FRAMEWORK FOR MATERNAL AND 1. COMMUNITY-CENTERED 9.

Encourages family bonding through rooming-in and

- The health of the families is both affected by family visiting in maternal and child healthcare
CHILD HEALTH NURSING
and influences the health of the communities. settings.
Goals and philosophies of maternal and CHN: 2. EVIDENCE-BASED
10. Encourages early hospital discharge options to
- Whereby critical knowledge increases.
• The primary goal: Promotion and maintenance reunite families as soon as possible in order to create
- A challenging role for nurses and a major
of optimal family health. a seamless, helpful transition process.
factor in keeping families well and optimally
• During a prenatal visit, a nurse assess that a functioning. 11. Encourages families to reach out to their
pregnant patient’s uterus is expanding normal. community so they can develop a wealth of support
• During a health maintenance visit, a nurse MNCHN (Nurse): people they can call on in a time of family crisis.
assesses a child’s growth and development.
1. Considers the family as a whole and as a partner in
MCHN extends from preconception to menopause care when planning or implementing or evaluating the
with an expensive array of health issues and effectiveness of care. MCH Goals and Standards
healthcare providers. 2. Serves as an advocate to protect the rights of all • NATIONAL HEALTHY PEOPLE 2020 GOALS
FAMILY – CENTERED APPROACH family members, including the fetus.
- Intended to help Americans most easily understand
• Preferred focus of nursing care 3. Demonstrates a high degree of independent nursing the importance of health promotion and disease
• The health of an individual and their ability to functions because teaching and counseling are major prevention and to encourage wide participation in
function as a number of a family can strongly interventions. improving health in the next decade.
influence and improve overall family 4. Promotes health & disease prevention because 3 OVERALL HEALTH & WELL-BEING MEASURES
functioning. these protect the health of the next generation.
• Enable nurses to better understand individuals a. Well-being, including overall life satisfaction.
and their effects on others and in turn, to 5. Serves as an important resource for families during
childbearing and childrearing as these can be b. Life expectancy in good health, free of activity
provide more holistic care.
extremely stressful times in a life cycle. limitations and of disability.
• It includes:
- Encouraging rooming in with the birthing 6. Respects personal, cultural, and spiritual attitudes c. Summary mortality and health measures.
parent by their partner or support person and and beliefs as these strongly influence the meaning
with the child by their caregiver. • GLOBAL HEALTH GOALS*
and impact of childbearing and childrearing.
- Family members are encouraged to provide - The UN and the WHO established millennium health
physical and emotional care based on the 7. Encourages developmental stimulation during both
goals in 2000 in an effort to improve health worldwide.
individual situation and their comfort level. health and illness as children can reach their ultimate
capacity in adult life. - The 169 SDGs with 17 targets were established.
MNCHN is (Nursing):
8. Assesses families for strengths as well as specific
FAMILY-CENTERED - Assessment should always needs or challenges.
include the family as well as the individual
MATERNAL AND CHILD HEALTH NURSING | CMAF
 strong professional practice can flourish with - All nurse managers and nurse leaders in magnet
regard to the hospital's mission, vision, and values. designated hospitals must have either a baccalaureate
- Central to this goal are targets that relate to MCH:
3. EXEMPLARY PROFESSIONAL PRACTICE- The or master’s degree in nursing.
a. By 2030, reduce the global maternal mortality ratio setting demonstrates a comprehensive
to less than 70 per 100,000 live births. understanding of the role of nursing, the Nursing Theory
application of that role with patients, families,
b. By 2030, end preventable deaths of newborns and • Callista Roy's Theory
communities, and the interdisciplinary team so
children under 5 years old. that new knowledge and evidence can be applied -Stresses that it is an important role of the nurse to help
c. Ensure universal access to sexual and reproductive to nursing care. patients adapt to change caused by illness or other
healthcare services. 4. NEW KNOWLEDGE, INNOVATION, AND stressors.
IMPROVEMENTS- The organization demonstrates
d. Achieve universal health coverage. strong nursing leadership, empowered • Dorothea Orem's Theory
professionals, and exemplary practice while -Concentrates on examining patients' ability to
e. Strengthen the prevention and treatment of
contributing to patient care. perform self-care.
substance abuse.
5. EMPIRICAL QUALITY RESULTS- The hospital
f. End the epidemics of AIDS, TB, malaria, and demonstrates solid structure and processes • Patricia Benner's Theory
neglected tropical diseases, and combat hepatitis, where strong professional practice can flourish
- Discusses the way nurses move from novice to expert
water-borne diseases, and other communicable and where the mission, vision, and values come to
as they become more experienced and prepared to
diseases (WHO, 2020). life, as the organization advances the outcomes
give interpersonal care.
believed to be important for the organization.
HEALTH SETTING MAGNET STATUS: - Extensive changes in the scope of MCHN have
Magnet Hospital (According to the ANCC) occurred: as health promotion (teaching, counseling,
Magnet Status
-Attract and maintain top talent; Improve patient care, supporting, and advocacy or keeping parents and
- Credential furnished by the American Nurses safety, and satisfaction; Foster a collaborative culture children well) has become a greater priority in care.
Credentialing Center (ANCC) to hospitals that meet a
rigorous set of criteria designed to improve the - Advance nursing standards and practice Framework
strength and quality of nursing care.
-Grow business and financial success Can be visualized into a framework in which nurses
5 Criteria: (TSENE) use the nursing process, nursing theory, and Quality
- Typically demonstrate a high level of nursing job
and Safety Education for Nurses (QSEN)
1. TRANSFORMATIONAL LEADERSHIP - Ability of satisfaction and a low staff nurse turnover rate
competencies to care for families during childbearing
nurses in the designated organization to convert
- Have policies in place that involve nurses in data and childrearing years and through the 4 phases of
their organization’s values, beliefs, and behaviors
collection and decision-making about patient care. healthcare.
in order to create a high professional level of
nursing care. - They value staff nurses, involve them in research-
2. STRUCTURAL EMPOWERMENT- Refers to the based practice, and encourage and reward them for
ability to provide an innovative environment where obtaining additional degrees in nursing.

