Prenatal and Postnatal Care E-Book

Robin G. Jordan

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 2570

Veröffentlichungsjahr: 2018

Beschreibung

Prenatal and Postnatal Care

The second edition of the comprehensive and award-winning text on prenatal and postnatal care

The updated edition of Prenatal and Postnatal Care offers a comprehensive text for the care of the woman during the childbearing year. The expert author team presents information needed to master foundational knowledge in anatomy, physiology, psychology, culture, the structure of preconception, prenatal and postnatal care, as well as the management of common health problems.

This edition has been revised throughout and contains six new chapters on the following topics: prenatal ultrasound, triage of the pregnant woman, assisting women to develop confidence for physiologic birth, pregnancy after infertility, oral health, and issues around diversity and inclusion in prenatal and postnatal care. Additional highlights include new and updated content on pregnant women in the workplace, prenatal genetic testing, trauma-informed care, and transgender pregnancy care. The second edition also includes commonly used complementary therapies and offers more detailed information on shared decision-making and planning for birth.

Prenatal and Postnatal Care:

• Provides expanded faculty resources with case studies and test questions for each chapter
• Offers a comprehensive text that covers essential aspects of prenatal and postnatal care of the childbearing woman
• Builds on the edition that won the Book of the Year award from the American College of Nurse Midwives (ACNM) in 2015.

This revised, authoritative text is an ideal resource for midwifery, nurse practitioner and physician assistant students, and healthcare providers working with pregnant and postpartum women.

Leseprobe

Table of Contents

Cover

Title Page

About the Editors

Contributors

Preface

The Need for This Text

New in the Second Edition

Gender and Language

About the Companion Website

Part I: Physiologic Foundations of Prenatal and Postnatal Care

1 Reproductive Tract Structure and Function

Anatomy of the Female Reproductive System

Menstrual Cycle Physiology

Resources for Women

Resources for Healthcare Providers

References

2 Conception, Implantation, and Embryonic and Fetal Development

Introduction

Conception and Implantation

The Placenta

The Embryo

The Fetus

Summary

Resources for Healthcare Providers

Resources for Women, Their Families, and Healthcare Providers

References

3 Maternal Physiological Alterations during Pregnancy

Introduction

Hematologic System Adaptations

Cardiovascular System Adaptations

Respiratory System Adaptations

Renal System Adaptations

Gastrointestinal System Adaptations

Metabolic System Adaptations

Skin Changes

Immune System Adaptations

Neurological System and Sensory Adaptations

Musculoskeletal System Adaptations

Endocrine System Adaptations

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

4 Physiological Alterations during the Postnatal Period

Introduction

Uterus

Lochia

Cervix

Vagina

Labia and Perineum

Rectal Anatomy

Additional Maternal Alterations during the Postpartum Period

Summary

Resource for Women

Resource for Healthcare Providers

References

Part II: Preconception, Prenatal Care, and Postnatal Care

5 Preconception Care

Introduction

Challenges to Providing Preconception Care

Benefits of Preconception Health Care

Evidence Supporting Preconception Health Care

Preconception Care

Risk Assessment and Screening

Preconception Health Care for Women with Chronic Illnesses

Preconception Health Promotion and Counseling

Unique Considerations

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

6 Prenatal Care

Introduction

A Brief History of Prenatal Care

Current Goals of Prenatal Care

Structure of Prenatal Care

Group Prenatal Care: CenteringPregnancy

Components of Prenatal Care

Preventative Care

Health Promotion and Education

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

7 Nutrition during Pregnancy

Introduction

Understanding Food Units and Recommendations

Prenatal Nutrition and Health Outcomes

Nutritional Needs in Pregnancy

Food Safety during Pregnancy

Factors Influencing Nutritional Intake

Making a Nutritional Assessment

Using Nutrition Resources

Counseling for Optimal Prenatal Nutrition

Special Issues in Prenatal Nutrition

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

8 Pregnancy Diagnosis and Gestational Age Assessment

Introduction

Benefits of Early Pregnancy Diagnosis and Gestational Age Assessment

Pregnancy Diagnosis

Gestational Age Assessment

Counseling for Pregnancy Diagnosis

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

9 Risk Assessment during Pregnancy

Introduction

Process and Purpose of Risk Assessment

Benefits of Risk Assessment

Limitations of Risk Assessment

Disadvantages of Risk Assessment and Risk Management

Labeling Women as High Risk

Misapplication of Risk Assessment and Risk Management

Perspective of Risk and Risk Assessment

Explaining Risk to Women

Informed Consent

Summary

Resources for Healthcare Providers and Women and Their Families

References

10 Prenatal Ultrasound

Introduction

The Physics and Mechanics of Ultrasound

Types of Scans

Use of Prenatal Ultrasound

Interpreting and Communicating Results

The Woman’s Experience of Ultrasound

Safety

Overuse of Ultrasound

Recreational Prenatal Ultrasound

Who Performs Prenatal Ultrasounds

Adding Ultrasound to Scope of Practice

Resources for Women and Their Families

Resources for Healthcare Providers

References

11 Genetic Counseling, Screening, and Diagnosis

Introduction

Family History and Risk Evaluation

Genetic Screening Tests

Screening for Neural Tube Defects

Screening for Aneuploidy

Genetic Screening by Ultrasound

Carrier Screening

Diagnostic Prenatal Genetic Testing

The Role of Genetic Counselors

Psychosocial Considerations in Genetic Testing

Genetic Testing Counseling during Prenatal Care

Summary

Resources for Women, Their Families, and Healthcare Providers

References

12 Assessment of Fetal Well‐Being

Introduction

Physiologic Principles

Indications

Interprofessional Care

Fetal Testing Methods

Education and Counseling

Cultural, Personal, and Family Considerations

Health Disparities and Vulnerable Populations

Legal and Liability Issues

Summary

Resource for Healthcare Providers

References

13 Common Discomforts of Pregnancy

Introduction

Back Pain and Pelvic Girdle Pain

Bleeding Gums

Breast Tenderness

Carpal Tunnel Syndrome (CTS)

Cervical Pain

Constipation

Dizziness/Syncope

Edema

Emotional Changes

Fatigue

Flatulence

Headache

Heartburn

Heart Palpitations

Hemorrhoids

Increased Warmth and Perspiration

Leukorrhea

Leg Cramps

Nasal Congestion

Epistaxis

Nausea and Vomiting of Pregnancy (NVP)

Ptyalism

Restless Leg Syndrome (RLS)

Round Ligament Pain

Shortness of Breath

Skin, Hair, and Nail Changes

Sleep Disturbances

Supine Hypotension Syndrome (SHS)

Urinary Frequency and Nocturia

Urinary Incontinence

Varicosities (Legs/Vulva)

