Preface
Maternal-Newborn Nursing was originally authored by Amy Giles, Regina Prusinski, and Laura Wallace, and published by OpenStax, Rice University. It is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). The original work is available at openstax.org. This version has been adapted for use in the Universal Open Textbook Initiative.
About Maternal-Newborn Nursing
Summary
Nurses in every area of specialty will care for persons assigned female at birth (AFAB). Therefore, nurses should be aware of the nuances of care across the life stages, including adolescence, pregnancy, postpartum, perimenopause, and menopause. People are unique, and nurses are in unique positions to promote health, detect vulnerability, intimate partner violence, homelessness, depression, and impacts of social determinates of health. This text introduces these concepts and encourages students to consider individual patient-centered care.
Maternal-Newborn Nursing is written with a focus on pregnancy, birth, postpartum, breastfeeding, and newborn care. This text presents normal physiology and abnormal conditions specific to maternal/newborn care. The student will be able to implement the Clinical Judgement Measurement Model to recognize, analyze, prioritize, create, act on, and evaluate outcomes throughout the many normal and abnormal conditions presented. After reading Maternal-Newborn Nursing, students will be able to provide patient education regarding contraception, pregnancy, labor, or chronic pelvic pain; screen for mental health issues such as postpartum depression and anxiety, grief, or fear; determine a patient's access to care questioning transportation, insurance, employment; and integrate inclusive care by addressing patients by their preferred name, recognizing populations at higher risk for health disparities or complications, and providing a safe place for care.
Pedagogical Foundation
Maternal-Newborn Nursing uses cognitivism and connectivism as the learning framework. The text provides visual tools such as pictures, charts, and graphs that allow students to internalize information and create long-term knowledge. The text also builds on the students' knowledge and skills likely obtained in previous courses, and expands their learning of new concepts of maternal/newborn nursing. The technology and formats of the offering allows for teachers to build and expand on the existing information, rearrange chapters to fit the needs of the class, and connect students to resources through suggested websites and links. These unique abilities increase active learning, leading to increased cognitive development.
Organizational Framework
The table of contents for Maternal-Newborn Nursing presents content in 27 chapters, organized into 6 thematic units.
- Unit 1 introduces the foundations of maternal-newborn and women's health nursing. It covers trends and standards across all areas, alongside current ethical and legal concerns. The focus on culturally competent care highlights issues affecting families and introduces foundational knowledge.
- Unit 2 explores health promotion and prevention strategies, addressing fertility, family planning, and common reproductive system disorders, including both malignant and benign neoplasms. It explores sexually transmitted infections, vaginal and urinary tract infections, and breast disorders. Additionally, it tackles violence against women, including sexual abuse, human trafficking, and the resultant psychological trauma and its effects on families.
- Unit 3 focuses on the physiological and psychological changes during pregnancy, detailed through prenatal care, screening, and education segmented by trimesters. The unit also presents abnormal pregnancy conditions and reviews various childbirth education models.
- Unit 4 breaks down the birthing process into stages of labor, discussing physiological and psychological adaptations, maternal and fetal monitoring options, and detailed nursing care for each stage. Pain management techniques and interventions for labor complications, such as labor dystocia, cesarean births, and obstetrical emergencies, are thoroughly explored.
- Unit 5 presents normal and abnormal postpartum adaptations, breastfeeding techniques, and the management of postpartum mood and psychiatric disorders. It also introduces postpartum nursing care and screening tools.
- Unit 6 covers immediate post-birth recovery and ongoing care for the newborn. It presents newborn assessments, gestational age estimation, typical newborn care, and parent education for newborn care. The importance of discharge planning is emphasized, alongside discussions on complications like congenital malformations, newborn resuscitation, and various aspects of newborn loss. The final chapter brings all the information together in an unfolding case study.
Nursing Features
To further enhance learning, Maternal-Newborn Nursing includes the following features:
- Clinical Judgment Measurement Model boxes guide students through the application of the Clinical Judgment Measurement Model in maternal-newborn nursing. The content explores the critical thinking and decision-making processes necessary to navigate patient care at different points in the process, from recognizing cues to evaluating outcomes.