MATERNAL AND CHILD HEALTH NURSING | CMAF

 • Plays an important role in evidence-based care
as bodies of professional knowledge only grow
4 Phases of Healthcare:
and expand to the extent people in that
1. Health Promotion Six Competencies: profession are able to carry out research.
- Educating parents and children to follow sound
health practices through teaching and role
1. Patient-Centered Care- The patient or designee Roles and Responsibilities of a MCN
is thought of as the source of control and full (Midwifery Clinical Nurse)
modeling.
partner in the provision of compassionate and
2. Health Maintenance
coordinated care based on respect for the • Often class-trained.
- Intervening to maintain health and reduce the patient's preferences, values, and needs. • Must retain skills and knowledge that allow
risk of illness in patients. 2. Teamwork and Collaboration- Nurses function them to assist the patient during the entire
3. Health Restoration effectively within nursing and interprofessional hospital stay.
- Using continuous assessment to be certain that teams, fostering open communication, mutual • Serves in tasks related to labor, delivery,
symptoms of illness are identified and respect, and shared decision-making as they recovery, educational, postpartum, and
interventions are begun to return the patient to achieve quality patient care. management of high-risk pregnancies.
wellness most rapidly. 3. Evidence-Based Practice- Nurses integrate the • Include: fetal monitoring, assisting in cesarean
4. Health Rehabilitation best current evidence with clinical expertise delivery, and identifying postpartum
- Helping prevents complications from illness by and patient/family preferences and values for complications.
helping a patient with residual effects achieve delivery of optimal care. • Often needs technical skills in order to
an optimal state of wellness and independence 4. Quality Improvement- Nurses use data to effectively understand advanced equipment
or helping a patient accept inevitable death. monitor the outcomes of care and use and procedures.
improvement methods to design and test • Continuing education in order to stay up-to-date
Quality and Safety Education for Nurses changes to continuously improve the quality on the latest innovations and new practices in
➢ Robert Wood Johnson Foundation and safety of healthcare systems. the field.
5. Safety- Nurses minimize the risk of harm to
In 2007, he challenged nursing leaders to improve patients and providers through both system BASIC NURSING SKILLS ARE A NECESSITY
the quality of nursing care and build the effectiveness and individual performance.
• Patient management pain
knowledge, skills, and attitudes necessary to help 6. Informatics- Nurses use information and
achieve that level of care, starting with pre- • Patient and family education
technology to communicate, manage
licensure and graduate programs. knowledge, mitigate error, and support • Assessment
decision-making. • Diagnosis
Overall Goal of QSEN • Communication
To address the challenges of preparing future nurses Nursing Research CARING FOR A MOTHER AND BABY
with the attributes necessary to continuously improve • The systematic investigations of problems that SIMULTANEOUSLY
the quality and safety of the healthcare systems in have implications for nursing practice usually
which they work. carried out by nurses.