Vision Changes

Resources for Women and Their Families

References

14 Oral Health

Introduction

Anatomy of the Oral Cavity

Initial Assessment of the Oral Cavity

Influence of Oral Health on Pregnancy Outcomes

Conditions Affecting Oral Health

Postpartum and Newborn Oral Health

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

15 Medication Use during Pregnancy

Introduction

Types of Pharmaceutical Agents

Prescriptive Authority

Governmental Oversight of Pharmaceutical Agents

Pre‐Marketing Drug Testing

The Prescription: Essential Components

Pharmacokinetics in Pregnancy

Common Medications Used During Pregnancy

Vaccines during Pregnancy

Rational Use of Drugs in Pregnancy

Summary

Resources for Healthcare Providers

Resources for Women and Their Families

References

16 Substance Use during Pregnancy

Introduction

Prevalence of Prenatal Substance Use

Terminology

Historical Approaches to Prenatal Substance Use

Harm Reduction Approaches to Prenatal Substance Use

Common Comorbid Conditions

Prenatal Screening

Treatment Types

Commonly Used Substances, Pregnancy Implications, and Recommended Treatment

Perinatal Care of Women with Substance Use Disorders

Summary

Resources for Healthcare Providers

References

17 Health Disparities and Social Issues in Pregnancy

Introduction

Poverty

Incarceration during Pregnancy

Intimate Partner Violence during Pregnancy

Reproductive Coercion

Human Trafficking

Pregnancy and a History of Childhood Sexual Abuse

Summary

Resources for Healthcare Providers

Resources for Women and Their Families

References

18 Diversity and Inclusiveness in the Childbearing Year

Introduction

Inequities in Perinatal Care and Outcomes

Contributors to Perinatal Health Disparities

Developing Cultural Competence

Communication

Selected Cultural Traditions in the Childbearing Year

Summary

Resources for Healthcare Providers

Resources for Women

References

19 Exercise, and Sexual, Occupational, and Environmental Health in Pregnancy

Introduction

Exercise

Environmental Exposures

Sexuality

The Workplace and Pregnancy

Resources on Pregnancy and Environmental Exposure for Women

Resources on Pregnancy and Environmental Exposure for Healthcare Providers

Resource on Work during Pregnancy for Women

References

20 Psychosocial Adaptations in Pregnancy

Introduction

Developing Relationship: A Trauma‐Informed Approach

Maternal‐Newborn Attachment and Adaptation

Maternal Role Development

Body Image

Sibling Preparation

Partner Adaptation and Attachment

Pregnancy in Transgender Men

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

21 Health Education during Pregnancy

Introduction

Sources and Quality of Consumer Childbirth Education

Prenatal Visit Approach to Individual Childbirth Education

Class Education and Group Prenatal Care

Developmental Considerations

Issues Integral to Prenatal Education

Summary

Resources for Women and Their Families (Government Websites)

Resources for Women and Their Families (Nongovernment Websites)

References

22 Preparing for Birth

Introduction

What Is Physiologic Birth?

Benefits of Physiologic Birth

Fear of Childbirth

Maternal Confidence for Physiologic Birth

Evidence Related to Women’s Prenatal Confidence for Physiologic Birth

Individual Strategies

Summary

Resources for Healthcare Providers

Resources for Women and their Families

References

23 Triage during Pregnancy

Introduction

Objectives and Goals of Triage Care and Evaluation

Obstetric Triage in the Hospital Setting

Primary Responsibilities of Professionals during Triage and Evaluation

Common Reasons Women Seek Urgent/Emergent Care during Pregnancy

Collaboration Between Obstetric and Emergency Departments

Obstetric Triage Unit Organization

Elements of Triage

Elements of Healthcare Provider Evaluation

Best Practices in Triage Units

Liability Issues in Obstetric Triage and Evaluation

Quality Measures in Triage

Anticipatory Guidance about Triage during Prenatal Care

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

24 Assessment and Care at the Onset of Labor

Introduction

Determining the Onset of Labor

Timing of Admission to the Birth Setting

Reframing “False Labor”