- Clinical Safety and Procedures (QSEN) align with the Quality and Safety Education for Nursing competencies by providing detailed explanations of safety protocols and procedures specific to maternal-newborn nursing. This feature emphasizes the importance of patient safety and quality care and offers checklists, step-by-step, or tips on various safety practices.
- Cultural Context boxes explore the impact of cultural factors on maternal-newborn nursing. Some features describe care provided in other countries, while other features discuss cultural considerations for patients in the United States. Cultural Context boxes encourage students to approach each patient individually, respecting their culture and values.
- Ethical/Legal Issues features explore topics concerning ethical or legal issues related to maternal-newborn care. One feature might provide information on legality of prescribing birth control to adolescents, while another feature discusses ethical concerns of genetic testing.
- Life-Stage Context features describe topics that are affected by a patient's age. Age-related topics, such as advanced maternal age, allow the students to critically think about what influences certain conditions.
- Link to Learning features provide a very brief introduction to online resources—videos, interactives, collections, maps, and other engaging resources that are pertinent to students' exploration of the topic at hand.
- Pharmacology Connections features introduce students to specific medications utilized in maternal-newborn nursing. Each feature includes instructions on administration, mechanism of action, dosing, safety for pregnancy or breastfeeding, and patient education.
- Real RN Stories feature firsthand accounts from registered nurses in the field of maternal-newborn nursing. These stories help students make connections to topics on a deeper level.
- Unfolding Case Studies present a hypothetical client scenario that unfolds in three parts across chapters, with each subsequent part presenting new information on the same client, to help foster clinical judgment. In each part of an unfolding case feature, the scenario is followed by two questions that require students to apply their knowledge of evidence-based care and allow them to practice with questions that mimic the style of Next-Gen NCLEX. The answers to these questions, with explanations, are included in the Answer Key for students at the end of the book.
Pedagogical Features
To support student learning, Maternal-Newborn Nursing includes the following standard elements:
- Learning Outcomes: Every chapter section begins with a set of clear and concise student learning outcomes. These outcomes are designed to help the instructor decide what content to include or assign and can guide students on what they can expect to learn and be assessed on.
- Assessments: A variety of assessments allow instructors to confirm core conceptual learning, elicit brief explanations that demonstrate student understanding, and offer more in-depth assignments that enable learners to dive more deeply into a topic or history-study skill.
- Review Questions test for conceptual apprehension of key concepts.
- Check Your Understanding Questions require students to explain concepts in their own words.
- Reflection Questions and Competency-Based Assessment Questions dive deeply into the material to support longer reflection, group discussion, or written assignments.
- What Should the Nurse Do? and Critical Thinking About Case Study Questions assess students' clinical judgment skills using case-based scenarios. Students review either a single case or an unfolding case that reveals information gradually. In response to their observations of the patient, students must decide how to navigate the Clinical Judgment Measurement Model process. This approach challenges them to apply theoretical knowledge to practical situations, determining the most appropriate interventions based on the patient's specific circumstances.
- Answers to Questions in the Book: The assessments are intended for homework assignments or classroom discussion; thus, student-facing answers are not provided in the book. Answers and sample answers are provided in the Instructor Answer Guide for instructors to share with students at their discretion, as is standard for such resources.
- Chapter Summary: Chapter summaries assist both students and instructors by outlining the primary subtopics addressed within the chapter.
- Key Terms: Key terms are presented in bold text and are followed by an explanation in context. Definitions of key terms are also listed in the end-of-chapter glossary.
- References: References are listed at the end of each chapter.
