MCN. The American journal of maternal child nursing
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MCN Am J Matern Child Nurs · Jul 2019
ReviewCare and Treatment Recommendations for Pregnant Women with Opioid Use Disorder.
Recent data suggest a significant increase in use of opioids among pregnant women. In the United States, reported rates of neonatal abstinence syndrome increased from 1.5 per 1,000 to 6.0 per 1,000 live births from 2000 to 2013. Use of opioids, both pharmacologic and nonpharmacologic, during pregnancy exposes women and babies to increased risks of adverse health outcomes. Professional organizations recommend addressing the complex needs of women who use opioids during pregnancy. ⋯ During prenatal care, nurses can screen for opioid use disorder, develop positive relationships, and refer to treatment. This care should be based on values-neutral strategies to promote healthy outcomes for pregnant women and their babies.
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Infertility affects more than 7 million American couples. As traditional treatments fail and the costs of hiring a surrogate increase in the United States, transnational commercial surrogacy becomes a feasible alternative for many couples. Infertile couples may opt for this choice after reading enticing Internet advertisements of global medical tourism offering "special deals" on commercial surrogacy. ⋯ This multidisciplinary review of the literature suggests that the issue of commercial surrogacy is complex and influenced by a number of factors including expensive infertility costs, ease of global travel, and the financial vulnerability of Indian commercial surrogate mothers and their families. Questions are being raised about decision making by the surrogate mother particularly as influenced by gender inequities, power differentials, and inadequate legal protection for the surrogate mother. More research is needed to understand commercial surrogacy, especially research inclusive of the viewpoints of the Indian mothers and their families involved in these transactions.
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MCN Am J Matern Child Nurs · Mar 2010
ReviewOvercoming the challenges: maternal movement and positioning to facilitate labor progress.
The benefits of maternal movement and position changes to facilitate labor progress have been discussed in the literature for decades. Recent routine interventions such as amniotomy, induction, fetal monitoring, and epidural anesthesia, as well as an increase in maternal obesity, have made position changes during labor challenging. The lack of maternal changes in position throughout labor can contribute to dystocia and increase the risk of cesarean births for failure to progress or descend. This article provides a historical review of the research findings related to the effects of maternal positioning on the labor process and uses six physiological principles as a framework to offer suggestions for maternal positioning both before and after epidural anesthesia.
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MCN Am J Matern Child Nurs · Jan 2009
ReviewCaring for the extremely obese woman during pregnancy and birth.
This article describes the special care needed by the pregnant woman who is extremely obese. Many pregnant women who are extremely obese have underlying medical conditions, and a multidisciplinary, coordinated approach to their care involving anesthesia providers, physicians, and the nursing staff is needed to develop a detailed plan for vaginal and cesarean births. Such an approach, begun preconceptionally or during pregnancy, can enable care to be delivered smoothly and safely and should include an evaluation of the unit's equipment and furniture to determine if they are appropriate for obese persons. Equipment that should be evaluated for size and weight limits include beds, operating room tables, commodes, wheelchairs, scales, walkers, blood pressure cuffs, transfer devices, and intermittent pneumatic compression devices.
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MCN Am J Matern Child Nurs · Jul 2008
ReviewConsiderations for emergencies & disasters in the neonatal intensive care unit.
This article outlines outside principles of emergency and disaster planning for neonatal intensive care units and includes resources available to organizations to support planning and education, and considerations for nurses developing hospital-specific neonatal intensive care unit disaster plans. Hospital disaster preparedness programs and unit-specific policies and procedures are essential in facilitating an effective response to major incidents or disasters, whether they are man-made or natural. All disasters place extraordinary stress on existing resources, systems, and personnel. If nurses in neonatal intensive care units work collaboratively to identify essential services in disasters, the result could be safer care for vulnerable patients.