Determining Active Labor

Anticipatory Guidance during the Prenatal Period

Assessment of the Woman with Report of Labor Onset

Plan of Care

Summary

References

25 Components of Postnatal Care

Introduction

Fourth‐Trimester Tasks

Immediate Postpartum Care

Later Postpartum Care

Assessment of Maternal Physical and Emotional Adjustment

Maternal Role Development

Infant Feeding

Activity and Exercise

Diet and Nutrition

Lochia

Afterbirth Pain

Perineal Discomfort

Diureseis and Diaphoresis

Constipation and Hemorrhoids

Sleep

Sexuality

Resumption of Menses and Ovulation

Contraception

Postpartum Physical Examination

Abdominal Exam

Postpartum Depression and Intimate Partner Violence Screening

Postpartum Warning Signs

Cultural Considerations

Health Disparities and Vulnerable Populations

Interprofessional Care

Recovery and Employment

Summary

Resources for Women

Resources for Healthcare Providers

References

26 Lactation and Breastfeeding

Introduction

Benefits of Breastfeeding

Breastfeeding as a Public Health Issue

Promoting and Supporting Breastfeeding

Maternal and Infant Anatomy and Physiology of Lactation and Breastfeeding

Basics of Breastfeeding Support and Assessment

Care of the Breastfeeding Mother

Summary

Resources for Women and Healthcare Providers

References

27 Contraception in the Postnatal Period

Introduction

Postpartum Care and Return to Fertility after Childbirth

Selecting a Postpartum Contraceptive Method

Contraceptive Methods

Tier One Methods

Tier Two Methods

Tier Three Methods

Emergency Contraception

Summary

Resources for Women and Healthcare Providers

References

Part III: Complex Prenatal and Postnatal Conditions

28 Bleeding during Pregnancy

Introduction

Early Pregnancy Bleeding

Subchorionic Hemorrhage

Leiomyomas

Spontaneous Pregnancy Loss

Ectopic Pregnancy

Gestational Trophoblastic Disease

Bleeding during the Second Half of Pregnancy

Placenta Previa

Placental Abruption

Vasa Previa

Diagnosis and Management of Bleeding in the Second Half of Pregnancy

Resources for Women and Their Families

References

29 Amniotic Fluid and Fetal Growth Disorders

Introduction

Amniotic Fluid Dynamics

Placentation and Perinatal Outcomes

Amniotic Fluid Disorders

Fetal Growth Disorders

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

30 Preterm Labor and Birth

Introduction

Social and Racial Disparities

Pathophysiology of Preterm Birth

Perinatal Morbidity Related to Prematurity

Risk Factors for Preterm Birth

Predicting Preterm Birth

Primary Prevention of Preterm Birth

Prenatal Education on Signs and Symptoms of Preterm Labor

Diagnosis and Management of Women with Preterm Labor

Interprofessional Care

Summary

Resources for Women and Healthcare Providers

References

31 Hypertensive Disorders of Pregnancy

Introduction

Classification of Hypertensive Disorders in Pregnancy

Screening for Hypertensive Disorders

Preeclampsia‐Eclampsia

Chronic Hypertension

Chronic Hypertension with Superimposed Preeclampsia

Gestational Hypertension

HELLP Syndrome

Interprofessional Care

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

32 Gestational Diabetes

Introduction

Pathophysiology and Potential Problems

Prenatal Screening and Diagnosis

Management

Pharmacologic Treatments

Social Considerations

Fetal Surveillance and Timing of Birth

Postpartum Follow‐Up

Interprofessional Care

Perspective on GDM Risk

Care of the Pregnant Woman with Pregestational Diabetes

Resources for Women and Their Families

Resources for Healthcare Providers

References

33 Multifetal Gestation

Incidence

Embryology

Diagnosis

Potential Problems

Prenatal Care

Psychosocial Aspects

Resources for Healthcare Providers

Resources for Women and Their Families

References

34 Post‐Term Pregnancy

Introduction

Potential Problems

Prevention, Intervention, and Management Options

Resources for Healthcare Providers

Resources for Women and Their Families

References

35 Hyperemesis Gravidarum

Introduction

Etiology and Risk Factors

Potential Problems

Evaluation

Care and Management

Resource for Healthcare Providers

Resources for Women and Their Families

References

36 Abdominal Pain

Introduction

Evaluation

Appendicitis

Gall Bladder Disease

Abdominal Trauma

CPR in Pregnancy

Pancreatitis

Resources for Healthcare Providers

Resources for Women and Their Families

References

37 Pregnancy after Infertility

Introduction

Prevalence of Infertility

Context and Course of Infertility

Preexisting Conditions and Perinatal Issues

Pharmacologic Considerations

Lifestyle Considerations

Psychological Impacts of Infertility Treatment and Transition to Pregnancy

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

38 Common Complications during the Postnatal Period

Introduction

Postpartum Morbidity and Mortality

Postpartum Cultural Considerations

Postpartum Disorders

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

39 Common Breastfeeding Problems

Introduction

Common Infant‐Related Breastfeeding Problems

Common Maternal Breastfeeding Problems

Low Milk Supply

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

40 Perinatal Loss and Grief

Introduction

Stillbirth

Care and Management of Women with Stillbirth

Grieving and Emotional Care after Perinatal Loss

Physical Care after Stillbirth

Follow‐Up Care

Interconception and Subsequent Pregnancy Care

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

Part IV: Common Primary Care Health Conditions during the Prenatal and Postnatal Periods

41 Obesity

Introduction

Prevalence

Health Disparities and Cultural Considerations

Personal and Family Considerations

Obesity Physiology

Potential Problems

Management of Pregestational Obesity

Bariatric Surgery and Pregnancy Issues

Prolonged Pregnancy

Intrapartum and Postpartum Issues

Interprofessional Care

Legal and Liability Issues

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

42 Mood and Anxiety Disorders

Introduction

Depression during Pregnancy

Bipolar Disorder in Pregnancy

Anxiety and Trauma‐Related Disorders

Interprofessional Care

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

43 Hematologic and Thromboembolic Disorders

Introduction

Anemia

Alloimmunization of Pregnancy

Hemoglobinopathies

Folate Deficiency

Vitamin B12 Deficiency

Bleeding Disorders

Thromboembolic Disorders

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

44 Respiratory Disorders

Introduction

Respiratory Physiology and Pregnancy

Asthma

Influenza

Upper Respiratory Infection

Pneumonia

Summary

Resource for Healthcare Providers

References

45 Urinary Tract Disorders

Introduction

Urinary Tract Infection

Evaluation

Care of Women with Urinary Tract Infections

Recurrent UTI

Care of Women with Suspected Acute Pyelonephritis

Nephrolithiasis

Summary

Resources for Women and Their Families

Resource for Healthcare Providers

References

46 Gastrointestinal Disorders

Relevant Terms

Introduction

Initial Evaluation

Gastroenteritis

Intraheptic Cholestasis of Pregnancy

Cholecystitis and Cholelithiasis

Acute Appendicitis

Summary

Resources for Healthcare Providers

Resource for Women and Their Families

References

47 Endocrine Disorders

Introduction

Thyroid Disorders in Pregnancy

Overt Hypothyroidism

Hyperthyroidism

Postpartum Thyroiditis

Iodine in Pregnancy

Pregestational Diabetes Mellitus

Summary

Resources for Women and Healthcare Providers

References

48 Neurological Disorders

Introduction

Seizure Disorders

Headache

Multiple Sclerosis

Restless Legs Syndrome/Willis‐Eckbom Disease

Carpal Tunnel Syndrome

Central Nervous System Imaging in Pregnancy and Lactation

Interprofessional Care

Resources for Women and Their Families

Resources for Healthcare Providers

References

49 Dermatological Disorders

Introduction

Atopic Eruption of Pregnancy

Pruritic Urticarial Papules and Plaques of Pregnancy

Pruritic Folliculitis of Pregnancy

Pemphigoid Gestationis

Pustular Psoriasis of Pregnancy

Intrahepatic Cholestasis of Pregnancy

Summary

Resources for Healthcare Providers

References

50 Infectious Diseases

Introduction

Cytomegalovirus (CMV)

Group B Streptococcus (GBS)

Hepatitis A

Hepatitis B

Hepatitis C

Parvovirus B19

Rubella

Toxoplasmosis

Varicella

Emerging Infectious Diseases

Ebola

Zika

Summary

Resources for Women and Their Families

Resources for Healthcare Providers

References

51 Sexually Transmitted Infections and Vaginitis

Introduction

Sexually Transmitted Bacterial Infections

Sexually Transmitted Viral Infections

Sexually Transmitted Parasitic Infection

Fungal Vaginitis

Bacterial Vaginitis

Partner STI Treatment

Legal Requirements for Reporting STI Diagnosis

Psychosocial Impact of STI Diagnosis

Summary

Resources for Healthcare Providers

Resource for Women and Partners

References

Index

End User License Agreement

List of Tables

Chapter 01

Table 1.1 Normal menstrual cycle characteristics

Table 1.2 Hormones of the menstrual cycle

Chapter 02

Table 2.1 Four main transport mechanisms

Table 2.2 Transplacental infections

Table 2.3 Placental hormones and their functions

Table 2.4 Vulnerable periods in embryonic and fetal growth and development

Chapter 03

Table 3.1 Changes in hematologic laboratory parameters during pregnancy

Table 3.2 Changes in coagulation factors in pregnancy

Table 3.3 Signs and symptoms of a normal pregnancy that mimic heart disease

Table 3.4 Changes in respiratory parameters in pregnancy

Table 3.5 Liver Function Changes in Pregnancy

Table 3.6 Lipid and lipoprotein levels in the third trimester

Table 3.7 Pituitary hormones

Chapter 04

Table 4.1 Selected physical alterations in the postpartum period

Table 4.2 Maternal physiologic benefits to breastfeeding

Chapter 05

Table 5.1 Indicators of preconception wellness

Table 5.2 Content of preconception health care for women

Table 5.3 Screening recommendations for infections at a preconception visit

Table 5.4 Summary of preconception care for women with selected chronic illnesses

