Women's Health Nursing Course - Week 17

Istanbul Gelisim University

• Istanbul Gelisim University is focused on ecological, economic, and social sustainability.
• Website and social media links are provided.

Department of Nursing (ENG)

• The department's focus is on Women's Health and Diseases Nursing.
• The lecturer is Dr. N. Alper Sahbaz, MD.

Course Information

• Course credit: 8
• ECTS: 9
• GBS Link: https://gbs.gelisim.edu.tr/en/lesson-details-17-319-12715-2
• Week: 17

What We Will Learn This Week

• Basic concepts of women's reproductive health indicators
• Roles and functions of a women's health nurse

Women's Reproductive Health Indicators

• Total fertility rate
• Contraceptive prevalence
• Maternal mortality ratio
• Antenatal care coverage
• Births attended by skilled health personnel
• Availability of basic essential obstetric care
• Availability of comprehensive essential obstetric care
• Perinatal mortality rate
• Prevalence of low birth weight
• Prevalence of positive syphilis serology in pregnant women
• Prevalence of anaemia in women
• Percentage of obstetric and gynaecological admissions owing to abortion
• Reported prevalence of women with genital mutilation
• Prevalence of infertility in women
• Reported incidence of urethritis in men
• Prevalence of HIV infection in pregnant women
• Knowledge of HIV-related preventive practices

Total Fertility Rate (TFR)

• Total number of children a woman would have if she experienced the current fertility rate throughout her childbearing years.
• Age-specific (ASFR) and total fertility rates (TFR) are presented, using data from Indonesia (1986-1997).

What is Maternal Death?

• Death of a woman during pregnancy or within 42 days of termination of pregnancy.
• Related to or aggravated by the pregnancy (not accidental deaths).
• Global rate (2017): 211 per 100,000 live births.
• Almost 95% of maternal deaths occur in low and lower-middle-income countries in 2020.

Why Do Women Die?

• Complications during and after pregnancy and childbirth.
• Majority of complications are preventable and treatable.
• Major complications (nearly 75% of maternal deaths) include: severe bleeding, infections, high blood pressure during pregnancy (pre-eclampsia/eclampsia), and complications from delivery, unsafe abortion.

What is Maternal Death? (Measures)

• Maternal mortality ratio (MMR): Ratio of maternal deaths to 100,000 live births within a given time period.
• Maternal mortality rate (MMRate): Number of maternal deaths in a population per 1,000 women of reproductive age.
• Lifetime risk of maternal death: Calculated prediction of a woman's risk of death after childbirth (e.g., per 1,000 women).
• Proportion of maternal deaths among deaths of women of reproductive age (PM): Number of maternal deaths divided by the total deaths among women aged 15-49 years.

Maternal Mortality Ratio (2015)

• Number of women who die from pregnancy-related causes per 100,000 live births.
• Global reduction target: Less than 70 per 100,000 live births (global target achieved, and all countries less than 140).

Perinatal Mortality Rate

• Death of a fetus or neonate within the first week of life.
• Includes stillbirths
• 1,000 live births are used to calculate perinatal deaths.
• Data for top 10 countries with the highest perinatal mortality rate (PNMR) in 2012 is provided.

Definitions

• Live birth: Complete expulsion of a product of conception after birth, showing evidence of life (breathing, heartbeat, movement).
• Fetal death: Death prior to expulsion from the mother, lacking signs of life after separation.
• Duration of gestation: Measured from the first day of the last normal menstrual period, expressed in completed days or weeks.

Brief information

• Low birth weight (<2500g) accounts for 23.4% of all births globally.
• Very low birth weight (<1500g) is also given.
• Prenatal (antenatal) period: From embryo formation to birth.
• Perinatal period: The period immediately before and after birth.
• Postnatal period: The first 6 weeks after birth.

Prenatal Stage

• Germinal stage: From fertilization to 2 weeks.
• Embryonic stage: 3-8 weeks.
• Fetal stage: 9 weeks-birth.

Perinatal Stage

• Period immediately before and after birth.
• Spans from 22 weeks gestation to 7 days after birth.

Nurses' Roles in Prenatal Care

• Education and Counseling
• Health Check-ups and Tests
• Managing High-risk Pregnancies
• Family Planning and Prenatal Guidance
• Breastfeeding and Nutrition Education
• Emotional Support
• Spotting Emergencies and Acting Fast

Hypertension (High Blood Pressure in Pregnancy)

• Definition: Blood pressure above 140/90mmHg during pregnancy.
• Risk factors: Obesity, previous hypertension, diabetes and family history.
• Monitoring: Regular blood pressure checks, urine tests to monitor protein.
• Complications: Preeclampsia if left untreated.

Preeclampsia/Eclampsia

• Preeclampsia: Marked by high blood pressure and protein in the urine after 20 weeks of pregnancy.
• Symptoms: Severe headaches, swelling, blurred vision.
• Risks: Preterm birth, organ damage, placental separation or abruption.
• Eclampsia: Severe complication of pre-eclampsia that leads to seizures or coma.
• Risk and complications are life threatening, and require emergency medical care.

Postpartum Care

• Nurses' role during the postpartum period: Monitor mother's recovery, ensure baby's health, and help the family adjust.
• Complication monitoring: Infections, excessive bleeding, deep vein thrombosis.
• Newborn care: Feeding, gaining weight, jaundice.
• Breastfeeding support: Proper techniques, challenges, and support systems.
• Postpartum depression: Symptoms, risks, treatment, and support.

Infertility and Assisted Reproductive Techniques

• Support for couples struggling with infertility.
• Education about infertility treatments (e.g., IVF), treatment administration and follow up.
• Providing emotional support, options and help explore other support options such as adoption or surrogacy.

Quiz Questions

• Multiple choice questions are provided about definitions.
• Concepts, risk factors and indications are outlined for each.