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Chapter 10

Chapter 10 . Promoting a Healthy Pregnancy Edited by Catherine Marin, MSN/Ed(c), WHCNP, RN. Planning for Pregnancy. Preconception Periconception Interconception Preconception counseling Identify conditions that could adversely affect pregnancy. The Healthy Body.

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Chapter 10

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  1. Chapter 10 Promoting a Healthy Pregnancy Edited by Catherine Marin, MSN/Ed(c), WHCNP, RN

  2. Planning for Pregnancy • Preconception • Periconception • Interconception • Preconception counseling • Identify conditions that could adversely affect pregnancy

  3. The Healthy Body • Menstrual and medical history • Exposure to childhood illnesses • Exposure to STIs (for example, chlymydia,gonorrhea, herpes) • Exposures related to lifestyle choices (for e.g., monagamous relationship or multiple partners) • Physical examination • Laboratory evaluation (for e.g., CBC, UA, Blood Type, Rubella, VDRL/RPR, Hepatitis, HIV • Genetic testing

  4. The Healthy Mind • Readiness for motherhood • Psychological changes during pregnancy (Ambivalence, Acceptance, Preparation for motherhood) • The healthy relationship • Readiness for fatherhood • Support for life changes

  5. Nutrition and Weight Gain • Nutritional elements • Calories • Protein • Water • Minerals and vitamins • Iron • Folic acid

  6. Weight Gain • Affected by: • Physiological factors • Social influences • Inadequate diet • Inadequate physical activity • Management • Daily food and fluid intake

  7. Factors That Affect Nutrition • Eating disorders • PICA- associated with anemia • Anorexia nervosa, bulimia nervosa • Cultural factors • Vegetarian diets • Food cravings and food aversions

  8. Exercise, Work, and Rest • Exercise • Muscle strengthening • No rigorous aerobic activity • Work • Impact on pregnancy • Maternity leave • Rest

  9. Medications • Safe versus teratogenic • Always consult physician regarding ANY medication • Over-the-counter • Herbal and homeopathic preparations • Prescription • FDA pregnancy categories

  10. Common Discomforts • Nausea and vomiting • Ptyalism • Fatigue • Nasal congestion • Backache • Leukorrhea

  11. Common Discomforts (cont.) • Urinary frequency • Dyspepsia • Flatulence • Constipation/hemorrhoids • Dental problems • Leg cramps

  12. Common Discomforts (cont.) • Dependent edema • Varicosities • Dyspareunia • Nocturia • Insomnia • Round ligament pain

  13. Common Discomforts (cont.) • Hyperventilation, shortness of breath • Numbness/tingling in fingers • Supine Hypotensive Syndrome

  14. Signs and Symptoms of Danger

  15. First Trimester • Severe, persistent vomiting • Abdominal pain and vaginal bleeding • Indicators of infection

  16. Second Trimester • Maternal complications • Preeclampsia • Premature rupture of the membranes • Preterm labor • Fetal complications • Decreased fundal height • Absence of fetal movement after quickening

  17. Third Trimester • Maternal complications • Gestational diabetes • Placenta previa • Abruptio placentae • Fetal complications • Hypoxia

  18. Pregnancy Map • Prenatal care map • Timetable

  19. Childbirth Education • Primary goal • To promote a positive childbearing experience • Topics • Anatomy and physiology • Comfort measures • Labor and birth process • Relaxation and pain management

  20. Childbirth Education—Methods • Lamaze • Empowerment • Dispelling myths • Controlled breathing, position, massage, relaxation • Bradley • Inward relaxation • Normal breathing

  21. Other Methods • Dick-Read • HypnoBirthing • LeBoyer method • Odent method • Birthing from within

  22. Finding Information on Childbirth Education • Primary source—health care provider • Online and at-home programs • Parents need to ask questions about the class to determine if it fits their needs • Factors related to personal values and beliefs

  23. The Birth Plan • Written information that identifies labor and birth preferences • The choices • Choosing a provider • Choosing a location

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