Table 5.5 Folic acid recommendations by risk status

Table 5.6 Adult immunizations for women of reproductive age

Chapter 06

Table 6.1 Goals of prenatal care

Table 6.2 Prenatal visit schedule

Table 6.3 Group care components and defining elements

Table 6.4 Medical and psychosocial prenatal history content

Table 6.5 Recommended laboratory studies in pregnancy

Table 6.6 IOM recommended pregnancy weight gain

Table 6.7 Health education topics throughout pregnancy

Chapter 07

Table 7.1 Food groups and subgroups

Table 7.2 Serving size guidelines and pregnancy needs

Table 7.3 Select daily macronutrient and micronutrient dietary reference intakes in pregnancy

Table 7.4 IOM Recommendations for total and rate of weight gain during pregnancy by prepregnancy BMI

Table 7.5 Foods and beverages to avoid during pregnancy

Table 7.6 Factors that influence nutritional status

Table 7.7 Components of a detailed nutritional health history

Table 7.8 Clinical signs of nutritional status

Table 7.9 Vegetarian and vegan diet nutrient sources

Table 7.10 Pica evaluation and management

Chapter 08

Table 8.1 Signs and symptoms of pregnancy

Table 8.2 Types of endocrine pregnancy tests

Table 8.3 Timing of events in gestation

Chapter 09

Table 9.1 Principles of communicating risk

Chapter 10

Table 10.1 Indications for first‐trimester ultrasound

Table 10.2 Early pregnancy viability characteristics

Table 10.3 Components of the first‐trimester standard exam

Table 10.4 Indications for second‐trimester ultrasound

Table 10.5 Fetal anatomical components and measurements of a standard second‐trimester ultrasound examination

Table 10.6 Measurement of amniotic fluid

Table 10.7 Common soft marker ultrasound findings

Chapter 11

Table 11.1 Degree of relationship and shared genes

Table 11.2 Prenatal genetic screening options

Table 11.3 Condition, carrier frequency, and condition characteristics

Chapter 12

Table 12.1 Causes of fetal hypoxia

Table 12.2 Conditions related to an increased risk of fetal death

Table 12.3 Ultrasound methods to estimate amniotic fluid volume

Table 12.4 Biophysical profile manning scoring criteria

Table 12.5 Biophysical profile Vintzileos scoring criteria

Table 12.6 Interpretation and management of biophysical score

Chapter 13

Table 13.1 Instructions for pelvic floor and pelvic tilt exercises

Table 13.2 Remedies for constipation

Table 13.3 PUQE Scale

Table 13.4 Relief measures for nausea and vomiting of pregnancy

Table 13.5 RLS diagnostic criteria

Table 13.6 Evidence‐Based Sleep Hygiene Measures

Chapter 15

Table 15.1 Schedules for controlled substances

Table 15.2 Wilson’s six principles of teratology

Table 15.3 Selected known and possible teratogens

Table 15.4 Physiologic changes in pregnancy and pharmacokinetics

Table 15.5 Selected drugs commonly used during pregnancy

Table 15.6 Vaccines during pregnancy and postpartum

Table 15.7 Common ingredients in prenatal vitamin/mineral supplements

Chapter 16

Table 16.1 Criteria to diagnose substance use disorders*

Table 16.2 AUDIT‐C screening tool for alcohol use

Table 16.3 Brief substance use intervention steps

Table 16.4 Conditions associated with prenatal alcohol exposure

Table 16.5 Specific substances and breastfeeding

Chapter 17

Table 17.1 Selected maternal and infant outcomes by race/ethnicity

Table 17.2 Poverty thresholds by family size and number of adults at home, 2012 vs. 2016

Table 17.3 Intimate partner violence: assessment and planning

Table 17.4 Top states for sex trafficking, 2016

Table 17.5 Considerations for providing care for potential victims of trafficking

Table 17.6 Possible signs and symptoms of prior CSA

Chapter 18

Table 18.1 Maternal mortality in the united states by race/ethnicity

Table 18.2 Infant mortality in the united states by race/ethnicity

Table 18.3 Health belief models

Table 18.4 Steps in developing cultural competence

Chapter 19

Table 19.1 Absolute and relative contraindications to exercise

Table 19.2 Substances, Sources and Adverse Health Effects

Chapter 20

Table 20.1 Methods to achieve pregnancy for lesbian and bisexual women and transgender men

Chapter 21

Table 21.1 Prenatal Care Guideline Topics and Suggested Timing

Chapter 25

Table 25.1 Two‐week postpartum visit

Table 25.2 Six‐week postpartum visit

Table 25.3 Resumption of menses

Table 25.4 Postpartum warning signs

Chapter 26

Table 26.1 Maternal, child, and adult health benefits of breastfeeding

Table 26.2 Factors regulating milk production

Chapter 27

Table 27.1 MEC categories for contraceptive use

Table 27.2 Contraceptive methods grouped by level of effectiveness

Chapter 28

Table 28.1 Benign causes of bleeding in early pregnancy

Table 28.2 Discriminatory levels for beta‐human chorionic gonadotropin (β‐hCG)

Table 28.3 Classification of first‐trimester pregnancy loss

Table 28.4 Risk factors for early pregnancy loss

Table 28.5 Age and early pregnancy loss rate

Table 28.6 Risk factors for ectopic pregnancy

Table 28.7 Signs and symptoms of ectopic pregnancy

Table 28.8 Criteria for managing ectopic pregnancy

Table 28.9 Types of gestational trophoblastic disease

Table 28.10 Risk Factors for Gestational Trophoblastic Disease

Table 28.11 Suggested indications for physician consultation, collaboration, or referral for women with early pregnancy bleeding

Table 28.12 Risk factors for placenta previa

Table 28.13 Risk factors for placental abruption

Chapter 29

Table 29.1 Risk factors for development of FGR

Chapter 30

Table 30.1 Potential neonatal complications of prematurity

Table 30.2 Risk factors for preterm birth

Table 30.3 Cervical changes and preterm labor diagnosis

Chapter 31

Table 31.1 Criteria to diagnose preeclampsia and preeclampsia with severe features

Table 31.2 Laboratory manifestations of preeclampsia–eclampsia syndrome

Table 31.3 Maternal–fetal potential problems due to chronic hypertension

Table 31.4 Laboratory findings in HELLP syndrome

Chapter 32

Table 32.1 Potential problems related to gestational diabetes

Table 32.2 Risk factor classification for gestational diabetes screening

Table 32.3 Criteria for abnormal result on 100 g, three‐hour oral glucose tolerance test in pregnant women

Table 32.4 Sample diet at 2000 calories with 35–40% carbohydrate (CHO)