MATERNAL AND CHILD HEALTH NURSING | CMAF

 • This family-centered model of maternity • Infant Mortality Rate: - The number of deaths • The primary goal is to provide maximum health
healthcare encourages family decision and per 1,000 live births occurring at birth or in the to expectant mothers and their babies.
bonding and facilitates education. first 12 months of life.
Goals:
• Also encompasses care before and after the • Childhood Mortality Rate: - The number of
delivery. deaths for 1,000 live population in children aged 1. To ensure a healthy and uncomplicated pregnancy
• Involves duties such as prenatal dress 1-14 years. and the delivery of a healthy infant.
testing and checking on new mothers and
infants after discharge. SUSTAINABLE DEVELOPMENT GOALS 2. To identify and treat high risk conditions.

AREAS OF EXPERTISE IN MCN • Also known as the Global Goals. 3. To individualize patient care.
• Adopted by the UN in 2015 as a universal call to 4. To assist the patient for her preparation for labor,
• Treating a pregnant teenager. action to end poverty, protect the planet, and delivery and puerperium.
• A critically ill child. ensure that by 2030 all people enjoy peace &
• Another group within the community. prosperity. 5. To identify risk factors or diseases that may affect
the mother or the infant's health and life.
COMMON STATISTICAL TERMS USED TO REPORT
MCH 6. To reinforce healthy habits to the woman and her
family.
• Birth Rate: The ratio of the number of total live
births to the total population, expressed as Definitions of Terms
births per 1,000 population.
• Fertility Rate: The number of pregnancies per • Antepartum: time between conception and the
1,000 biological women of childbearing age onset of labor; usually used to describe the
• Fetal Death Rate: - The number of fetal deaths period during which a woman is pregnant.
(over 500g) per 1,000 live births. • Intrapartum: time from the onset of true labor
• Neonatal Death Rate: - The number of deaths until the birth of the infant and placenta.
per 1,000 live births occurring at birth or in the • Postpartum: time from the delivery of the
first 28 days of life. placenta and membranes until the woman's
• Perinatal Death Rate: - The number of deaths body returns to a non-pregnant condition.
during the perinatal time period (beginning • Gestation: the number of weeks of pregnancy
when a fetus reaches 500g about 28 weeks into since the first day of the last menstrual period.
pregnancy and ending about 4-6 weeks after • Para or Parity: the number of pregnancies in
birth). It is the sum of the fetal and neonatal Pre Natal-Care which the fetus or fetuses have reached viability
rates. when they are born, regardless of whether the
• also known as antenatal care is a type of infants were born alive; not the number of
• Maternal Mortality Rate: - The number of
preventive healthcare provided to a woman fetuses (twins) born.
maternal deaths per 100,000 live births that
during pregnancy.
occur as a direct result of the reproductive • Gravida: a person who is or has been pregnant
process.
MATERNAL AND CHILD HEALTH NURSING | CMAF
• Primigravida: a person who is pregnant for the • Term: a pregnancy from the beginning of week - based on the assessment findings, the nurse-
first time. 38 of gestation to the end of week 42 of midwife should identify risk conditions or factors
• Primipara: a person who has given birth to one gestation. that increase the possibility of complications for
child past age of viability. • Post term: a pregnancy that goes beyond 42
the mother and the fetus during pregnancy.
• Multigravida: a person who has had two or more weeks of gestation.
pregnancies. • Parturient: a woman in labor. Components of Prenatal Care at the
• Grand Multipara: a person who has carried five
ANTENATAL VISIT BHS and RHU Under Maternal Care
or more pregnancies to viability.
• Multipara: a woman who has completed two or Program of the DOH
FOLLOW-UP VISITS: DURING PREGNANCY
more pregnancies to the stage of fetal viability. 1.History Taking
• Nulligravida: a woman who has never been • Visits every 4 weeks up to 28 weeks gestation
pregnant. (during the 1st & 2nd trimesters). • Home Base Mother's Record/Mom & Baby Book:
