11200-00_FM_rev.qxd 10/31/08 4:23 PM Page i CANADIAN MATERNITY, NEWBORN, AND WOMEN’S HEALTH NURSING Comprehensive Care Across the Life Span Robin J. Evans, RN, PhD, PNC(C) Assistant Professor, College of Nursing University of Saskatchewan (Regina site) Regina, Saskatchewan Marilyn K. Evans, RN, PhD Assistant Professor Arthur Labatt Family School of Nursing University of Western Ontario London, Ontario Yvonne M.R. Brown, RN, MCEd Professor Emeritus, College of Nursing University of Saskatchewan Saskatoon, Saskatchewan Susan A. Orshan, PhD, RN, BC University of Phoenix On-Line Education Phoenix, Arizona; Healthy Matters, LLC Rocky Hill, New Jersey 11200-00_FM_rev.qxd 11/18/08 12:49 PM Page ii Acquisitions Editor:Jean Rodenberger Senior Managing Editor:Helen Kogut Senior Production Editor:Marian A. Bellus Director of Nursing Production:Helen Ewan Senior Managing Editor / Production:Erika Kors Senior Designer:Joan Wendt Art Director, Illustration:Brett MacNaughton Manufacturing Coordinator:Karin Duffield Production Services / Compositor:Circle Graphics Copyright ©2010 by Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia PA 19106, via email at [email protected] or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China Library of Congress Cataloging-in-Publication Data Canadian maternity, newborn, and women's health nursing : comprehensive care across the life span / Robin J. Evans . . . [et al.]. p. ; cm. Canadian ed. of: Maternity, newborn, and women's health nursing / Susan A. Orshan. c2008. Includes bibliographical references and index. ISBN 978-0-7817-8836-6 1. Maternity nursing. 2. Gynecologic nursing. I. Evans, Robin J., Ph. D. II. Orshan, Susan A. Maternity, newborn, and women's health nursing. [DNLM: 1. Maternal-Child Nursing—Canada. 2. Women's Health—Canada. WY 157.3 C2115 2010] RG951.C26 2010 618.2'0231—dc22 2008042556 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, express or implied, with respect to the content of the publication. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in his or her clinical practice. LWW.com 11200-00_FM_rev.qxd 10/31/08 4:23 PM Page iii Dedication This edition is dedicated to the many students and faculty who provided the stimulus for this project by consistently requesting a Canadian obstetrics textbook. 11200-00_FM_rev.qxd 10/31/08 4:23 PM Page iv 11200-00_FM_rev.qxd 10/31/08 4:23 PM Page v Acknowledgements I want to acknowledge Susan Orshan for her encourage- Thanks to Robin Evans who piqued my interest in ment and support throughout the process of this edition. working on this textbook revision. I also thank Corey I also want to acknowledge Corey Wolfe for his faith Wolfe for inviting me to participate in this challenging in me when he first approached me about the project. project. Finally and most important, I want to acknowledge my husband Jack and daughter Sarah for their unfailing sup- Yvonne M.R. Brown, RN, MCEd port throughout this project. We would like to acknowledge: Robin Evans, RN, PhD, PNC(C) ● Susan Orshan and the contributors of the original text- book. Susan’s vision for the textbook and the original I extend my gratitude to all my nursing colleagues and work provided a strong foundation for this Canadian students who provided me with continual support, in- edition. spiration, and encouragement throughout this project. ● The Canadian contributors who shared their expertise. I want to thank Corey Wolfe who invited me to partici- ● The editorial staff at Lippincott Williams & Wilkins pate in developing this particular edition and encouraged who believed the time was right for a Canadian book me