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The care of childbearing and childrearing families is a major focus of nursing practice, because to have healthy adults you must have healthy children. To have healthy children, it is important to promote the health of the childbearing woman and her family from the time before children are born until they reach adulthood. Both preconceptual and prenatal care are essential contributions to the health of a woman and fetus and to a family’s emotional preparation for childbearing and childrearing. As children grow, families need continued health supervision and support. As children reach maturity and plan for their families, a new cycle begins and new support becomes necessary. The nurse’s role in all these phases focuses on promoting healthy growth and development of the child and family in health and in illness. Although the field of nursing typically divides its concerns for families during childbearing and childrearing into two separate entities, maternity care and child health care, the full scope of nursing practice in this area is not two separate entities, but one: maternal and child health nursing (Fig. 1.1). GOALS AND PHILOSOPHIES OF MATERNAL AND CHILD HEALTH NURSING The primary goal of maternal and child health nursing care can be stated simply as the promotion and maintenance of optimal family health to ensure cycles of optimal childbearing and childrearing. Major philosophical assumptions about maternal and child health nursing are listed in Box 1.1. The goals of maternal and child health nursing care are necessarily broad because the scope of practice is so broad. The range of practice includes • Preconceptual health care • Care of women during three trimesters of pregnancy and the puerperium (the 6 weeks after childbirth, sometimes termed the fourth trimester of pregnancy) • Care of children during the perinatal period (6 weeks before conception to 6 weeks after birth) • Care of children from birth through adolescence • Care in settings as varied as the birthing room, the pediatric intensive care unit, and the home In all settings and types of care, keeping the family at the center of care delivery is an essential goal. Maternal and 4 UNIT 1 Maternal and Child Health Nursing Practice T FIGURE 1.1 Maternal and child health nursing includes care of the pregnant woman, child, and family. (A) During a prenatal visit, a maternal child health nurse assesses that a pregnant woman’s uterus is expanding normally. (B) During a health maintenance visit, a maternal child health nurse assesses a child’s growth and development. (© Barbara Proud.) A B BOX 1.1 Philosophy of Maternal and Child Health Nursing • Maternal and child health nursing is familycentered; assessment data must include a family and individual assessment. • Maternal and child health nursing is communitycentered; the health of families depends on and influences the health of communities. • Maternal and child health nursing is researchoriented, because research is the means whereby critical knowledge increases. • Both nursing theory and evidence-based practice provide a foundation for nursing care. • A maternal and child health nurse serves as an advocate to protect the rights of all family members, including the fetus. • Maternal and child health nursing includes a high degree of independent nursing functions, because teaching and counseling are so frequently required. • Promoting health is an important nursing role, because this protects the health of the next generation. • Pregnancy or childhood illness can be stressful and can alter family life in both subtle and extensive ways. • Personal, cultural, and religious attitudes and beliefs influence the meaning of illness and its impact on the family. Circumstances such as illness or pregnancy are meaningful only in the context of a total life. • Maternal and child health nursing is a challenging role for a nurse and is a major factor in promoting high-level wellness in families. child health nursing is always family-centered; the family is considered the primary unit of care. The level of family functioning affects the health status of individuals, because if the family’s level of functioning is low, the emotional, physical, and social health and potential of individuals in that family can be adversely affected. A healthy family, on the other hand, establishes an environment conducive to growth and health-promoting behaviors that sustain family members during crises. Similarly, the health of an individual and his or her ability to function strongly influences the health of family members and overall family functioning. For these reasons, a family-centered approach enables nurses to better understand individuals and, in turn, to provide holistic care. Box 1.2 provides a summary of key measures for the delivery of family-centered maternal and child health care. STANDARDS OF MATERNAL AND CHILD HEALTH NURSING PRACTICE The importance a society places on human life can best be measured by the concern it places on its most vulnerable members—its elderly, disadvantaged, and youngest citizens. To promote consistency and ensure quality nursing care and outcomes in these areas, specialty

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