• Puerpera: a woman who has just delivered • 29-36 weeks visits are scheduled every 2 Used when rendering prenatal care in pregnancy,
(within 6 weeks after delivery) weeks. -37-40 weeks gestation visits are every childbirth and postpartum period, identifying risk
• Live birth: A live birth is recorded when the week. factors, danger signs, health education and
infant born shows signs of life: breathing, • Although less intense, visits include additional referrals.
spontaneous movement of voluntary muscles interview data & physical examination. • BHW performs regular home visits in areas without
and heartbeat. licensed health personnel using the HBMR and
DOH MNCH Program
• Stillbirth: An infant born without signs of life. • makes referral when necessary.
• Early Neonatal Death: Death of newborn within • 1st tri = up to 12 weeks and 6 days AOG (at least • Risk factors that need close monitoring and
7 weeks after birth. 1 checkup) referral to physician:
• Late Neonatal Death: An infant who died • 2nd tri = 13-27 weeks and 6 days AOG (at least - Below 18 years old and above 35 years old
between 7 to 29 days after birth. 1 check-up) - Below 4 feet or 145 cm tall
• Low birth weight/Small for Gestational Age • 3rd tri = 28 weeks AOG and more (at least 2 - 5th or more pregnancy
(SGA): An infant with a birthweight below the check-ups) - Previous CS Tuberculosis
10th percentile rank. A term infant is
COMPONENTS OF PRENATAL CLINIC - Heart Disease
considered low birthweight if the birthweight is
- Diabetes
less than 2500 grams. Large for gestational Age VISITS
(LGA): an infant with birthweight above 90th - Bronchial Asthma
percentile rank. A term infant with a birth weight FIRST CLINIC VISIT - Goiter
of more than 4000 rowgrams. - is a time to obtain baseline data through interview, - Three consecutive abortions, miscarriages or
• Preterm: a pregnancy that has reached 20 laboratory tests and complete physical still birth.
weeks of gestation but before completion of 37 examination. • Classification of pregnant women based on
weeks of gestation. initial prenatal check-up:
- Normal patients
- Patients with serious complications
MATERNAL AND CHILD HEALTH NURSING | CMAF
- Patients with mild complications with 400 mcg Folic acid, once a day for 6 months or - First postpartum visit within 24 hours after
180 tablets for the entire pregnancy period. delivery, next visit at least 1 week after
2. Complete Physical Examination per visit delivery, third visit after 2-4 weeks
• Iron tablet should be taken as soon as
• Weight pregnancy is confirmed - Mother advised to visit healthcare facility
within 4 to 6 weeks after delivery.
• Height • Calcium Carbonate: 1.25g with 500 mg calcium
carbonate equivalent to 40 mg elemental - Birth certificate should be filled up by birth
• Blood Pressure calcium, 1-tab 3x times a day starting at 20th attendant and filed at civil service registry.
week until delivery - Newborn should be enrolled in Under five and
• Examination of conjunctiva and palms for pallor issued Growth Monitoring Chart
Note: To be given starting 2nd trimester. If pregnant
• Abdominal Exam for fundic height, fetal position,
women failed to visit the health facility at 2nd trimester,
presentation and FHT
calcium carbonate may still be given in the third SUBSEQUENT CLINIC VISITS
• Examination of face, hands, lower extremities for trimester
edema A. Maternal Assessment
• Iodized oil fluid oral 500 mg equivalent to
• Examination of the breasts 200mg elemental iodine, 2 capsules, single - Blood Pressure
dose (preferably given during the 1st trimester) - Weight and edema assessment
• Examination of thyroid for enlargement
• Deworming Drug (Albendazole 400mg or - Nutrition and appetite, discomforts of
• One capsule iodized oil a year for goiter endemic Mebendazole 500mg): given one dose of pregnancy, sign and symptoms of pregnancy,
area deworming tablet preferably during the 2nd or danger signs
3rd trimester among the total number of - Urinalysis
estimated pregnant women in the population. - Other problems and concerns of the woman.
6. Health Education B. Fetal Assessment
7. Laboratory Examination • Fetal Heart Rate after it has been auscultated
