Innovations in The Care of Women During Pregnancy and Labor

Armen Hareyan's picture

Family centered pregnancy care

The March issue of Journal of Obstetric Gynecologic and Neonatal Nursing is challenging nurses who care for pregnant and laboring women to reconsider family centered maternity care.

In four articles in the Clinical Issues section of the journal, guest editor Merry-K Moos, brings together experts who explore new innovations in caring for pregnant women and their families to improve the birthing experience for not only the mother, but also the healthcare provider and the institution. "...these articles were written to promote reflection on current efforts to alter the care dynamics for pregnant women in this country" writes guest editor Moos. "I am hopeful that they will stimulate you to examine the current and potential energy in your practice setting to encourage family-centered maternity care."


In the first article Prenatal Care: Limitations and Opportunities, Moos, explores the limitations of the way pregnant women are currently cared for and presents three promising alternatives to the dominant medical model: the comprehensive prenatal care approach illustrated by many publicly funded prenatal clinics; the prenatal empowerment model as exemplified by midwifery care; and the prenatal group model as illustrated by Centering Pregnancy.

The second article, Zohar Massey, Sharon Schindler Rising, and Jeannette Ickovics take a closer look at the model of Centering Pregnancy. In Centering Pregnancy: Relationship-Centered Care the authors explain the philosophy behind this innovation of prenatal care provided in a group setting which is changing the fundamental nature of how health care professionals and women interact during gestation. It is suggested that in group prenatal care, women come together for support and empowerment, with positive effects on babies and families.

The last two articles in the series explore strategies to decrease tensions that sometimes arise when laboring women are perceived by nursing staff as trying to control professional practices in labor and delivery units. In Birth Plans: The Good, The Bad and The Future, Judith Lothian discusses the genesis of birth plans, once thought to improve the birthing experience, but are now seen to hinder communication. This article will attempt to untangle the issues surrounding birth plans and propose new ways of thinking about, developing, and using birth plans.

Finally, in Nurses and Doulas: Complementary Roles to Provide Optimal Maternity Care Lois Eve Ballen and Ann J. Fulcher explore the role of the doula