Scope and Standards of

Maternal and Child practice

in the Philippines

PPT Presentation by: Group 5

 Scope and Standards of Maternal and Child
practice in the Philippines

1. Health care technology

advances maternal and child
care; making it accessible.
 Scope and Standards of Maternal and Child
practice in the Philippines

2. Childbearing families is a major focus

of nursing today; helping prenatal care
and helping to achieve emotional
preparation for childbearing.
 Scope and Standards of Maternal and Child
practice in the Philippines

3. Continues health supervision and

support for health assurance.
 Scope and Standards of Maternal and Child
practice in the Philippines

4. As maturity reach, cycle repeats and

generation of support becomes
necessary.
 Scope and Standards of Maternal and Child
practice in the Philippines

5. Maternity and child care are not two

separate entities; but a continuum.
 Scope and Standards of Maternal and Child
practice in the Philippines

EXAMPLE OF SCOPE:
-Preconceptual Health Care
-care of women during three trimester and the puerperium
-care of infants during the perineal period
-care of children from birth through young adulthood
-care in birthing room, pediatric intensive care unit, or at
home.
 Scope and Standards of Maternal and Child
practice in the Philippines

Keeping the family as center of care or

considering the family as the primary unit
of care is vital because family functioning
affects health status of its members.
Legal considerations of
Maternal child practice
 Legal Considerations of Maternal Child
Practices

Maternal and child health nursing carries

some legal concerns above and beyond
other areas of nursing because care is often
given to “unseen clients”— the fetus to to
client who are not legal age for giving
consent.
 Legal Considerations of Maternal Child
Practices

NEW TECHNOLOGIES

can lead to potential legal actions, especially if clients are uninformed about
the reason or medical necessity for these procedures.

(e,g,. assisted reproduction, surrogate motherhood, umbilical cord sampling,

safety of new medications with children, and end-of-life decisions)
 Legal Considerations of Maternal Child
Practices

Nurses

legally responsible for protecting the rights of their clients, including

con dentiality, and are accountable for the quality of their individual nursing
care and that of other health care team members.
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 Legal Considerations of Maternal Child
Practices

Documentations
essential for justifying actions.

This concern is long lasting, because children who feel they were
wronged by health care personnel can bring lawsuit at thetime they
reach legal age.
Personal liability insurance is strongly recommended for all
nurses, so they do not incur great nancial losses during a
malpractice or professional negligence lawsuit.
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Legal Considerations of Maternal Child
Practices

In divorced or blended families

it is important to establish who has
the right to give consent for health
care.
Ethico-moral Considerations
of Maternal child practice
 Ethico-moral Considerations of Maternal
child practice

1. Some of the most dif cult ethical quandaries in health

care today are those that involve children and their families.

Conception issues, especially those related to in vitro fertilization, embryo

transfer, ownership of frozen oocytes or sperm, and surrogate motherhood.

Abortion, particularly partial-birth abortion

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 Ethico-moral Considerations of Maternal
child practice

2. Legal and ethical aspects of issues

are often intertwined, which makes the decision-making process in this

area complex.

maternal and child health nursing is strongly family centered

 Ethico-moral Considerations of Maternal
child practice

3. Maintaining privacy yet aiding Problem solving

in these instances can be dif cult but is a central
nursing role.

Nurses can help clients by providing factual information and supportive

listening, and helping the family and health care providers clarify their
values.
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 Ethico-moral Considerations of Maternal
child practice

4. The Pregnant Woman’s Bills of Rights and the United Nations

Declarations of Rights of the Child

provide guidelines for determining the rights of women and children with
regard to maternal and child health care.
ETHICAL AND SOCIAL ISSUES IN
PERINATAL NURSING
 ETHICAL AND SOCIAL ISSUES IN
PERINATAL NURSING

Ethical Principles and Framework

Ethical principles the guide ethical action include four primary moral
principles:
— respect for bene cence
— nonmale cence
— justice
— autonomy
which upholds the rights of individuals and families.
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 ETHICAL AND SOCIAL ISSUES IN
PERINATAL NURSING

Bene cence Nonmale cence

• is the obligation to do good. • which is the obligation to do no harm.

These two principles should be considered in relationship to healthcare

technology that has the ability to sustain life without accurate predictions
of long-term outcomes.
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 ETHICAL AND SOCIAL ISSUES IN
PERINATAL NURSING

Justice

• is the principle of treating everyone fairly through providing comparative

and equitable treatment.
• Other principles important in interaction with women and
children and their families as well as healthcare professionals include
· delity,
· veracity,
· con dentiality, and
· privacy
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 ETHICAL AND SOCIAL ISSUES IN
PERINATAL NURSING

Privacy and Con dentiality Veracity

of patient information are clearly is the obligation to demonstrate
outlined in the American Nurses integrity and truth-telling, disclosing
Association (ANA) Code of Ethics to women and their families accurate
for Nurses (2001). information regarding the relative risk
and bene ts of health management.