• Quickening and presence of daily fetal
- Syphilis Screening Test movements after 20 weeks
- CBC or Hgb & Hct • Fundal Height to estimate fetal growth rate.
- HIV Screening Test • Specific assessments as indicated: Ultrasound,
- Hepa B Screening Test Biophysical profile, amniocentesis, electronic
fetal heart rate, non-stress test (NST),
8. Oral Dental Examination
contraction stress test (CST)
5. Supplementation
9. Referral when necessary • Abdominal palpation after 24 weeks to
• Complete iron tablet with folic acid determine lie, position and presentation.
supplementation refers to 60 mg of elemental iron 10. Home Delivery • Late in pregnancy, Vaginal examination is
performed to obtain data about presenting part,
11. Postnatal services:
MATERNAL AND CHILD HEALTH NURSING | CMAF
 pelvic measurement, cervical effacement, • preeclampsia headache, visual disturbances, or swelling of
dilatation and station. • congenital anomalies the hands and face.
• cephalopelvic disproportion • Document whether the pregnancy was
C. Health Teachings
b. Women above 35 years old are at increased the risk intended. If you feel uncomfortable asking
• Normal signs and symptoms of pregnancy for: about this directly, use a statement such as,
• Minor discomforts, prevention and • hypertension "All pregnancies are a bit of a surprise. Is that
management • diabetes mellitus how it was with this one?" Another way to word
• Danger signs and symptoms • placenta previa and abruptio placenta such a question might be, "Some couples plan
• Nutrition and Diet • cesarean section on having children right away; some plan on
• Rest, exercise and Relaxation • ectopic pregnancy waiting. How was it with you?"
• Avoidance of drugs, alcohol, cigarettes and too • fetal growth retardation • Interview should be in a private setting so that
much caffeine. • chromosomal abnormality especially Down the woman will not be inhibited from voicing out
all her concerns and other information.
• Clothing syndrome
• Sexual Relations • abortion • Interview should be conducted unhurriedly and
in a relax manner.
• Employment • perinatal and infant mortality
• All information obtained from the patient should
• Travel
CHIEF CONCERN be treated confidential and must be known only
• Preparation for baby's birth, labor, delivery and
by the people involved in the care of the patient.
pueperium. • History Taking is initiated by asking the woman
about her FAMILY PROFILE
COMPONENTS OF THE HEALTH HISTORY
• CHIEF CONCERN for coming to the healthcare
- Obtaining information about the woman's family
DEMOGRAPHIC DATA facility (health center, clinic, hospital)
structure and function early in an interview helps you
• Chief concern is the reason the patient has get to know her, identify her important support
• Is the first information gathered during the come to the healthcare setting-in this instance
interview and includes name, address and persons, shape the nature and kind of questions you
confirmation of pregnancy. want to ask, and evaluate the possible impact of the
contact number, birth, date, age, civil status, • Document the date of her last menstrual
race, religion, economic status, occupation, woman's culture on care. It also lays a foundation for
period. health teaching. Areas important to ask about include:
choice of whom to contact in case of • Elicit information about the usual signs that
emergency, health insurance information and occur with early pregnancy, such as nausea, • Marital status and support people available and if a
other personal preferences. vomiting, breast changes, or fatigue. partner will be accompanying her for visits.
Age: • Ask if she is feeling any discomfort with her
• Educational level of her and her partner (helps you
pregnancy, such as constipation, backache, or
estimate the level of teaching you will need to plan
• Women below 15 years of age are at increased risk frequent urination.
for: • Ask also about any danger signs of pregnancy, • Size and structure of the apartment or house. You'll
• anemia such as bleeding, abdominal pain, continuous need this information so you can talk with her in the
• prematurity coming months about space for a baby. If she is

