Before birth (prenatal)

Antepartum

During birth

Intrapartum

After birth

Postpartum

Obstetricians

Family practice physicians

certified nurse midwives

Nurse practitioners

Prenatal Care Providers

Ensure adequate intake of folic acid to prevent neural tube defects in developing fetus

Preconception care

Obstetric

Menstrual

contraceptive

medical and surgical

womans family

partners family

both womans and partners history to identify risk factors

psychosocial

Components of prenatal health history

evaluate the womans general health

determine baseline weight and vital signs

evaluate nutritional status

identify current physical/social problems

determines the estimated date of delivery (EDD)

Physical Examination

Evaluate the size adequacy, and condition of the pelvis and reproductive organs.

assess for signs of pregnancy.

Pelvic examination objectives

Conception to 28 weeks - every 4 weeks

29 to 36 weeks - every 2-3 weeks

37 weeks to birth - weekly

certain laboratory and/or diagnostic tests are performed at various times throughout the pregnancy

Recommended schedule of prenatal visits. Uncomplicated pregnancy

Risk factors: review known and assess for new

Vital signs and weight: determine if gain is normal

Urinalysis: protein, glucose, and ketone levels

Blood glucose screening

Fundal height: fetal growth/amniotic fluid volume

Leopolds maneuvers: assess presentation/ position

fetal heart rate

nutrition intake

any discomforts or problems since last visit

Routine assessments at each prenatal visit

Bacterial vaginosis is most common caused by decrease in lactobacilli.

increase in bacteroid and other anaerobic microorganisms.

may be milk-white discharge.

Vaginal discharge during pregnancy

collecting data from the pregnant woman

identifying and reevaluating risk factors

educating in self-care

providing nutrition counseling

promoting family adaptation to pregnancy

Role of the nurse during prenatal care

Average pregnancy is 40 weeks (280 days) after first day of LNMP, plus or minus 2 weeks.

Nageles Rule

-identify first day of LNMP

-Count backward 3 months

-add 7 days

-update year, if applicable

Determining the estimated date of delivery

Pregnancy divided into 3 13 week parts

important to know what occurs during each trimester to both woman and fetus

helps provide anticipatory guidance

identify deviations from the expected pattern of development

Trimesters

Amenorrhea

nausea

breast tenderness

deepening pigmentation

urinary frequency

fatigue and drowsiness

quickening

Presumptive signs of pregnancy