Development and Implementation of a Perinatal Education Consortium

The North Puget Sound Perinatal Education Consortium provides a collaborative framework for planning, implementing, and evaluating a basic orientation program for newly hired and cross-trained perinatal nurses. The program currently provides 9 days of prenatal, labor and delivery, mother-infant couplet, and neonatal didactic orientation at no cost to registrants from participating hospitals. Consortium hospitals supply instruction time and additional services to support this high-quality, regional, perinatal orientation program.     

Perinatal Patient Education: A Practical Guide With Education Handouts for Patients

New York: Berkley Publishing Group, 2002. 300 pages. $14.95, paperback. Reviewed by: Robyn Churchill, BA, BSN, MSN, CNM, WomenCare, Arlington, MA.     

Decreased Cesarean Birth Rates and Improved Perinatal Outcome: A Seven-Year Study

ABSTRACT: This study examined the decrease in cesarean section rates in relation to perinatal mortality between 1987 and 1993 at the primary referral hospital in north Jordan. Most of the population is at high risk and of low socioeconomic status. The cesarean section rate decreased from 15.5 percent in 1987 to 8.7 percent in 1993, and has remained at this low rate. During the same period the perinatal mortality dropped from 52 to 20.9 deaths per 1000 live births. These results do not include perinatal morbidity. The successful reduction of the cesarean section rate is attributed to active management of labor, trial of labor for women with a previous cesarean birth, and vaginal breech delivery in selected women. We conclude that the rate of cesarean delivery can be safely reduced in a developing country without adverse effects on birth outcomes.     

Perinatal Nursing Education in Tennessee A Regional Approach

The role of Professional continuing education in the development of regionalized perinatal health care systems is of primary importance to the success of these systems. Below is a report of the establishment of a Level III hospital-based program for providing professional education in a large, predominantly rural, urea. The program's emphasis IS on meeting educational needs of the region as defined by the practitioners themselves, rather than by outside observers.     

Perinatal Depression: A Randomized Controlled Trial of an Antenatal Education Intervention for Primiparas

Background: Depression can be an unexpected and distressing companion for a woman during the major life transition of becoming a mother for the first time. Researchers now demonstrate that approximately 50 percent of women will experience perinatal distress. Therefore, the etiology and management of perinatal depression is essential for a quality care of childbearing women. The objectives of this study were to develop an education intervention tailored to the information needs of primiparous women about perinatal depression, to deliver this intervention antenatally, and to conduct a randomized controlled trial to determine the effect of the antenatal education intervention in the reduction of postnatal depression. Method: A prospective, randomized controlled trial of the education intervention (n= 206) was conducted at three sites in Australia. The outcome of changes in mood state was measured by the Profile of Mood States questionnaire once antenatally (12–28 wk), and twice postnatally (8–12 and 16–24 wk); social support and demographic data were also collected. The education package was administered to the intervention group at the antenatal assessment of mood. Results: A significant and steady reduction in scores (overall and on the subscales) was observed over time for both groups that showed significant improvement in symptoms of depression. No difference was detected when comparing the intervention group with the control group. Additional multivariate regression analyses revealed no relevant influence of social support or demographic variables. Conclusions: Women in both the study and control groups were more depressed antenatally than postnatally. The finding that the education intervention made no difference challenges the two strongly held tenets of health education in childbearing women—that depression can be reduced through education and that antenatal education interventions can endure into the postnatal period.     

A Perinatal Continuing Education Program: Its Effects on the Knowledge and Practices of Health Professionals

Objectives: To determine whether there was an increase in knowledge when an interdisciplinary group of health care providers participated in the same comprehensive perinatal continuing education program and to determine whether care practices followed before the program differed from those followed 1 year after its completion.
Design: Administration of a 100-item comprehensive pretest and a similar posttest measuring knowledge before the continuing education program and 1 year after taking it, as well as an ex post facto audit of medical records of newborns who were sick and at risk.
Setting: Hospitals throughout the state of Oklahoma that provide perinatal care. Test data were derived from health care providers in 24 hospitals; data on care practices were obtained from 12 hospitals.
Intervention: A comprehensive program of perinatal continuing education.
Participants: Physicians, nurses, and other providers of perinatal health care.
Main outcome measures: Scores on a 100-item test measuring knowledge of perinatal care and newborn care practices taught in the educational program.
Results: Pretest and posttest scores demonstrated an increase in scores at the p < 0.001 level for each group of providers studied. There was a statistically significant increase in use of two care practices and a definite trend toward an increase in the use of three others.
Conclusion: A continuing education program delivered to a multidisciplinary group of health care providers can increase knowledge and improve perinatal care to newborns who are sick and at risk.     