MATERNAL AND CHILD HEALTH NURSING | CMAF

restricted from climbing stairs more than once or -Ask the woman about any past surgical procedures • Genetically inherited diseases
twice a day during the last part of pregnancy or after • Congenital anomalies
-Ask the woman whether she has had immunization
birth, knowing whether essential rooms are located on • Multiple gestation
the ground floor is helpful. -Ask about alcohol intake cigarette smoking and use of • Diabetes mellitus
drugs. • Psychiatric disorders
• Lifestyle. Are finances a problem? Does the woman
take usual safety precautions such as use of a Existing medical problems that may cause DAY HISTORY/SOCIAL PROFILE
seatbelt when in her car? Does she smokes, drink complications or be aggravated by the pregnancy
alcohol, or use recreational drugs? Does she have include: -Information about a woman's current nutrition,
smoke and carbon monoxide monitors in her elimination, sleep, recreation, and interpersonal
home? • kidney disease interactions can be elicited best by asking a woman to
• Document whether a woman has recently • heart disease describe what her typical day is like.
experienced any lifestyle changes such as a • hypertension
change in status from independence to • sexually transmitted
dependence, a chronic illness, the death or loss of • diabetes
a significant person, a geographic move, financial • thyroid disease
hardship, o or lack of s f support people. These are • recurrent seizures GYNECOLOGIC HISTORY
all examples of stressful situations that could • gallbladder disease
Menstrual History
hinder a woman's ability to accept her pregnancy • varicosities
and child. • urinary tract infections • Ask the woman
• phenylketonuria • Age of menarche
HISTORY OF PAST ILLNESSES
• tuberculosis • Menstrual cycle (interval, duration, amount,
-Ask the woman about childhood diseases such as • asthma discomforts)

• Chickenpox (varicella) HISTORY OF FAMILY ILLNESS Breast Health

• Mumps (parotitis)
-Identifying any illnesses that occur frequently in a • Inquire about breast surgery, history of breast
• Measles (Rubeola)
woman's relatives can help identify potential problems cancer, other breast disorders and
• German measles (Rubella)
a woman or her infant could experience during breastfeeding of previous infants.
• Poliomyelitis
pregnancy or after birth. • Perineal and Breast Self-Examination. Perineal
-Confirm whether a woman has had an HPV vaccine; self-examination is inspecting the external
-Try to elicit a 3-generation family history
many women are not yet aware that the vaccine has genitalia monthly for signs of infection or
the potential not only to prevent HPV infections but -Ask the woman about her family's illness such : lesions
also to prevent cervical cancer. • Breast self-examination is no longer thought to
• Cardiovascular diseases yield enough reliable information to be
-Ask the woman about allergies, and any drug • Renal disease continued as a monthly self-care routine, but
sensitivities. • Cognitive impairment women should be alerted to normal breast
• Blood disorders
MATERNAL AND CHILD HEALTH NURSING | CMAF
 changes during pregnancy and about the • Another woman, not certain she is pregnant, • Women can relieve stress incontinence to
responsibility to begin having mammograms may be continuing to take an oral some degree by strengthening perineal
when they reach 40 years of age. They still contraceptive. If a pregnancy is confirmed, you muscles with the use of Kegel exercises
should have a yearly breast examination by a can assure her taking the pill while pregnant will (periodic tightening of the perineal muscles).
health care provider, so this will be done at a not cause fetal harm but she should discontinue • Surgical correction to increase support to the
first prenatal visit taking it for the remainder of pregnancy. bladder neck could be performed following the
pregnancy.
Past Surgery
Sexual History
• Any type of past surgery on the reproductive
tract is important to document because it can • Be certain to obtain a sexual history, including DOMESTIC VIOLENCE
influence a woman's ability to conceive and give the number of sexual partners and the use of
• It is imperative for the nurse-midwife to screen
birth. safer sex practices, to establish a woman's risk
prenatal patients for domestic violence as
• For example, if a woman had tubal surgery for contracting a sexually transmitted infection
battering causes both physical and emotional
following an ectopic pregnancy, her statistical such as herpes (a viral infection spread by direct
trauma on the woman and jeopardizes the life of the
risk of another tubal pregnancy is greater than contact) or hepatitis C (a viral infection spread
fetus.
usual because of possible tubal scarring. by contact with blood or by intercourse with a
• Questions related to domestic violence should be
• If she had uterine surgery, a cesarean birth may partner who is infected).
asked directly in a private setting.
be necessary because her uterus may not be • The nurse-midwife must maintain a nonjudgmental
Urinary Incontinence
able to contract as efficiently as usual because attitude throughout the interview
of a surgical scar. • assess for the possibility of stress incontinence
• If she has undergone frequent dilatation and (incontinence of urine on laughing, coughing, MATERNAL ATTITUDE AND REACTION
curettage of the uterus or cervical biopsies, her deep inspiration, jogging, or running). TOWARDS PREGNANCY
cervix may be weakened or unable to remain • Urinary incontinence occurs with these actions
closed for 9 months, leading to preterm birth because they cause the diaphragm to descend, • Take note of the feelings and reactions of the
unless she has a surgical procedure (cerclage) which then increases overall abdominal mother towards her present condition.
to prevent premature dilation. pressure and bladder tension; increased tension • Explore the following areas:
leads to sudden emptying if the woman lacks - Is this a planned or wanted pregnancy? What
Reproductive Planning support persons/systems are available for her?
strength in her perineal muscles or bladder
supports. - What are her expectations about the pregnancy,
• ask what contraceptive method is being
labor, puerperium and the baby?
currently used
Stress Incontinence -What are her plans for prenatal care, labor,
• duration of usage
delivery, puerperium, and baby?
• reason for using such method and other • Commonly, this weakness occurs from past
contraception used, including acceptance or difficult births, the birth of large infants, grand Obstetric History:
reason for termination of their usage. multiparity, or instrument births.