to take on this challenge. Finally, I want to acknowl- and supported its development. edge my husband Rick and my children for their constant love and support. Marilyn K. Evans, RN, PhD v 11200-00_C2-FEP.qxd 10/31/08 4:19 PM Page C2 Brief Contents 1 4 U N I T U N I T FOUNDATIONS OF MATERNAL, NEWBORN, LABOUR AND CHILDBIRTH . . . . . . . . . . . . . . . . . . . . . . . . .574 AND WOMEN’S HEALTH CARE . . . . . . . . . . . . . . . . . . . . . . . . .2 15 Labour and Childbirth 577 1 Philosophy and Framework for Women’s 16 High-Risk Labour and Childbirth 623 Reproductive and Sexual Health 5 17 Pharmacologic Pain Management of Labour 667 2 Health Promotion 33 3 Nutrition for Adolescent and Adult Women 89 5 U N I T 4 Medical Alterations in Women During Adolescence and Adulthood 117 POSTPARTUM PERIOD AND NEWBORN CARE . . . . . . . . . .700 5 Mental Health Concerns for Women in Adolescence and Adulthood 175 18 Fourth Stage of Labour and Postpartum Period 703 6 Sexuality and Reproduction 209 19 The High-Risk Postpartum Woman 737 7 Family Formation 241 20 The Healthy Newborn 773 21 Newborn Nutrition 853 2 U N I T 22 The High-Risk Newborn 891 6 SPECIAL REPRODUCTIVE AND HEALTH CONCERNS . . . . . .280 U N I T 8 Fertility Control and Contraception 283 9 Voluntary Pregnancy Termination 317 MENOPAUSE AND BEYOND . . . . . . . . . . . . . . . . . . . . . . . .958 10 Fertility Challenges 331 23 The Menopausal Experience 961 11 Genetics, Embryology, and Preconceptual/ 24 The Older Postmenopausal Woman 985 Prenatal Assessment and Screening 365 3 U N I T PREGNANCY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .426 12 Process of Pregnancy 429 13 High-Risk Pregnancy 485 14 Educational Preparation for Pregnancy, Childbirth, and Parenthood 547 11200-00_FM_rev.qxd 10/31/08 4:23 PM Page vii Contributors to the Canadian Edition Melanie Basso, RN, MSN, PNC(C) Wendy Hall, RN, PhD BC Women’s Hospital & Health Centre Professor Vancouver, British Columbia School of Nursing University of British Columbia Jocelyn Churchill, RN, MN, LCCE, FACCE Vancouver, British Columbia Education Coordinator Prenatal Community Programs Lorraine Jarvie, RN, RM, Master’s of Midwifery Calgary Health Region Clinical Nurse Specialist, Birth Unit Calgary, Alberta IWK Health Centre Halifax, Nova Scotia Luisa Ciofani, RN, MSc(A), IBCL Faculty Lecturer Janice Kinch, RN, PhD McGill University Health Centre—RVH site Assistant Professor Montreal, Quebec Faculty of Nursing University of Calgary Sherrill Conroy, RN, PhD Calgary, Alberta Assistant Professor Faculty of Nursing Karen MacKinnon, RN, PhD, PNC(C) University of Alberta Assistant Professor Edmonton, Alberta School of Nursing University of Victoria Debbie Fraser Askin, MN, RNC Victoria, British Columbia Associate Professor Faculty of Nursing Carol McDonald, RN, PhD University of Manitoba Assistant Professor Winnipeg, Manitoba School of Nursing University of Victoria Jean Haase, MSW, RSW Victoria, British Columbia Social Worker, Reproductive Endocrinology and Infertility Program London Health Sciences Centre London, Ontario vii 11200-00_FM_rev.qxd 10/31/08 4:23 PM Page viii viii ● Contributors to the Canadian Edition Viola Polomeno, RN, PhD Erna Snelgrove-Clarke, RN, PhD(c) Assistant Professor Assistant Professor School of Nursing Dalhousie University School of Nursing University of Ottawa Halifax, Nova Scotia Ottawa, Ontario Nancy Watts, RN, MN, PNC(C) Deborah Salyzun, RN, MN Clinical Nurse Specialist, Maternal/Newborn Care Certified Nurse Specialist, Reproductive London Health Sciences Centre Mental Health Service London, Ontario IWK Health Centre Halifax, Nova Scotia