Solvent Abuse in Pregnancy: A Perinatal Perspective

Objective: To review the scope and sequelae of solvent abuse in women presenting to a Manitoba teaching hospital.Methods: Fifty-six patient charts with a diagnosis of solvent abuse in pregnancy were identified through computer search in the medical records of Winnipeg Health Sciences Centre, General Hospital. These charts were reviewed and data obtained from birthing records and associated pediatric charts.Results: Renal tubular acidosis was diagnosed in three patients (5.3%). Two patients (3.6%) had adverse neurological sequelae. One patient was diagnosed with brain damage, including expressive aphasia. Twelve patients (21.4%) delivered preterm infants.Nine infants (16.1%) had major anomalies. Seven infants (12.5%) had fetal alcohol syndrome (FAS)-like facial features. Six neonates (10.7%) had hearing loss.Conclusion: Substance abuse in pregnancy is associated with severe maternal and neonatal sequelae. Physicians must be aware of this increasing problem in the obstetrical population and assistance should be offered to each woman, ideally before a woman becomes pregnant, but at least at the first contact a pregnant woman makes with the health care community.     

Perinatal pathology reports: A guide for obstetricians

This article will provide the practising obstetrician with a general guide to the structure and interpretation of the histopathology report, with a focus on placental and perinatal autopsy reports. The relevance and readability of a histopathology report is heavily dependent on the quality of clinical information provided by the referring clinician. Walkthroughs of example placental and autopsy reports are provided, along with examples of pathologies and their possible significance to the underlying diagnosis.     

An In-house Program of Continuing Education for Perinatal Nurses

A learning program implemented with motivation and peer-group teaching was combined with a program of learning through research on a topic and sharing this information with others. In using these two methods of learning, both inexperienced and highly skilled perinatal nurses have been able to continue effectively their education, using resources in their own institution.     

Creating an Alianza: Group Perinatal Education for Newly Immigrated Latinx Pregnant People

Pregnant people who are recent immigrants often face barriers navigating the health care system and establishing a support network to sustain them through pregnancy and new parenthood. The Cultivando una Nueva Alianza (CUNA) program from the Children's Home Society of New Jersey was created to address these obstacles. For over 20 years, CUNA has collaborated with local midwives to develop a program for newly immigrated, Spanish-speaking Latinx pregnant people. The curriculum, facilitated by trained members of the community, provides education around pregnancy, birth, and early parenting and connects participants with prenatal care and community resources while cultivating a social support network. The program's success is seen in improved clinical outcomes, ongoing involvement by graduates, and strong continued support from community stakeholders. The CUNA program has been replicated in nearby communities and offers a blueprint for a low-tech intervention to improve the health and wellness of this population.     

Evaluating the Effectiveness of a Perinatal Outreach Education Program

Quality care for high-risk mothers and neonates is achieved only after quality perinatal care on all levels can be realized. In order to attain this goal in southern Illinois, a perinatal outreach education program was designed for health professionals within the region. An evaluation provided documentation of changes in perinatal care at the community hospital level.     

Perinatal mental health in Ireland: A scoping review

BackgroundThe international literature clearly indicates that perinatal mental health issues affect many women, and can have profound negative consequences for both the mother, infant and family, and that the causes of perinatal mental health issues are multifaceted and complex.AimThis scoping review explores the existing research on perinatal mental health in Ireland to provide a baseline and to guide further research as well as inform the implementation of the recent policy strategies.DesignScoping ReviewMethodsWe conducted a structured literature search on Science Direct, Web of Science, PubMed, PsychInfo and Scopus, using key words to search for publications up to December 2018. All publications based on empirical studies on perinatal mental health in Ireland (regardless of research design, sample size, and methods used) were included. Exclusion criteria were: study location not the Republic of Ireland; not relating to the perinatal period (pregnancy up to the first 12 months after birth); not relating to mental health; and not relating to maternal mental health, not relating to human subjects; not an empirical study; international study with generalised results. Data were mapped onto a charting form, allowing us to a) conduct a basic numerical analysis of prevalent research questions and designs, and b) to identify key themes within the data, utilising Braun and Clarke's (2006) thematic analysis.ResultsThe search resulted in 623 unique references. 29 publications were included in this review. Our analysis resulted in three main findings. (1) A significant number of women in Ireland are affected by perinatal mental health problems, but prevalence rates vary significantly between studies. (2) A history of mental health problems and lack of social support were identified as key risk factors. (3) The existing perinatal mental health services in Ireland are generally inadequate. We further noted a focus on quantitative approaches and a medicalisation of perinatal mental health, resulting in an absence of women's voices and their lived experiences, particularly those of women of colour, migrant women and ethnic minorities. Conclusions and implications for practice: We conclude that in order to further the vision of woman-centred maternity care, we need to conduct woman-centred research that puts women's subjective experiences of perinatal mental health and well-being at the centre, including those of marginalised women in an increasingly diverse Irish society.     

Perinatal coaching: program development

Perinatal Coaching is a training/educational program introduced to new parents in the first days following the birth of their baby. This program provides support while teaching new parents skills to communicate and interact with their newborn following birth. The article gives an overview of the content of the Perinatal Coaching Program, a review of the newborn's capabilities and their relationship to perinatal coaching, important features of some ongoing programs, early identification and selection of parents, and speculation for future development.     

Perinatal asphyxia: clinical aspects

This article reviews the significance of hypoxic-ischemic encephalopathy and the associated patterns of cerebral injury in the context of the most probable timing of the insult and prognosis. The evolution of the clinical features of significant hypoxic-ischemic encephalopathy, and the diagnostic value of imaging and electrophysiologic and metabolic studies are discussed. Current approaches to management are outlined.