MATERNAL AND CHILD HEALTH NURSING | CMAF

provides greater details on a woman's pregnancy • All marital acts must respect both the unitive and 1. The family is behaving, functioning organism.
history. procreative purposes of the marital act.
2. The family develops its own lifestyle.
2 DIGIT SYSTEM:
• SEXUAL RELATIONSHIP IN MARRIAGE HAS TWO 3. The family operated as a group.
• G-Gravida represents the number of PURPOSES
4. The family accommodates to the need of the
pregnancies the woman has had.
1. Strengthen the couple and allows them to individual.
• P- Para represents the number of pregnancies
express their love in a powerful way (unitive)
that have reached 20 or more weeks of CHARACTERISTICS OF HEALTHY FAMILIES:
gestation before birth. 2. Leads to the creation of new life
(procreation) 1. Communicates and listens
2. Supports its members
5 DIGIT SYSTEM: (G-T-P-A-L)
PROCREATION, CREATION AND
EVOLUTION 3. Teaches respect for others
• G- Gravida
• Procreation - is the creation of a new human 4. Develops trust
• T-Term Number of full-term infants born (infants
born at 37 weeks or after) person, by the act of sexual intercourse, by a man 5. Plays and shares a sense of humor
• P-Preterm Number of preterm infants born and a woman.
• Creation - is the making of all things from nothing, 6. Strong sense of family
(infants born before 37 weeks)
• A - Abortions Number of spontaneous by an act of God, at some time in the past. God's 7. Seeks help when necessary
miscarriages or therapeutic abortions action could have taken a second, or 6 days, or a
• L-Living Number of living children
million years. The Concept of Family
• Evolutionary theory - is the theory that all things
came about by the repeated random actions of • Family is defined by the U.S. Census Bureau
A CONCEPT OF UNITIVE AND (USCB, 2010) as "a group of people related by
natural selection, whereby:
PROCREATIVE HEALTH 1. Life came into existence, and then blood, marriage, or adoption living together."
2. Primitive life evolved into more and more • Allender (2013) defines the family in a much
• UNITIVE - Union of two individuals that is mutually
complex organism, and eventually producing broader context as "two or more people who live in
agreed to become one.
mankind. the same household (usually), share a common
• PROCREATIVE - Create and produce another life.
• Family of Orientation- the family to which one is emotional bond, and perform certain interrelated
• Thus, unitive, and procreative are sacred
born, reared and socialized. It consists of a father, social tasks."
• Marriage is when a man and woman unite "as one
flesh" Sex is unitive. mother, brothers and sisters.
• Family of Procreation- the family established by the
Family Types
• Marriage needs to be open to the possibility of
having children. Sex is procreative person by his/her marriage, consists of a husband, For the purposes of assessing families, two basic
wife, sons and daughters. family types can be described:
• The unitive and procreative aspects of the sexual
act are inseparable. CHARACTERISTICS OF THE FAMILY AS A CLIENT • Family of orientation (the family one is born into; or
oneself, mother, father, and siblings, if any)
MATERNAL AND CHILD HEALTH NURSING | CMAF
• Family of procreation (a family one establishes; or •Positive aspects: Companionship, possibly financial • Positive aspects: Companionship; shared
oneself, spouse or significant other, and children, if security; encourages a monogamous relationship resources
any)
• Potential negative aspects: As with dyad families, • Possible negative aspects: Not sanctioned by law;
Family types and its structure may result in a feeling of loss if only short term and the disapproval by community; decreased value of women
breakup isn't desired by both partners
A. The Dyad Family E. The Extended (Multigenerational) Family
- is two people living together without children. C. The Nuclear Family - includes not only a nuclear family but also other
- usually refers to single young adults who live family members such as grandmothers,
- is composed of a husband, wife, and children.
together in shared apartments or dormitories grandfathers, aunts, uncles, cousins, and
