Page 450 - Encyclopedia of Nursing Research

PReveNTION OF PReTeRM BIRTH, PReTeRM lABOR, AND lOW BIRTH WeIGHT n 417

birth of women who experienced cesarean coercion. Reproductive coercion is when a
section. Women with unplanned cesarean male partner tries to force a female partner
sections and those experiencing birth for the to become pregnant. Coercion can take many P
first time reported less favorable adaptation forms, including sabotaging contraception.
than women who had a scheduled (planned) Research in this area is in its infancy but is
cesarean birth or already had a child. Black expected to increase among nurses.
women reported lower social adaptation and In summary, nurse researchers have
Hispanic women had more role concerns. been instrumental in improving care to
Both Black women and Hispanic women pregnant women through their dedicated
reported more learning needs than White research efforts.
women.
Nurse researchers have also investi- Kristen S. Montgomery
gated maternal pushing during delivery.
Kelly et al. (2010) reported a study of delayed
pushing versus immediate pushing in the
second stage of labor among nulliparous Prevention of Preterm
women with continuous epidural anesthe- birth, Preterm labor, anD
sia. Women in the delayed pushing group
had shorter durations of pushing, and low birth weight
maternal fatigue scores, perineal injury, and
fetal heart rate decelerations (the secondary
outcome measures) were similar for both Prevention of preterm birth is the major
groups. Delayed pushing resulted in a sig- maternal–child health issue across devel-
nificant decrease in time spent pushing but oped countries and the leading cause of peri-
did not increase the total time in second natal mortality and long-term morbidity in
stage labor (Kelly et al., 2010). the United States (Ashton, lawrence, Adams,
On a related note, considerable amounts & Fleishman, 2009; Institute of Medicine,
of nursing research efforts have been devoted 2007; Williamson et al., 2008). Despite a
to the prevention of pregnancy and unin- recent slight decrease, preterm births in
tended pregnancy. Much of the prevention the United States have increased 36% since
work has addressed adolescent pregnancy 1984 (Macdorman & Mathews, 2009; Martin,
and interventions for both primary preven- Osterman, & Sutton, 2010). In 2007, 12.7% of
tion and prevention of a second pregnancy U.S. births were preterm compared with 5%
during adolescence. Noone and Young (2010) to 7% in most developed countries (Ashton
found that characteristics and behaviors of et al., 2009; Domingues, Matijasevich, &
adolescent daughters and mothers were bar- Barros, 2009; Hamilton, Martin, & ventura,
riers and facilitators to adolescent pregnancy 2009). As a result, the United States ranks
prevention. Over half of all pregnancies that 30th in the world for infant mortality. The
occur in the United States are unplanned; reasons for the increase are unclear (Institute
therefore, many women experience of Medicine, 2007; Macdorman & Mathews,
unplanned pregnancy and need resources 2009; Takayama & Matsuo, 2010).
to cope with decision making regarding the Preterm birth, that is, birth occurring at
pregnancy and how to manage the preg- less than 37 weeks of completed gestation, is
nancy. In addition, nurse researchers have associated with significantly increased peri-
examined outcomes for women and infants natal mortality and morbidity, including low
related to unplanned pregnancy. birth weight (<2,500 g). Both neonatal death
An emerging new topic in nursing and morbidity increase as birth weight and
research is the concept of reproductive gestational age decrease. Improvements in