Biomedical subjects

M D Avery

Publications and source records attributed to M D Avery.

25 records · Page 2Linked to original sources

PubMedDate not supplied

Women's experiences with combining breast-feeding and employment.

A group of primiparas who combined breast-feeding and employment are described in terms of how they felt about the experience, the difficulties they encountered, factors that affected their total duration of breast-feeding, and patterns of feeding while separated from their infant. These women are contrasted with primiparas who weaned prior to returning to work and those who remained homemakers. Of the 619 women included in the analyses, 499 (80.6%) of the women returned to work or school by 12 months postpartum and 288 (46.5%) continued to breast-feed after returning to work. Women who combined breast-feeding and employment were older, had more years of education, worked fewer hours per week, and more worked in professional jobs than those who weaned prior to returning to work. A number of women who chose to express breast milk only at home thought they would have had problems with having enough time and finding a place to express and to store expressed milk had they tried to express breast milk at work. The overwhelming majority of women who combined breast-feeding and employment felt that it was worth the trouble, that they would recommend it to others, and that they had done something special for their infants that no one else could do. The findings suggest that nursing interventions and workplace accommodations could assist more women to experience the benefits and rewards of continuing to breast-feed after returning to employment.

Adult↗

PubMedDate not supplied

Gestational diabetes.

Gestational diabetes is a condition that complicates 0.15% to 12.3% of pregnancies, with wide variation in the incidence of gestational diabetes reported among ethnic groups. When gestational diabetes occurs, health implications occur for the mother and infant not only during pregnancy and birth but for the long term as well. This article reviews what is known about gestational diabetes and presents an overview of carbohydrate metabolism in normal pregnancies and those complicated by gestational diabetes. A review of recent research and advances in the field focusing on the screening, diagnosis, and treatment of gestational diabetes is also provided. The most important aspect of gestational diabetes management is client participation. Recommended education and counseling for women with gestational diabetes is discussed for pregnancy, labor and birth, postpartum, and long-term follow-up. Although medical consultation is necessary in these pregnancies, many nurse-midwives continue to provide care for women with gestational diabetes. Appropriate nurse-midwifery management of women with gestational diabetes is emphasized.

Carbohydrate Metabolism↗

PubMedDate not supplied

Outcomes of macrosomic infants in a nurse-midwifery service.

The purpose of this study was to compare outcomes of term infants of average birth weight with outcomes of large infants in a nurse-midwifery service. A retrospective study design was used. Data were retrieved from a computer data base that contained information from a data form routinely completed for all births. Subjects were women cared for by the nurse-midwives including those for whom the birth was conducted by a physician. The final n study population was 2,228; 322 (14.5%) of the infants weighed 4,000 g or more. Women who delivered large infants had a significantly higher prepregnant body mass index and pregnancy weight gain. Shoulder dystocia occurred more often in large infants; however, newborn intensive care unit admission rates did not differ between the average birth weight and the large infants. Apgar scores at 1 and 5 minutes were significantly lower for infants weighing > or = 4,500 g compared to those with birth weights of 2,500-3,999 g and those 4,000-4,449 g; however, these differences were not clinically significant. A trend for fewer occurrences of shoulder dystocia in the side-lying birth position was observed. Logistic regression predicting poor Apgar scores (< 7) showed parity as a protective factor and increased gestational age and higher maternal body mass index as predictive of low Apgar scores. Large infants had birth outcomes comparable to those reported by others in the medical literature, suggesting that nurse-midwifery management, including consultation with physician colleagues, can be appropriate and safe.

Adult↗

PubMedDate not supplied

The experience of sexuality during breastfeeding among primiparous women.

The purpose of this study was to describe various aspects of sexuality for primiparous breastfeeding women. The conceptual framework used for the study was Bernhard's theory of women's integrated sexuality which describes female sexuality as a multidimensional, biopsychosocial phenomenon. The investigators used a descriptive design, analyzing data from the 576 primiparous breastfeeding women who, as part of a larger study, completed the Breastfeeding and Sexuality Tool at the time of complete weaning. The women were from a large, private hospital in urban Minnesota. Subjects completed initial questionnaires during the postpartum hospitalization. Follow-up data were collected by phone at 1, 3, 6, and 12 months postpartum. Those who had not weaned by 12 months were followed every 3 months until complete weaning was reported. Overall, women perceived that breastfeeding had a slightly negative impact on the physiologic aspects of sexuality, but did not greatly affect the woman's sexual relationship with her partner. In addition, breastfeeding mothers perceived their partners' attitudes towards breastfeeding and sexuality as slightly positive, and did not worry that sexual activity would harm their milk supply or their ability to nurse. Overall, breastfeeding had a slightly negative impact on sexuality. However, a wide range of responses were reported by the women. Health care providers should be familiar with the whole range of possible responses to sexuality while breastfeeding in order to appropriately counsel women about what is normal and what to expect during this time.

Analysis of Variance↗

PubMedDate not supplied

Diabetes in pregnancy: the midwifery role in management.

Although the primary focus of midwifery is on uncomplicated pregnancy, all midwives must screen for and, in some cases, comanage the care of women with diabetes mellitus and gestational diabetes. This article will review the types of diabetes, implications for preconceptional and pregnancy care, the changing recommendations relative to diabetes in pregnancy, and the role of the midwife in providing antepartal and intrapartal care for women with diabetes in collaboration with other health care professionals and in accordance with the philosophy and standards of the American College of Nurse-Midwives. A specific case study will highlight the role of the midwife, with an overall focus on medical consultation, collaboration, and referral, as well as client involvement in the planning of care.

Adult↗

PubMedDate not supplied

The evolution of the core competencies for basic midwifery practice.

The Core Competencies for Basic Midwifery Practice, as promulgated by the American College of Nurse-Midwives (ACNM), was first published in 1978 to provide a standard approach to nurse-midwifery education. Since then, it has been revised three times, most recently in 1997, and now serve as the curricular template for ACNM-accredited education programs. This paper discusses the historic evolution of the core competencies and the document's use in midwifery education and practice.

Certification↗

PubMedDate not supplied

An early postpartum hospital discharge program: implementation and evaluation.

The philosophy of the FBC strengthens the concept of childbirth as a normal physiologic process. Couples are guaranteed a high level of quality nursing and medical care. Simultaneously, provisions are made to enhance the family's assertiveness in obtaining a satisfying experience in the hospital that extends to the home environment. With careful planning and decision making throughout the pregnancy, early discharge becomes a satisfying and safe alternative for families and provides a means to decrease the ever rising cost of health care.

Chicago↗