- it was the most common family structure seen grandchildren.
for companionship and financial security while
worldwide.
completing school or beginning a career. - Advantage of such a family is it contains more
- The biggest advantage of a nuclear family is its people to serve as resources during crises and
- Dyad families are generally viewed as
ability to provide support to family members provides more role models for behavior or
temporary arrangements, but this could extend
because, with its small size, people know each values (Keene, Prokos, & Held, 2012).
into a lifetime arrangement.
other well and can feel genuine affection and
• Positive aspects: Companionship, possibly shared support for and from each other. • Positive aspects: Many people for child care and
resources member support
• Positive aspects: Support for family members;
• Potential negative aspects: Often a short-term sense of security • Possible negative aspects: Resources may be
arrangement so can result in a sense of loss when the stretched thin because of few wages’ earners
• Possible negative aspects: May lack support
relationship ends
people in a crisis situation
B. The Cohabitation Family F. The Single-Parent Family
D. The Polygamous Family
- are composed of couples, perhaps with -
children, who live together but remain
- Although polygamy (a marriage with multiple Single-parent families play a large role in
wives or husbands) has been illegal in the childrearing.
unmarried. Although such a relationship may be
United States since 1978, such families are not - Unfortunately, low income is often a problem
temporary, it may also be as long-lasting and as
an unusual arrangement worldwide, so new encountered by single-parent families,
meaningful as a more traditional alliance.
immigrants may report they have been raised in especially if a woman is the head of the
- Many couples choose cohabitation as a way of household.
this type of family (or may still be living in this
getting to know a potential life partner before
arrangement). - Single parents have difficulty working full time
marriage because of the hope this will make
their eventual marriage stronger. Statistically, - This category can be further divided into plus taking total care of young children.
however, couples who cohabit before marriage polygyny (a family with one man and several - Trying to fulfill several central roles (mother and
have a higher divorce rate than those who do wives) and polyandry (one wife with more than father) is not only time consuming but also
not (Cherlin, 2012). one husband) (Jacobson & Burton, 2011). mentally and physically exhausting and, in many
instances, not rewarded.
G. The Blended Family
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- (a remarriage or reconstituted family), a the child as well as for any other children in the
divorced or widowed person with children family (Jones, 2012).
marries someone who also has children.
H. The Gay or Lesbian Family
- Gay is the socially preferred term to describe
men who have sex with men; lesbian is used to
denote women who have sex with women.
- Gay couples or lesbian couples live together as
partners for companionship, financial security,
and sexual fulfillment, or form the same
structure as a nuclear family.
I. The Foster Family
- Children whose parents can no longer care for
them may be placed in a foster or substitute
home by a child protection agency (Kubiak,
Kasiborski, Karim, et al., 2012).
- Foster parents may have children of their own;
they receive remuneration for care of the foster
child.
- Theoretically, foster home placement is
temporary until children can be returned to
their own parents.
- Unfortunately, if return does not become
possible, children may be raised to adulthood in
a series of foster care families.

J. The Adoptive Family

- Families of a great many types (nuclear,
extended, cohabitation, blended, single parent,
gay, and lesbian) adopt children today.
- No matter what the family structure, adopting
not only brings unusual joy and fulfillment to a
family but can also offer a number of
challenges for both the adopting parents and

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