Table 32.5 Total daily carbohydrates for 35–40% of calories

Table 32.6 Follow‐up of women who have had GDM

Chapter 33

Table 33.1 Risks of multifetal pregnancy for the fetuses/neonates

Table 33.2 Maternal risks of multifetal pregnancy

Table 33.3 Recommended weight gain pattern in twin pregnancy by prepregnant BMI

Table 33.4 Daily nutrient recommendations in multifetal gestation

Chapter 34

Table 34.1 Classification of term and post‐term births by weeks’ gestation

Table 34.2 Methods of fetal surveillance for women at late‐term gestation

Table 34.3 Bishop cervical scoring

Chapter 35

Table 35.1 Suggested etiologies of hyperemesis gravidarum (HG)

Table 35.2 Pharmacologic measures to relieve hyperemesis symptoms

Chapter 36

Table 36.1 Differential diagnosis of abdominal pain in pregnancy

Chapter 37

Table 37.1 Strategies for bridging the gap from fertility care to routine prenatal care

Table 37.2 Summary of fertility care

Table 37.3 Prenatal and postnatal care considerations related to etiologies of subfertility

Chapter 38

Table 38.1 Common bacteria in uterine infection

Table 38.2 Uterine infection signs, symptoms, diagnosis, treatment

Table 38.3 Postpartum mood and anxiety disorders: clinical signs and symptoms

Table 38.4 FDA‐Approved common medications for depression and anxiety disorders

Chapter 39

Table 39.1 Infant factors associated with slow weight gain

Table 39.2 Maternal factors associated with slow infant weight gain

Table 39.3 Sample instructions for breastfeeding a late preterm infant

Table 39.4 Interventions for flat and inverted nipples

Table 39.5 Strategies for preventing and managing sore nipples

Table 39.6 Common contributors to low milk supply

Table 39.7 Interventions for low milk supply

Chapter 40

Table 40.1 Etiology of stillbirth

Table 40.2 Rights of parents when a baby dies

Table 40.3 Cultural beliefs and pregnancy loss

Chapter 41

Table 41.1 Prevalence of obesity in women age ≥ 20

Table 41.2 Potential problems associated with obesity in pregnancy

Table 41.3 IOM recommendations for total pregnancy weight gain for women with BMI ≥30

Chapter 42

Table 42.1 Definitions and classifications of select mood disorders

Table 42.2 Untreated depression and potential maternal/child outcomes

Table 42.3 Pharmacologic considerations in treating psychological disorders during pregnancy

Table 42.4 Bipolar disorder symptoms

Table 42.5 Dosing schedule for lamotrigine monotherapy

Table 42.6 Common anxiety and trauma‐related disorders: characteristics and treatments

Table 42.7 Screening tools for generalized anxiety disorder

Chapter 43

Table 43.1 Normal hematologic findings in pregnancy

Table 43.2 Hematologic conditions and differential laboratory findings

Table 43.3 Food sources of heme iron

Table 43.4 Food sources of nonheme iron

Table 43.5 Less common blood group antigens

Chapter 44

Table 44.1 Classification of asthma severity

Table 44.2 Medications for asthma

Table 44.3 Common treatments for the common cold

Chapter 45

Table 45.1 Laboratory testing for urinary tract infection

Table 45.2 Urinalysis results

Table 45.3 Medication regimens for asymptomatic bacteriuria and acute cystitis in pregnancy

Chapter 46

Table 46.1 Data gathering for pregnant women presenting with GI symptoms

Table 46.2 Common lab values in pregnancy

Chapter 47

Table 47.1 Causes of thyroid dysfunction and expected laboratory findings

Table 47.2 Common signs and symptoms of pregnancy and thyroid disease

Table 47.3 Diabetes mellitus classifications, etiology, onset, and usual treatment

Chapter 48

Table 48.1 Maternal and fetal effects of commonly prescribed antiepileptic medications

Table 48.2 Headache diary

Table 48.3 International headache society criteria for tension headaches

Table 48.4 Nonpharmacological treatment of headaches

Table 48.5 Diagnostic criteria for restless legs syndrome

Chapter 49

Table 49.1 Topical steroid therapy for dermatologic conditions in pregnancy

Table 49.2 Pregnancy‐specific dermatoses: defining characteristics

Table 49.3 Systemic Therapy for dermatologic conditions in pregnancy

Table 49.4 Classification of ICP by serum bile levels

Chapter 50

Table 50.1 Interpretation of results of serological tests for toxoplasmosis

Chapter 51

Table 51.1 Classification of genital hsv infections

Table 51.2 Recommended treatments for HSV in pregnancy

Table 51.3 Nugent scoring system for gram‐stained vaginal smears

List of Illustrations

Chapter 01

Figure 1.1. External female genitalia.

Figure 1.2. Development of external genitalia from embryonic structures.

Figure 1.3. Superficial muscles of the perineum.

Figure 1.4. The uterus and associated structures.

Figure 1.5. Oogenesis.

Figure 1.6. Hormonal stimulation of the gonads and feedback loops. GnRH, gonadotropin‐releasing hormone.

Figure 1.7. Cross section of the ovary during the reproductive years. (A) Frontal section. (B) Hemisection. (C) Ovulation of a secondary oocyte.

Figure 1.8. Changing hormone levels during the menstrual cycle. (A) Hormonal regulation of changes in the ovary and uterus. (B) Changes in concentration of anterior pituitary and ovarian hormones.

Chapter 02

Figure 2.1. Cleavage and travel of the conceptus to the uterus.

Figure 2.2. Gastrulation and the appearance of the primitive streak.

Figure 2.3. Notochord growth. (A) Dorsal and partial sectional views of the trilaminar embryonic disc, about 16 days after fertilization. (B) Sagittal section of the trilaminar embryonic disc, about 16 days after fertilization.

Figure 2.4. Folding of the embryo: (A) 22 days, (B) 24 days, and (D) 28 days.

Chapter 04

Figure 4.1. Uterine size changes.

Figure 4.2. Uterine involution assessed abdominally.

Figure 4.3. Nulliparous and parous cervices.

Figure 4.4. Diastasis recti.

Chapter 05

Figure 5.1. Preconception occupational/Environmental history checklist.

Chapter 07

Figure 7.1.

Figure 7.2. Starting the Conversation with Pregnant Women: Used with permission from Wiley.

Figure 7.3. USDA MyPlate Pregnancy Food Plan Checklist for a women needing 2400 daily calories.

Chapter 08

Figure 8.1. Jacquemin’s sign of pregnancy.

Figure 8.2. Hegar’s sign of pregnancy.

Figure 8.3. McDonald’s sign of pregnancy.

Figure 8.4. Auscultation of fetal heart sounds with a fetoscope.

Figure 8.5. Leopold maneuvers. (A) First maneuver; (B) Second maneuver; (C) Third maneuver; (D) Fourth maneuver.