Fidelity
is the obligation to keep
commitments.
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 ETHICAL AND SOCIAL ISSUES IN
PERINATAL NURSING

Frameworks for ethical practice include

Virtue ethics, which focuses on character
and morality rather than obligations and
rights.
 ETHICAL AND SOCIAL ISSUES IN
PERINATAL NURSING

Deontology or duty ethics (Kantanism)

• focuses on the professional responsibilities with an emphasis on
rules and principles.

The framework of utilitarianism

• focuses on doing the greatest good for the greatest number of people.

The framework of Justice

• is another framework that focuses ondistributing resources equally.
 ETHICAL AND SOCIAL ISSUES IN
PERINATAL NURSING

The ethics of Caring

• emphasizes empathy and concern and the responsibility nurses have to
demonstrate compassion and empathy.

Feminist ethics
• focuses on understanding the sociocultural context of the lives of
women in making ethical decisions.R
Contraception
 Contraception

Contraception
•refers to any method, device, or procedure used to prevent
pregnancy and allows individuals to control their reproductive
health.
•Dual protection and Hormonal contraceptives and IUDs.
 Contraception
A. Intrauterine Contraception
1. Levonorgestrel intrauterine system (LNG IUD)
- The LNG IUD is a small T-shaped device like the Copper T IUD.
- It is placed inside the uterus by doctor.
- It releases a small amount of progestin each day to keep you from
getting pregnant.
- The LNG IUD stays in your uterus for up to 3 to 6 years, depending on the
device.
- Typical use failure rate:0.1-0.4%.
 Contraception
A. Intrauterine Contraception

2. Copper T intrauterine device (IUD)

- This IUD is a small device that is shaped
in the form of a “T”.
- Your doctor places it inside the uterus
to prevent pregnancy.
- It can stay in your uterus for up to 10
years.
- Typical use failure rate: 0.8%.1
 Contraception
B. Hormonal Methods
1. Implant
- The implant is a single, thin rod that is
inserted under the skin of a women’s
upper arm.
- The rod contains a progestin that is
released into the body over 3 years.

2. Injection or “shot”
- Women get shots of intramuscular
injection of depot medroxyprogesterone
acetate (DMPA), the hormone progestin in
the buttocks or arm every (3) three
months from their doctor.
 Contraception
B. Hormonal Methods
3. Combined oral contraceptive
- Also called “the pill” combined oral contraceptives contain the hormones
estrogen and progestin. It is prescribed by a doctor.
- A pill is taken at the same time each day.
- If you are older than 35 years and smoke, have a history of blood clots or breast
cancer, your doctor may advise you not to take the pill.

4. Progestin only pill

- Unlike the combined pill, the progestin only pill (sometimes called the mini-pill)
only has one hormone, progestin, instead of both estrogen and progestin. It
is prescribed by a doctor.
- It is taken at the same time each day.
- It may be a good option for women who can’t take estrogen.
 Contraception
B. Hormonal Methods
5. Patch
- This skin patch is worn on the lower abdomen, buttocks, or upper body (but
not on the breasts).
- This method is prescribed by a doctor. It releases hormones progestin and
estrogen into the bloodstream.
- You put on a new patch (1) once a week for three weeks.
- During the fourth week, you do not wear a patch, so you can have a
menstrual period.

6. Hormonal vaginal contraceptive ring

- The ring releases the hormones progestin and estrogen.
- You place the ring inside your vagina.
- You wear the ring for (3) three weeks,
- take it out for the week you have your period, and
- then put in a new ring
 Contraception
C. Barrier Methods
1. Diaphragm or cervical cap
- Each of these barrier methods are placed inside the vagina to cover the
cervix to block sperm.
- The diaphragm is a circular rubber disk shaped like a shallow cup.
- The cervical cap is a thimble-shaped cup.
- Before sexual intercourse, you insert them with spermicide to block or kill
sperm.
- Visit your doctor for a proper tting because diaphragms and cervical caps
come in different sizes.

2. Sponge
- The contraceptive sponge contains spermicide and is placed in the vagina
where it ts over the cervix.
- The sponge works for up to 24 hours, and must be left in the vagina for at
least 6 hours after the last act of intercourse, at which time it is removed
and discarded.
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 Contraception
C. Barrier Methods
3. Male condom
- Worn by the man, a male condom keeps sperm from getting into a woman’s
body.
- Latex condoms, the most common type, help prevent pregnancy, and HIV and
other STDs, as do the newer synthetic
condoms.
- “Natural” or “lambskin” condoms also help prevent pregnancy, but may not
provide protection against STDs, including HIV.

