Family-Centered Maternal and Newborn Care

• Family-centered care is research-based, holistic, collaborative, and crucial in multicultural settings, especially for Indigenous peoples during pregnancy and birth and should be provided close to home.
• Individualized maternal and newborn care is ideal, requiring women and families to be well-informed.
• Women and families should be central in decision-making pertaining to maternal and newborn care.
• A provider’s language influences a family’s experience, demanding respect for reproductive rights and a system for evaluation, potentially incorporating global best practices.
• Family Nursing as Relational Inquiry involves nurses collaborating with families, is interpretive, critical, and spiritual and uses pattern identification for health promotion.
• Family health is viewed through phenomenological, sociopolitical, spiritual, and socio-environmental lenses.
• Technology has boosted survival rates for children, but has increased rates of chronic illnesses, amplifying tech needs at home.
• Nurses advocate for older kids, involving them in planning modified advance directives with family and the medical team.
• Historically, fathers were excluded from birthing rooms, mothers were heavily sedated, and newborns were separated for hours, delaying bonding and hospital stays averaged a week long.
• Current trends include declining fertility and marriage rates, rising divorce rates, and single-parent or blended families.
• Institutional culture shifts toward family-centered care, LGBTQ2S inclusivity, midwifery care, doulas, baby-friendly initiatives, and tech advances.
• Immigration can cause healthcare access issues due to language or system navigation barriers, thus translators and family health beliefs are key.
• Perinatal nursing involves caring for women and families during pregnancy, childbirth, and postpartum.
• Family-centered approach acknowledges pregnancy and birth as healthy and normal in promoting early parent-infant attachment.
• Immigrant families can struggle accessing healthcare due to language barriers or trouble navigating systems.
• Nurses must confirm that families understand health teachings, and might need translators while respecting family health beliefs.
• National guidelines promote care close to home, individualized care, and the integral role of women and families in decisions.
• Family-centered maternity and newborn care respects reproductive rights and requires ongoing evaluation along with considering global best practices.
• Nurses strive to build ethnic, sociocultural, and linguistic diversity to meet patient needs and respect diverse traditions.
• Culturally competent care involves cultural awareness, valuing diversity, effective communication, sensitivity to personal space, understanding time orientation, and respect for family roles.

Cultural Competence

• Nurses should aim for cultural awareness, sensitivity, competence, safety, understanding power imbalances, and cultural humility.
• Cultural humility is recognizing that one can never be fully "experts" or "competent" in another's culture/history.

Baby Friendly Initiative (BFI)

• The WHO and UNICEF promote and protect breastfeeding through hospitals/community services in Canada through the BFI 10 steps and WHO Code Outcome Indicators.
• Technology increased survival in perinatal nursing and subsequently grew technology requirements and chronic illnesses at home, therefore nurses organize this care along with advocating for older children.

Maternal and Neonatal Health

• Indigenous populations face the highest pregnancy-related mortality in Ontario/Canada linked to low income, education, poor housing, and food choices.
• The top five causes of neonatal mortality are low birth weight, infections, and SIDS.

Fetal Development

• Fetal development includes fertilization to birth.
• Fertilization starts with sperm and egg uniting to form a zygote; sperm can live in the cervix for up to seven days, and pregnancy can occur with sex up to five days before ovulation.
• Zygote: The initial single-celled fertilization product.
• Morula: The solid ball of cells that develop from division of a zygote.
• Implantation starts when the morula moves to the uterus and attaches to the uterine lining.
• Blastocyst: Morula develops into a blastocyst, which has a fluid-filled cavity and an inner cell mass that develops into an embryo.
• Outer blastocyst layer (trophoblast) helps with placenta development.
• Ectoderm, Mesoderm, Endoderm: The three germ layers that differentiate from the inner cell mass, producing various tissues and organs.
• The yolk sac forms in the uterus early in pregnancy, therefore it nourishes and facilitates gas exchange impacting the umbilical cord, reproductive organs, umbilical cord and blood cells.
• Amnion: The amnion encloses the developing embryo within a fluid-filled amniotic sac.
• Chorion: The chorion is an extraembryonic membrane, that contributes to the placenta formation.
• Sperm has either an X or Y chromosome.
• XX pairing results in a female; XY yields a male.
• pH and estrogen levels in the female reproductive tract influence the survival rate and motility of the X- and Y-bearing sperm.

Nursing Care Management

• Perinatal nursing care requires assessment, recognizing cues, nursing diagnoses, prioritizing hypotheses, expected outcomes, generating solutions, plan of action, implementation, and evaluation.