| Description |
The research investigated the components of prenatal care provided by certified nurse-midwives, with the purpose of identifying the components and describing their incorporation into nurse-midwifery practice. The conceptual framework for the research was based on theory proposed by Weidenbach (1967), which allowed the content and process of the prenatal visit to be examined as the components of prenatal care. An exploratory descriptive design was followed. Prenatal care was observed and data were collected by audio tape recordings of prenatal visits between the nurse-midwife and her client. The collected data were transferred to a measurement instrument by the in investigator and submitted to computer analysis for descriptive statistics and correlation coefficients. The sample was composed of 23 nurse-midwives, all members of the American College of Nurse-Midwives, from seven western states. There were 40 clients and prenatal visits in the sample. The gestational ages of the clients ranted from 12 to 41 weeks. The study found that the average prenatal visits last 23.7 minutes, with the nurse-midwife talking for 12.6 minutes and the client talking for 4.9 minutes. A significant other was present during 32.5% of the visits. There was an average of four incidents of reassurance by the nurse-midwife per visit. The content varied from visit to visit. This may have been due to the client's gestational age and needs at a particular visit. The client’s progress in her pregnancy and history since her previous visit were discussed in all visits for an average of 1.7 minutes. There was evidence of continuity of care in 97.5% of the visits, family centered care in 72.5% of the visits, noninterventionist care in 52.5% of the visits, participative care in 47.5% of the visits, flexibility in care in 42.5% of the visits and consumer advocacy in 30% of the visits. The client’s health status was discussed for an average of 0.7 minutes per visit. Preparation for labor was discussed for an average of 0.5 minutes per visit. Preventive health care, treatments, and preparation for parenthood were each discussed for 0.2 minutes per visit. Significant relationships were found among several variables. There were high correlations between the length of the visit and the amount of time taken by education and counseling (r=.74), and between the client’s age and the amount of verbalization by the client (r=.63). There was also a significant relationship between the amount of time taken for the physical exam, and the amount of time taken for participative care (r=.57). No significant relationship was found between the nurse-midwives' educational background and other measures. |