About the Authors
Senior Contributing Authors
Amy Giles, Baylor University. Dr. Giles has been a nurse-midwife since 2002. She received her bachelor's degree from Baylor University, master's degree in nursing from Texas Woman's University, certificate in nurse-midwifery from University of Texas Southwestern Medical School/Parkland School of Nurse-Midwifery, and her Doctor of Nursing Practice from Touro University. She owns Allen Midwifery & Family Wellness, a birth-center, hospital practice, and wellness center outside of Dallas, Texas. Dr. Giles is also a Clinical Assistant Professor in the DNP program at the Louise Herrington School of Nursing at Baylor University.
Regina Prusinski, Otterbein University. Dr. Prusinski holds a BSN from the University of North Carolina, Chapel Hill, an MSN in Acute Care Pediatric Nurse Practitioner from Duke University, a post-master's certificate in Family Nurse Practitioner from Otterbein University, and a Doctor of Nursing Practice from The Ohio State University. She is the Graduate Nursing Director and FNP Director for Otterbein University Department of Nursing.
Laura Wallace, Mercer College. Dr. Wallace received a BSN from Spalding University, an MS with a focus in Nurse-Midwifery from the University of Minnesota, and a PhD in Adult Education from Capella University. She is Assistant Professor-D at Chamberlain University and Faculty Emeritus at Brenau University. Dr. Wallace's nursing career spans more than 40 years as a maternity nurse and certified nurse-midwife.
Contributing Authors
Leah Elliott, Bakersfield College
Rachel Hill, California State University, Sacramento
Debra Hrelic, University of North Carolina Wilmington
Kelly LaMonica, Penn Medicine Princeton Health
Emily Langley, Johns Hopkins All Children's Hospital
Rachael Mooney, Northwood Technical College
JoAnn Peterson, University of Kansas
Courtney Watson, Georgetown University
Nicole Wheeler, Wayne State University
Reviewers
Ashley Anderson, Athena Health and Wellness
Stephane Blundell, University of Massachusetts Global
Beth Condley, University of Oklahoma Health Sciences Center
Jessica Crockett, Pensacola Christian College
Samantha Crouch, Baylor University
Janine Eagon, Marquette University
Amber Essman, Victoria Haynes, University of North Dakota The Ohio State University
Kelley Hicks, Managing Care Solutions
Stacey Hobbick, University of North Florida
Karyn Holt, Drexel University
Jennifer Johnson, Chamberlain University
Yuko Kawasaki, West Valley-Mission Community College
Brittney Kenney, University of Missouri-St. Louis
Thanayi Lambert, University of Texas at Arlington
Wendy Martin, Gordon State College
Angela McCain, Southern University Shreveport
Mikki Meadows-Oliver, New York University
Autumn Mels, University of Chicago
Jacqueline Mendoza-Lu, Herzing University
Melanie Mertz, Gordon State College
Michael Mooney, University of Michigan, Ann Arbor
Nicole M. Murry, University of Texas at Austin
Lauren Olvera, Baylor University
J. Paulat, Concordia-St. Paul University
Claudia Reed, Seattle University
Sarah Shealy, Mount Saint Mary's University
Joy Ferretti Shoemaker, Otterbein University
Katie Sleaford, St. Ambrose University
Mary Williams, Gordon State University
Rachel Wooten, Jacksonville State University
Additional Resources
Instructor resources for this book include an instructor's answer guide, a test bank with more than 1,100 assessments, and PowerPoint lecture slides. These are available through the OpenStax instructor resources page for this book. Instructors can also find and share community-created teaching materials at oercommons.org/hubs/OpenStax.
Special Thanks
The Division of Digital Learning at the Texas Higher Education Coordinating Board (THECB) has a history of dedicated research initiatives, services, and programs that have advanced open education in Texas by providing support, advocacy, and resources to Texas institutions in their OER efforts. The Division maintains a diverse OER portfolio including OERTX, a digital library and community space for open education work. The leadership and collaboration of the Division of Digital Learning staff made the OER Nursing Essentials (ONE) project possible, throughout research, planning, and development phases of the eight-textbook series.
This work was supported in whole or in part by the THECB. The opinions and conclusions expressed in this document are those of the author(s) and do not necessarily represent the opinions or policies of the THECB.