Figure 8.6. Landmarks used to measure fundal height.

Chapter 09

Figure 9.1. Sensitivity and specificity.

Figure 9.2. The Paling Palette Risk Communication Tool Paling Palettes©.

Chapter 12

Figure 12.1. Algorithm for the management of decreased fetal movement. FGR, intrauterine growth restriction; DFM, decreased fetal movement; FDIU, fetal demise in utero; FHR, fetal heart rate; NST, nonstress test.

Figure 12.2. Example of a reactive fetal heart rate monitoring strip.

Figure 12.3. Algorithm for the use of modified BPP. AFV, amniotic fluid volume; FBM, fetal breathing movements; NST, nonstress test.

Chapter 13

Figure 13.1. Symphysis separation.

Figure 13.2. Stretching calf muscles to prevent leg cramps.

Figure 13.3. P6 acupressure point for relief of nausea. P6 point is three of the woman’s fingerbreadths from the wrist.

Figure 13.4. Round ligaments.

Figure 13.5. Striae gravidarum.

Figure 13.6. Vulvar varicosities. Permission obtained from Elsevier.

Chapter 14

Figure 14.1. Structure of the mouth.

Figure 14.2. A typical tooth and surrounding structures.

Chapter 15

Figure 15.1. Causes of birth defects.

Figure 15.2. Critical periods in human development according to postconceptional weeks.

Chapter 16

Figure 16.1. Algorithm for discussing levels of care for substance use disorder.

Chapter 19

Figure 19.1 Borg RPE.

Chapter 20

Figure 20.1. Stages of maternal role development.

Chapter 23

Figure 23.1. The Maternal Fetal Triage Index Classification Algorithm.

Chapter 25

Figure 25.1. Lochia.

Chapter 26

Figure 26.1. Sample hospital or birth center discharge instructions for breastfeeding mothers.

Figure 26.2. Sample telephone triage tool for clinicians.

Figure 26.3. Side view of the breast.

Figure 26.4. Common breastfeeding positions. Retrieved from http://www.ihs.gov/healthed/docs/BF‐BreastfeedingPositions%20Provider.pdf.

Figure 26.5. The correct approach to bringing the infant to the breast to latch.

Figure 26.6. Mother’s index finger gently draws the mouth open for a better latch.

Chapter 28

Figure 28.1. Leiomyomas: Intramural—most common, develop within the uterine wall; subserosal—develop on the outside wall of the uterus and grow outward; submucosal—least common, develop on the inside wall of the uterine cavity and grow inward.

Figure 28.2. Types of placenta previa.

Figure 28.3. Visible and concealed bleeding in placental abruption. Types of abruption: (A) With visible abruption, blood tracks between the membranes and escapes through the vagina and cervix; (B) with concealed abruption, blood collects behind the placenta, with no evidence of vaginal bleeding.

Figure 28.4. Vasa previa.

Chapter 29

Figure 29.1. Nomogram showing amniotic fluid volume as a function of gestational age. The black dots are the mean for each 2‐week interval.

Figure 29.2. Formation of the placenta and umbilical cord. (A) Details of the placenta and umbilical cord; (B) Fetal surface of the placenta.

Figure 29.3. Amniotic fluid index (in millimeters) plotted with gestational age (weeks). The solid line denotes the fiftieth percentile; dashed lines, the fifth and ninety‐fifth percentiles; and dotted lines, +2 standard deviations (2.5th and 97.5th percentiles).

Figure 29.4. Birth weight percentiles throughout gestation.

Chapter 30

Figure 30.1. Comparison of racial disparities in PTB rates.

Figure 30.2. Cervical cerclage procedure.

Chapter 31

Figure 31.1. Two‐stage model of preeclampsia pathophysiology.

Chapter 33

Figure 33.1. Types of amnionicity and chorionicity in multifetal gestation. By Kevin Dufendach—Own work, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=5324027

Chapter 34

Figure 34.1. Algorithm for the management of late‐term and post‐term pregnancy.

Chapter 36

Figure 36.1. Proper positioning of seat belt for a pregnant woman.

Chapter 38

Figure 38.1. Pregnancy‐related deaths in the United States, 2011–2013.

Figure 38.2. Deep vein thrombosis

Chapter 39

Figure 39.1. Dropper incentive for latching.

Figure 39.2. Mother gently opening infant’s mouth for latch on.

Figure 39.3. Using a dropper to stop rapid side‐to‐side head movement.

Chapter 40

Figure 40.1. Stillbirth evaluation schematic

Chapter 44

Figure 44.1. Management of asthma exacerbations during pregnancy and lactation: home treatment. MDI, metered‐dose inhaler; PEF, peak expiratory flow.

Chapter 47

Figure 47.1. Hypothalamic–pituitary–thyroid interactions. [+], stimulation; [−], inhibition.

Figure 47.2. Thyroid hormone and human chorionic gonadotropin fluctuations throughout pregnancy.

Chapter 49

Figure 49.1. Pruritic urticarial papules and plaques of pregnancy (PUPPP). The papules often first localize in the abdominal striae.

Figure 49.2. Pemphigoid gestationis: Urticarial plaques progress to generalized tense bullae on erythematous base.

Chapter 50

Figure 50.1. Life cycle of

T. gondii

. The only known definitive hosts for

T. gondii

are members of the family Felidae (domestic cats and their relatives). Unsporulated oocysts are shed in the cat’s feces (1). Although oocysts are usually only shed for 1–2 weeks, large numbers may be shed. Oocysts take 1–5 days to sporulate in the environment and become infective. Intermediate hosts in nature (including birds and rodents) become infected after ingesting soil, water, or plant material contaminated with oocysts (2). Oocysts transform into tachyzoites shortly after ingestion. These tachyzoites localize in neural and muscle tissue and develop into tissue cyst bradyzoites (3). Cats become infected after consuming intermediate hosts harboring tissue cysts (4). Cats may also become infected directly by ingestion of sporulated oocysts. Animals bred for human consumption and wild game may also become infected with tissue cysts after ingestion of sporulated oocysts in the environment (5). Humans can become infected by any of several routes:Eating undercooked meat of animals harboring tissue cysts (6).Consuming food or water contaminated with cat feces or by contaminated environmental samples (such as fecal‐contaminated soil or changing the cat litter box) (7).Blood transfusion or organ transplantation (8).Transplacentally from the mother to the fetus (9).In the human host, the parasites form tissue cysts, most commonly in skeletal muscle, myocardium, brain, and eyes; these cysts may remain throughout the life of the host. Diagnosis is usually achieved by serology, although tissue cysts may be observed in stained biopsy specimens (10). Diagnosis of congenital infections can be achieved by detecting

T. gondii

DNA in amniotic fluid using molecular methods such as PCR (11). Source: Image and information courtesy of DPDx of the CDC’s Division of Parasitic Diseases and Malaria (2016c). http://dpd.cdc.gov/dpdx/HTML/Image_Library.htm

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Prenatal and Postnatal Care

A Woman-Centered Approach

SECOND EDITION

Edited by

Robin G. JordanCindy L. FarleyKaren Trister Grace

This second edition first published 2019 © 2019 by John Wiley & Sons, Inc.

