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10.1 Physiologic Changes Due to Pregnancy

It is important for the nurse to understand how hormone production during pregnancy and the growth of the fetus are responsible for the physiologic and anatomic changes that occur throughout the pregnancy, affecting every system in the pregnant person’s body. The major hormones establishing, supporting, and maintaining the pregnancy are produced by the placenta.

The nurse also needs to differentiate between the presumptive, probable, and positive signs of pregnancy. The patient education provided by the nurse to the pregnant person includes the functions of the hormones of pregnancy, the systemic physiologic changes during pregnancy, and the signs of pregnancy.

10.2 Psychosocial Aspects of Pregnancy

Nursing actions to support the pregnant person’s, their partner’s, or their family members’ adaptation to the pregnancy include encouraging participation in childbirth preparation and assessing the patterns of communication. Nurses also need to encourage interaction among all those who will be in frequent contact with the pregnant person and the newborn, and to provide parenting education when requested. Successful adaptation of the pregnant person, the partner and support persons, and family members is linked with positive environments for raising children.

10.3 Common Discomforts of Pregnancy

Pregnancy causes multiple changes in the physiology of body systems, and the growing uterus temporarily alters the anatomy of the pregnant person. These changes can produce symptoms of discomfort throughout the pregnancy. The education provided by the nurse to the pregnant person includes the cause of the symptoms and relief measures. Because the symptoms of the common discomforts can also be early signs of pregnancy complications, it is important for the nurse to recognize when the cues require follow-up.

10.4 Fetal Growth and Development

Knowledge of genetics, fetal growth and development, and factors affecting embryonic and fetal growth and development helps the nurse to provide prenatal education, identify abnormalities and risk factors, and initiate interventions. Early interventions are associated with decreased morbidity and mortality of the fetus and pregnant person. Prenatal nurses are empowered to promote healthy lifestyle choices and assist pregnant persons to have a healthy outcome.

10.5 Choosing a Health Care Provider

Choosing a perinatal health care provider can be as easy as making a phone call to a family member or friend or determining which providers are covered by the pregnant person’s health insurance. What is important is understanding the levels of training of the different providers and feeling comfortable that the chosen health care provider will recognize when a complication of pregnancy starts to develop and will provide the extra monitoring needed. Nurses can assist the pregnant person with making a choice by being knowledgeable about the health care providers in the community.

10.6 Choosing a Birthing Place

Choosing a birthing place can be based on personal or cultural preferences of the pregnant person. Preferences most often focus on choice of provider and location of birthing place. The support person often has input into the birthing place preference as well. Additional influences on the choice of birthing place include perinatal risk factors, level of care the birthing place is capable of providing, and geographic factors. Other influences are the pregnant person’s health care insurance and financial factors.

Nurses who provide education regarding birthing place choices are knowledgeable about what factors to consider. The information is presented openly and nonjudgmentally without bias. The safety of the pregnant person and fetus is the priority of care and is considered at all times.


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