Although medical and technological advances in maternity care have drastically reduced maternal and infant mortality, these interventions have become commonplace if not routine. Used appropriately, they can be life-saving procedures. Routine use, without valid indications, can transform childbirth from a normal physiologic process and family life event into a medical or surgical procedure. Every intervention presents the possibility of untoward effects and additional risks that engender the need for more interventions with their own inherent risks. Unintended consequences to intrapartum interventions make it imperative that nurse educators work with other professionals to promote natural childbirth processes and advocate for policies that focus on ensuring informed consent and alternative choices. Interdisciplinary collaboration can ensure that intrapartum caregivers "first do no harm."The Journal of Perinatal Education, 22(2),[83][84][85][86][87][88][89][90][91][92] http://dx
On a medical mission into rural mountainous regions of Haiti, the authors were charged with teaching safer childbirth practices to untrained, mostly illiterate traditional birth attendants (TBA) who spoke HaitianCreole. In this isolated region with no physician or accessible hospital, almost all births occur at home. With no electricity, safe water supply, or sanitation facilities, childbirth education was a challenge. Accustomed to electronic, high-tech teaching aids, these childbirth educators had to modify educational strategies for these extraordinary circumstances. A successful solution was to revive decades-old teaching techniques and visual aids once used in Lamaze classes. The purpose of this article is to describe the teaching environment, the target audience, and the low-tech approach to childbirth education in Haiti.
The aim of this qualitative study was to explore the perception of women regarding long-term effects of childbirth education on future health-care decision making. This qualitative study used a purposive sample of 10 women who participated in facilitated focus groups. Analysis of focus group narratives provided themes in order of prevalence: (a) self-advocacy, (b) new skills, (c) anticipatory guidance, (d) control, (e) informed consent, and (f) trust. This small exploratory study does not answer the question of whether childbirth education influences future health-care decision making, but it demonstrates that the themes and issues from participants who delivered 15–30 years ago were comparable to current findings in the literature.
The U.S. maternal mortality rate has doubled in the past 25 years and has risen despite improvements in health care and an overwhelming global trend in the other direction. Forty-five countries have lower maternal mortality rates than the United States (CIA World Factbook, 2018). For a country that spends more than any other country on health care and more on childbirth-related care than any other area of hospitalization, this is a shockingly poor return on investment. After prolonged attention during pregnancy and birth, there is relatively little attention to the mother's health and well-being in the postpartum period. Yet more than half of childbirth-related deaths occur during this time (Muza, 2017). To minimize complications leading to maternal mortality, childbirth educators need to teach mother and families to identify and respond promptly to warning signs of postpartum complications.
The intrapartum period is a crucial time for implementing steps to protect, promote, and support breastfeeding. Labor and delivery nurses may be more concerned with the immediate safety of the mother and fetus than with future implications for breastfeeding. The purpose of this article is to review the potential effects that prenatal education and intrapartum practices and interventions have on lactation, and to encourage nurses to thoughtfully consider these effects in their clinical practices. By implementing these recommendations they can better educate the mother, empower her to make informed choices, avoid unnecessary intrusion into the normal birth process, and maximize the potential for meeting her breastfeeding goals.
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