Edition History [John Wiley and Sons 1e, 2014]

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of Robin G. Jordan, Cindy L. Farley and Karen Trister Grace to be identified as authors of editorial work in this book has been asserted in accordance with law.

Registered Office(s)John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USAJohn Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial Office9600 Garsington Road, Oxford, OX4 2DQ, UK

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Limit of Liability/Disclaimer of WarrantyThe contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Library of Congress Cataloging‐in‐Publication Data

Names: Jordan, Robin G., 1954– editor. | Farley, Cindy L., editor. | Grace, Karen Trister, editor.Title: Prenatal and postnatal care : a woman‐centered approach / edited by Robin G. Jordan, Cindy L. Farley, Karen Trister Grace.Description: Second edition. | Hoboken, NJ : Wiley, 2019. | Includes bibliographical references and index. |Identifiers: LCCN 2018001930 (print) | LCCN 2018002300 (ebook) | ISBN 9781119318354 (pdf) | ISBN 9781119318361 (epub) | ISBN 9781119318347 (pbk.)Subjects: | MESH: Maternal‐Child Nursing | Pregnancy Complications–nursing | Pregnancy–physiologyClassification: LCC RJ254 (ebook) | LCC RJ254 (print) | NLM WY 157.3 | DDC 618.92/01–dc23LC record available at https://lccn.loc.gov/2018001930

Cover Design: WileyCover Image: Courtesy of Robin G. Jordan

This book is dedicated to women who persist.

To the wide circle of women in my life who help keep me physically strong, intellectually growing, and emotionally sustained. And laughing the whole time.

~Robin~

To my granddaughter, Isabel Brown, from Brooklyn Town. My wish for you is expressed in the Girl’s Globe Manifesto and my hope is that this book contributes in small part toward a healthy life for women and their families:

“A girl should be free to live to her full potential, to live a healthy life, free from violence and discrimination. To get educated and access her right to go to school. To choose when, if and whom to marry and have children when she is ready. Simple, these are her rights. With them she can change the world.”

~With love, Nana Cindy~

To my husband, Peter, whose love, support, and co‐parenting makes it all possible.

~Karen~

About the Editors

Robin G. Jordan, PhD, CNM, FACNM, studied midwifery at the University of Medicine and Dentistry of New Jersey, after earning her MSN from Case Western Reserve University. She earned a PhD in Health Sciences from Touro University. Dr. Jordan started the first hospital‐based nurse‐midwifery service in the greater Northern Michigan area. During her clinical practice career, she has attended childbearing women in hospital, birth center, and home settings. Dr. Jordan was a long‐standing faculty member of Frontier Nursing University, developing and teaching the Antepartum Care course series for midwifery and nurse practitioner students. She has also served as adjunct faculty at Georgetown University in the Nurse‐Midwifery/Women’s Health Nurse Practitioner (WHNP) programs teaching antepartum care. She is coauthor of Clinical Practice Guidelines for Midwifery and Women’s Health. Dr. Jordan currently serves her community as a member of the board of directors of the local women’s safe home, and is active in state politics with a focus on improving health care for women and girls.

Cindy L. Farley, PhD, CNM, FACNM, studied midwifery at Emory University. She earned her BSN and PhD from The Ohio State University and her MSN from Emory University. She is an associate professor at Georgetown University in the Nurse‐Midwifery/WHNP programs. She serves as a locum tenens midwife for Mount Eaton Care Center, an Amish birth center, and Pomerene Hospital, a rural hospital in Millersburg, Ohio. Dr. Farley works as a legal expert on selected cases involving midwifery regulatory issues and clinical care. She is co‐author of Clinical Practice Guidelines for Midwifery and Women’s Health. Dr. Farley has been instrumental in organizing groups of midwifery students to visit their federal legislators and advocate for positive change in important maternal health policies and legislation. Making midwives to improve the health of women and their families is Dr. Farley’s passion.

Karen Trister Grace, PhD(c), MSN, CNM, has been a midwife for 18 years. She earned a BA in sociology at Barnard College, a BSN and MSN from the University of Pennsylvania, a Certificate in Health Disparities and Health Inequality from Johns Hopkins Bloomberg School of Public Health, and she is currently a PhD candidate at Johns Hopkins University School of Nursing. Her research focuses on unintended pregnancy and reproductive coercion. Ms. Grace has also been a nursing and midwifery educator for 10 years, and is currently an Adjunct Instructor at Georgetown University in the Nurse‐Midwifery/WHNP program. She practices clinically at Mary’s Center, a FQHC in the metropolitan Washington, DC, area.

Contributors

Janyce Cagan Agruss, PhD, CNE, APRNAssociate ProfessorFamily Nurse PractitionerCollege of Nursing Rush UniversityChicago, IL

Tia P. Andrighetti, DNP, CNM, CHSEAssociate Professor FrontierNursing UniversityNorthfield, NH

Rhonda Arthur, DNP, CNM, WHNP‐BC, FNP‐BC, CNEAssociate ProfessorFrontier Nursing UniversityFloyd, VA

Melissa D. Avery, PhD, CNM, FACNM, FAANDirector, Nurse‐Midwifery ProgramProfessorSchool of NursingUniversity of MinnesotaMinneapolis, MN

Kelley A. Bowden, MS, RNPerinatal Outreach Nurse Educator Maine Medical CenterPortland, ME

Heather M. Bradford, MS, CNM, ARNP, FACNMAssistant Program DirectorNurse Midwifery/WHNP ProgramsSchool of Nursing and Health StudiesGeorgetown UniversitySeattle, WA

Mary C. Brucker, PhD, CNM, FACNM, FAANAdjunct Associate ProfessorNurse Midwifery/WHNP ProgramsSchool of Nursing and Health StudiesGeorgetown UniversityEditor, Nursing for Women’s HealthArlington, TX

Victoria H. Burslem, MSN, CNM, APRN, FACNM, Clinical Bound FacultyFrontier Nursing UniversityNicholasville, KY

Patricia W. Caudle, DNSc, CNM, FNP‐RetAssociate ProfessorFrontier Nursing UniversityHeber Springs, AK

Amy R. Chavez, MA, CMT, CCEReStoryative Somatics, Trauma Informed Birth EducationYellow Springs, Ohio

Joyce D. Cappiello, PhD, FNP, FAANPAssistant ProfessorCollege of Health and Human ServicesUniversity of New HampshireDurham, NH

Debora M. Dole, PhD, CNM, FACNMVice‐Chair, Department of Advanced Practice NursingAssociate ProfessorNurse Midwifery/WHNP ProgramsSchool of Nursing and Health StudiesGeorgetown UniversityWest Harrison, IN

