the death of woman while pregnant or within 42 days
of termination of pregnancy and cause related to or
aggravated by the pregnancy or its management but not
from accidental or incidental causes.

31. Common Statistical Terms
• Maternal Mortality Rate
 Is the number of maternal deaths occurring as a direct
result of the reproductive process per 100, 000 live births.
 Early in the 20th century, the maternal morality (death from
child birth) rate reached levels as high as 600 per 100,000 live
births .
 Currently the maternal mortality rate has declined to a low of
6.5 per 100,000 live births

32. Common Statistical Terms
Maternal Mortality (cont.)
 This dramatic decrease can be attributed to improved
preconception, prenatal, labor and delivery and postpartum
care, such as the following:
1. Greater detection of disorders such as ectopic pregnancy or
placenta previa and prevention of related complication
through the use of ultrasound.
2. Increased control of complication associated with
hypertension of pregnancy.
3. The development of widespread of training and education
programs maternal and child health care

33. Summary – Outcomes Achieved
Recap the terms used by asking the
students

34. References
 Lowdermilk D.L (2016)Maternity and Women’s
Health Care,11th Ed. Elsevier Inc. Ricci, S. 2007.
Essentials of Maternity Newborn and Women’s
Health Nursing .1st Edition . Lippincott Williams &
Wilkins, Philadelphia.
World Health Organization;
www.who.int/topics/millennium_development_goals/abo
ut/en/World Health
Organization;www.who.int/topics/pregnancy/en/