4. Female condom
- Worn by the woman, the female condom helps keeps sperm from
getting into her body.
- It is packaged with a lubricant and is available at drug stores. It can be
inserted up to (8) eight hours before sexual intercourse.
 Contraception
C. Barrier Methods

5. Spermicides
- These products work by killing sperm and come in several forms—
• foam, gel, cream, lm,suppository, or tablet.
- They are placed in the vagina no more than one hour before
intercourse.
- You leave them in place at least (6) six to (8) eight hours after
intercourse.
- You can use a spermicide in addition to a male condom, diaphragm, or
cervical cap.
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 Contraception
D. Fertility Awareness-Based Methods

- Understanding your monthly fertility pattern icon can help you plan to get
pregnant or avoid getting pregnant.
- Your fertility pattern is the number of days in the month when you are fertile (able to
get pregnant), days when you are infertile,
and days when fertility is unlikely, but
possible.
- If you have a regular menstrual cycle, you have about (9) nine or more fertile days
each month.
- If you do not want to get pregnant, you do not have sex on the days you are fertile, or
you use a barrier method of birth control on those days.
 Contraception
D. Fertility Awareness-Based Methods
 Contraception
E. Lactational Amenorrhea Method
• For women who have recently had a baby
and are breastfeeding, the Lactational
Amenorrhea Method (LAM) can be used as
birth control when three conditions are
met:

1. amenorrhea (not having any menstrual periods

after delivering a baby),
2. fully or nearly fully breastfeeding, and
3. less than 6 months after delivering a baby. LAM
is a temporary method of birth control, and
another birth control method must be used
when any of the three conditions are not met
 Contraception
F. Permanent Methods of Birth Control
1. Female Sterilization”Tubal ligation or
“tying tube”
- A woman can have her fallopian tubes tied (or closed) so that sperm and eggs
cannot meet for fertilization.
- The procedure can be done in a hospital or in an outpatient surgical
center.
- You can go home the same day of the surgery and resume your normal
activities within a few days.
2. Male Sterilization Vasectomy
- This operation is done to keep a man’s sperm from going to his penis, so his
ejaculate never has any sperm in it that
can fertilize an egg.
- The procedure is typically done at an outpatient surgical center.
- The man can go home the same day.
- Recovery time is less than (1) one week. After the operation, a man visits his
doctor for tests to count his sperm and to make sure the sperm count has
dropped to zero; this takes about 12 weeks.
- Another form of birth control should be used until the man’s sperm count has
dropped to zero.
ALTERNATIVE METHODS OF BIRTH
 ALTERNATIVE METHODS OF BIRTH

1. Vaginal Delivery
• In a vaginal birth, the baby is born through the birth canal. It's hard to know when
exactly you will go into labor, but most women give birth at around 38-41 weeks
of pregnancy.
• The nation’s largest ob-gyn organization recommends that pregnant women plan for
vaginal birth unless there is a medicalreason for a cesarean.
• In new guidelines issued in 2013, The American College of Obstetricians and
Gynecologists says maternal-request cesareans are especially not recommended
for women planning to have several children, nor should they be performed
before 39 completed weeks of pregnancy.

Bene ts of vaginal delivery:

· shorter hospital stays
· lower infection rates
· quicker recovery
· babies born vaginally have a lower risk
of respiratory problems
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 ALTERNATIVE METHODS OF BIRTH

2. Cesarian Section (C-Section)

• A cesarean section or C-section is the delivery of a baby through a surgical
incision in the mother's abdomen and uterus.
• In certain circumstances, a C-section is scheduled in advance. In others, it's done in
response to an unforeseen complication.

Events that may require C-Section:

• Multiples (twins, triplets, etc)
• A very large baby
• Previous surgery, C-Sections, or other
uterine conditions
• Baby is in breech (bottom rst) or
transverse (sideways) position
• Placenta previa (when the placenta is low in
the uterus and covers the cervix)
• Fibroid or other large obstruction
•
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 ALTERNATIVE METHODS OF BIRTH

3. Vaginal Birth After Cesarian

•VBAC isn't right for everyone, though. Sometimes a pregnancy complication or
underlying condition prevents the possibility of a successful VBAC.
•Many local hospitals don't offer VBAC because they don't have the staff or
resources to handle emergency C-sections.
4. Vacuum Extraction
• A vacuum extraction is a procedure sometimes done during the course of
vaginal childbirth.
• During vacuum extraction, a health care provider applies the vacuum (a soft or rigid
cup with a handle and a vacuum pump) to the baby's head to help guide the baby
out of the birth canal.
5. Forceps Delivery
•A forceps delivery is a type of operative vaginal delivery. It's sometimes needed in
the course of vaginal childbirth.
•In a forceps delivery, a health care provider applies forceps (an instrument shaped like a
pair of large spoons or salad tongs) to the baby's head to help guide the baby out
of the birth canal.
COMMON REPRODUCTIVE ISSUES
 COMMON REPRODUCTIVE ISSUES

1. Birth Control Has Become More Widely Available

2. The Rates of HPV Have Increased
3. The Education and Screening for Endometriosis Is Improving
4. Women’s Pain Still Isn’ t Taken Seriously Enough
5. Products Targeting Women Vaginal Health Often Are
Unnecessary
PADAYON f;RN2028