Melicia Escobar, MSN, CNM, WHNP‐BCClinical Faculty Director, InstructorNurse Midwifery/WHNP ProgramsSchool of Nursing & Health StudiesGeorgetown UniversityPhiladelphia, PA

Jenifer Fahey, MPH, PhD(c), CNM, FACNMAssistant Professor & Director Division of Midwifery University of Maryland School of Medicine Department of Obstetrics, Gynecology & Reproductive ScienceBaltimore, MD

Cindy L. Farley, PhD, CNM, FACNMAssociate ProfessorNurse Midwifery/WHNP ProgramsSchool of Nursing & Health StudiesGeorgetown UniversityYellow Springs, OH

Eva M. Fried, DNP, MS, RN, WHNP‐BCAdjunct FacultyNurse Midwifery/WHNP ProgramsSchool of Nursing & Health StudiesGeorgetown UniversityColumbus, OH

Elizabeth Gabzdyl, DNP, CNM, APNAssistant ProfessorCollege of NursingSeattle UniversitySeattle, WA

Meghan Garland, MSN, CNMFacultyFrontier Nursing UniversityWinter Haven, FL

Daisy J. Goodman, DNP, MPH, CNM, WHNP‐BCClinical Assistant Professor, Obstetrics & Gynecology Dartmouth Institute for Health Policy and Clinical PracticeHanover, NH

Karen Trister Grace, PhD(c), MSN, CNMAdjunct FacultyNurse‐Midwifery/WHNP ProgramsSchool of Nursing & Health Studies Georgetown UniversityBethesda, MD

Nena R. Harris, PhD, FNP‐BC, CNMAssistant ProfessorFrontier Nursing UniversityShelter Health ServicesCharlotte, NC

Lise Hauser, DNP, APN, CNMAssistant Director of Public Health Nursing Kane County Health Department Aurora, IL

Lisa Hanson, PhD, CNM, FACNMProfessor and Director Midwifery Program College of NursingMarquette UniversityMilwaukee, WI

Kathryn Harrod, PhD, CNM, FACNMLead Nurse Midwife Aurora HealthcareAssistant Clinical ProfessorCollege of Nursing Marquette UniversityMilwaukee, WI

Cecilia M. Jevitt, PhD, CNM, FACNMMidwifery and Women’s Health Specialties Coordinator School of NursingYale UniversityNew Haven, CT

Robin G. Jordan, PhD, CNM, FACNMAdjunct FacultyNurse Midwifery/WHNP ProgramsSchool of Nursing & Health StudiesGeorgetown UniversityPetoskey, MI

Deborah Brandt Karsnitz, DNP, CNMProfessorFrontier Nursing UniversitySimpsonville, KY

Julia Lange Kessler, DNP, CM, FACNMProgram Director, Assistant ProfessorNurse Midwifery/WHNP ProgramsSchool of Nursing & Health StudiesGeorgetown UniversityWesttown, New York

Tekoa L. King, MPH, CNM, FACNMDeputy Editor, Journal of Midwifery & Women’s Health Health Sciences Clinical ProfessorSchool of NursingUniversity of California San FranciscoSan Francisco, CA

Carrie S. Klima, PhD, CNM, FACNMProgram Director, Clinical Associate ProfessorNurse‐Midwifery & WHNP ProgramsUniversity of IIlinois in ChicagoChicago, IL

Jalana Lazar, MS, CNM, WHNP, MPHClinical Midwife, Lifestages Women’s CenterAdjunct FacultyNurse‐Midwifery/WHNP programsSchool of Nursing & Health StudiesGeorgetown UniversityYellow Springs, OH

Amy Marowitz, DNP, CNMAssociate ProfessorFrontier Nursing UniversityLeland, MI

Carrie E. Neerland, PhD(c), CNM, FACNMStaff MidwifeUniversity of Minnesota HealthMinneapolis, MN

Cynthia Nypaver, PhD, CNM, WHNP‐BCAssociate ProfessorDirector, Nurse Midwifery ProgramCollege of NursingUniversity of CincinnatiCincinnati, OH

Alane B. O’Connor, FNP, DNPFaculty Maine Dartmouth Family Medicine ResidencyAugusta, ME

Cindy Parke, RNC, C‐EFM, MSN, CNMDirector and Owner, Professional Education CenterChico, CA

Elizabeth A. Parr, MSN, CNM,Assistant Professor, Advisor and Clinical CoordinatorMidwifery Institute at JeffersonEmmaus, PA

Nancy Pesta Walsh, DNP, CNPAssistant ProfessorFrontier Nursing UniversityHutchinson, MN

Nancy Jo Reedy, MPH, CNM, FACNMCourse Faculty, Clinical AdvisorNurse‐Midwifery/WHNP programsSchool of Nursing & Health StudiesGeorgetown UniversityArlington, TX

Karen Robinson, PhD, CNMAssistant ProfessorCollege of NursingMarquette UniversityMilwaukee, WI

Cathy Ruhl, MS, CNMDirector, Women’s Health ProgramsPresbyterian HospitalAlbuquerque, NM

Melissa A. Saftner, PhD, CNM, FACNMClinical Associate ProfessorSchool of NursingUniversity of MinnesotaMinneapolis, MN

Heather Shlosser, DNP, FNP‐BC, PMHNP‐BCDirector, Psychiatric Mental Health NursePractitioner ProgramFrontier Nursing UniversityPMHNP Iris TelehealthKeene, NH

Nell L. Tharpe, MS, CNM, FACNM, CRNFA (E)Perinatal and Women’s Health ConsultantAdjunct ProfessorSchool of Continuing Professional Studies at Jefferson (Philadelphia University + Thomas Jefferson University)Adjunct Faculty, Birthwise Midwifery School East Boothbay, ME

Leah N. Torres, MDRocky Mountain Health CenterWest Valley City, UT

Kimberly K. Trout, PhD, CNM, APRNAssistant Professor Department of Family & Community HealthSchool of NursingUniversity of PennsylvaniaPhiladelphia, PA

Leona VandeVusse, PhD, CNM, FACNMAssociate Professor EmeritaCollege of NursingMarquette UniversityMilwaukee, WI

Marsha Walker, RN, IBCLCExecutive DirectorNational Alliance for Breastfeeding AdvocacyChair Board of Directors Massachusetts Breastfeeding CoalitionBoston, MA

Kaitlin Wilson, MS, CNMBrookhaven, GA

Michal J. Wright, MS, CNMRayle, GA

Preface

Pregnancy and the birth of a baby are significant life‐changing events for a woman and her family. A woman transforms into a mother, and a family is created. Optimal care not only focuses on the physical process but also on the emotional experience of pregnancy and the postpartum period. The context of a woman’s culture, life experiences, social roles, and physical and mental health status on the childbearing experience influence her options, choices and outcomes.