Electronic Fetal Heart Rate Monitoring

Christine Le, an accountant living in Flushing, New York, gave birth to a healthy baby “Nathan” on January 29th, 2010. She found out that she was pregnant with her first child when her period was late. She had the routine prenatal care starting at 12 weeks and delivered at 40 weeks in a hospital with the present of her husband, Robert, and the in-laws. To insure her baby was healthy, Christine underwent several prenatal diagnostic methods like amniocentesis to examine for genetic defects. Another method was ultrasound; its purpose is to assess fetal age, multiple pregnancies, size and shape of the fetus. Christine underwent numerous lab tests to ensure that there are no complications (Berk, pg.43). Lab tests like a complete blood count that screens

Maternity Care and Delivery is a totally different situation that involves the health and well being of two patients, the mom and the baby. The procedures we code for would include the monitoring

Childbirth is one of the greatest privileges on the earth anyone could have and we, as women, should feel proud to be major contributors for it. Thus, a mother has to play a key role in aiding the healthcare workers to mitigate the health crisis associated with childbirth by performing her duties faithfully. One such associated health crisis is “Premature (preterm) birth” which occurs when the baby is born too early, before 37 weeks of gestational period (CDC, 2015). The rate of preterm birth ranges from 5% to 18% of babies born across 184 countries (WHO, 2015).

Once this distinction is made, contractions must continually be monitored because fetal well-being is assessed by monitoring fetal response (FHR) during contractions. Also, the frequency, duration and intensity of the contractions provide information about the progression of labor.

The writer explained there could be no concern for fetal or maternal health during the delivery although some obstetricians tended to induce labor in all diabetic mothers to protect babies and mothers. Moreover, labor progress was supposedly assessed by old-fashioned methods, which resulted in performing unnecessary obstetrical practices. Intervention was imposed in cases of inaccurately labeled slow or abnormal labors and failures to progress. It is common practice that a primary cesarean generally produces subsequent surgical deliveries. The author realized that cesareans were performed because of insufficient data on laboring women’s

Randomization was used to generate what patient went to which group. The way the patients were chosen eliminated bias because “Randomization was performed according to a computer-generated list by means of sequentially numbered, opaque, sealed envelopes which revealed the allocation of the subject to either induction or expectant management”(Nielsen et al. p. 60). This secure randomization added a great strength to the study. The sample size seemed fairly large, 226 patients were split into 116 for elective induction and 110 to expectant management, although the power analysis was disclosed in this study and determined that 600 patients were required. Only 226 patients were used and because it would take 4 years to reach the required amount of patients, the study was discontinued. This was both a strength and weakness because disclosing this information made the study more honest but the quota needed to reach the best answers was not attained. The study for the 226 patients was pretty standard with the 80% power and alpha at 0.05. T-test and chi square tests were used to compare the proportions between the groups of people. The women were chosen based on the inclusion criteria of being 39 weeks gestation or older, maternal age of more than 17, fetal cephalic presentation, singleton gestation, a candidate for vaginal delivery, and a Bishop score of 5 or greater in nulliparous women and 4 or greater for multiparous women. This inclusion criterion was a concern because both nulliparous women and multiparous women were being tested together. This was a weakness because the labor patterns of a nulliparous woman compared to a multiparous woman are very variable and sure to distort study data. It was also disclosed how gestational age was achieved which included the crown rump test measured in 6-12

While we were doing our assessment I noticed that Ms. K.R. had been lying on her back for some time. During moms contractions the fetal heart monitor displayed variable decelerations and a slight deviation from the baseline heart tones. Once contractions subsided the fetal heart rate recovered to

Ricci, S. Kyle, T. and Carman, S. (2017). Maternity and pediatric nursing 3rd ed. Philadelphia:

Cesarean section (C/S) births can occur in the hospital for several reasons. Some women choose to have elective C/S birth and others require C/S births out of infant or maternal safety, complications, or by necessity. This paper discusses both elective and emergency C/S deliveries and reviews both National Guideline policy and Carilion Clinic policies on C/S births. The problem statement is: in pregnant women (population), does C/S delivery following National or Carilion policies (IV: exposure vs. none-exposure) differ in terms of patient care and outcomes concerning maternal and neonatal health (DV)?

Decelerations in fetal heart rate can indicate a number of complications, and since it is not in our scope of practice to make medical diagnoses, it is crucial for the nurse to relay their finding to the health care provider in order for them to make an assessment and proper diagnosis.

Woman-centred care requires a holistic approach and should encompass all a woman’s expectations from an emotional, physical, spiritual and cultural perspective (Fahy K 2012 & Australian College of Midwives (ACM) 2016). I believe that woman-centred care is of utmost importance in all aspects of midwifery care, and I am sure that many others in the profession would share my opinion. Simple principals of woman-centred care include but are not limited to: collaborative care between health professionals, continuity of care provider, care focused on the woman’s needs and expectations before those of the institution or health professionals and ensures the woman’s autonomy and ability to make informed decisions is supported and respected (Fahy K 2012 & ACM 2016). Unfortunately in some situations, woman-centred care is not always successfully implemented. A common example is when there is an indication for Electronic Fetal Monitoring (EFM), particularly in the intrapartum period

Providing continuous physical and emotional support during labour can reducing maternal fear, stress, and anxiety and protect physiological birth (Steen, 2012). Research shows that fear and anxiety during labour and birth can be detrimental to physiological birth. An environment that women feel unsafe in may stimulate a surge of neuro-hormones that can influence both fetal and maternal physiology, causing irregularity of contractions, fetal distress and subsequent medical inteverntions (Fahy & Parratt, 2006). Conversly, maintaining an environment where women feel safe, protected and supported can facilitate favourable physiological performance (Fahy & Parratt, 2006). Midwives can do this by giving women one-on-one continuous support and placing her at the centre of care throughout childbirth (Steen, 2012). As observed in practice, by constantly reassuring the woman about her progress, her baby’s health and addressing any of her concerns, the midwife can provide a calm and relaxing environment that is conducive to the labouring woman (Buckley, 2015; Steen, 2012). The midwife worked with the woman, encouraging her throughout labour and birth by telling her that she was doing extremely well. The midwife also breathed in-tune with the woman while giving her a back massage, inducing a sense of comfort. The atmosphere was calm and this contributed to the woman garnering confidence in her ability to avoid medical pain relief. Downe (2008) noted that the positive impact of

a. Joseph C. Howard, the director of the American Bioethics Advisory Commission gave strong evidence “Studies involving ultrasoudonography, electronic fetal heart monitoring

monitor fetal heartbeat. In the first stage of labor , the neck of the uterus,

Prenatal care is widely accepted as an important element in improving pregnancy outcome. (Gorrie, McKinney, Murray, 1998). Prenatal care is defined as care of a pregnant woman during the time in the maternity cycle that begins with conception and ends with the onset of labor. A medical, surgical, gynecologic, obstretic, social and family history is taken (Mosby's Medical, Nursing, and Allied Health Dictionary, 1998). It is important for a pregnant woman as well as our society to know that everything that you do has an effect on your baby. Because so many women opt not to receive the benefits of prenatal care, our society sees the ramification, which include a variety of complications primarily