Author: The Association of Women’s Health, Obstetrics & Neonatal Nurses (AWHONN)

Cardiovascular Disease In Pregnancy & Peripartum Cardiomyopathy

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by, Julie Vasher, DNP, RNC-OB, CNS, C-EFM
Clinical Implementation Lead at the California Maternity Quality Care Collaborative at Stanford University

Janine is a 27-year-old African American woman who gave birth to her second baby without complications ten days ago. She came into the emergency room with complaints of cough and extreme tiredness. She attributes the fatigue to her new baby’s sleep schedule. She spoke in bursts because she appeared to be short of breath. Her vital signs are: blood pressure 120/60; heart rate 112 bpm; afebrile; respiratory rate 28 with an oxygen saturation of 94%; and she is considered obese (BMI 36). She has continued swelling in her feet. She is given antibiotics, steroids and breathing treatments. She feels better and is discharged home. A week later she returns to her physician with continued and worsening symptoms. The physician changes her antibiotic for an upper respiratory infection and suggests future testing for asthma.  A few days later, the patient experiences cardiac arrest at home and resuscitative attempts are not successful. Autopsy findings indicate she died from cardiomyopathy. (A composite case study representative of several PPCM cases found online)

Women are entering pregnancy with more chronic disease like hypertension, diabetes, and obesity. (CDC). Cardiovascular disease (CVD) is the leading cause of death for women during pregnancy and the postpartum period (Hameed, Lawton, McCain et al., 2015). Peripartum cardiomyopathy (PPCM) is an unusual disorder occurring in pregnancy that causes the heart to dilate and weaken, leading to symptoms of heart failure. Continue reading →

Wellness for Nurses

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by, Lori Boggan, RN

The closing of one year and start of a new inundates us with self improvement posts, the year’s super foods, super exercise, or super drink.  According to The Global Wellness Institute, wellness is a trillion-dollar industry worldwide that we buy, eat, and drink up.

We want so badly to find a quick solution to weight loss, health, and the pursuit of happiness.  It’s a fact that Americans suffer from stress related diseases.  According to the Center for Disease Control and Prevention, numerous studies have shown that stress in the workplace can be linked to cardiovascular disease, depression, anxiety, workplace injury, and impaired immune function, to name a few.  This is a very strong and clear indication that we are stressing ourselves to death!! Continue reading →

Perinatal Nurses Advocating for Bereavement Care for Women who Miscarry in the Emergency Department

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by, Joyce Merrigan, RN

“If we don’t do it……it will never be done.”

The image will be forever ingrained in my memory: the remains of a miscarriage scooped up by a gloved hand in the emergency department,  tossed into a plastic specimen container and left on a counter. No condolences were offered to the woman who had experienced this loss. This memory haunts me to this day but also drives me to advocate for change. Continue reading →

Not your mother’s Pap smear: what women need to know about cervical cancer screening

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by Sue Woodson, CNM. MSN
Certified Nurse Midwife at Jefferson Obstetrics & Gynecology, Ltd., Charlottesville, VA

Tips for Clinicians and their Patients

“What do you mean you only want to see me every 3-5 years?  I am used to coming EVERY year for my pap smear!” 

In the US, women generally think having a Pap smear is the main purpose of an annual exam as a way to screen for cervical cancer. This perception is understandable given that as a result of regular Pap screening, the incidence and mortality from cervical cancer in US women has dropped by at least 80% since the 1960’s.  Today, annual pap smears are rarely performed every year, yet, many women continue to confuse a pelvic exam (physical assessment) with a Pap smear (lab test).   To address this misperception women’s health nurses must educate women about the screening tests offered during an annual exam and why and when they are recommended. Continue reading →

Why I Give: To Honor My Nurse

by, Summer Hunt

IMG_1271“I had a textbook pregnancy,” Pam Spears remembers. She didn’t have a lot of problems with morning sickness, and she even went the Full 40 and then some (her daughter came along 15 days after her due date). “I’d been experiencing contractions for four days when we finally checked into the hospital,” she says. After a few days of little progress and even less sleep, Pam’s husband, John, was grateful when she sent him home to rest a bit. “It’ll be hours before the baby comes,” she’d told him. But waiting in a darkened hospital room at the end of the hall, things started to veer off course from Pam’s uneventful pregnancy. Continue reading →

Standardizing Postpartum Oxytocin Administration

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by, Jennifer Doyle, MSN, WHNP-BC
Director, AWHONN Executive Board
APN, Women’s Service Line
Summa Health
Akron City Hospital
Akron, OH

Photo: Jennifer Doyle assessing and caring for fellow colleague Amy Burkett, MD, FACOG.

Somewhere in a Labor and Delivery unit, a woman gives birth.  A family is born. A nurse remains at the bedside.  A sentinel, who assesses, plans, and intervenes.  The nurse is equipped with knowledge and skills to holistically care for mom and baby.  The nurse’s primary focus is to promote bonding and breastfeeding. However, despite a safe birth, risk remains.  Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality.  It is often preventable.

As a labor and delivery staff nurse, there were countless occasions when I held vigil at the side of my patients after they gave birth.  I was prepared with an array of resources to treat PPH. In part, this included uterine massage, oxytocin, methylergometrine, carboprost, and misoprostol.   As a nurse caring for a woman in the immediate postpartum period, my goal was to assess maternal bleeding and avoid PPH, or treat early if it occurred.  I would often stand at the bedside, pondering how much oxytocin I should administer to this new mother, and for how long. Continue reading →

Top 10 Posts of 2015

When we launched AWHONN Connections in May of this year, we could not have imagined the response that we would have received from our members, nurses, parents and members of the media.

In less than a year our blog has received over 232,000 visits, from 167 countries and had 4 blogs republished on the Huffington Post! As the year comes to a close we want to say a HUGE Thank You to our readers and our bloggers.

Here’s Our 2015 Top Ten Round Up! Continue reading →

Growing as a Leader

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Cathy Ivory, PhD, RNC-OB
2014 AWHONN President

At some point in their life, every person is called upon to lead.

As perinatal nurses, the call to lead may come from many directions. Perhaps you have a friend or loved one who needs to make an important decision about a pregnancy or birth experience and looks to you for advice. You base that advice on current evidence and your experience as a nurse; if we are honest, we acknowledge that our own birth experiences (if we have them) influence the advice given to others. Those who ask our advice look to us as leaders in nursing, even if we consider ourselves (to use a phrase I really dislike) “just a nurse”. At the bedside, we lead by advocating for our patients and families, by mentoring new nurses, and by participating in unit improvement activities. Continue reading →

Top 5 US Airport Mother’s Lounges & Nursing Stations

The holidays are in full swing and that means a lot of busy moms on the go! Traveling during the holidays can be stressful and traveling with little ones can add more stress. Finding a private and/or quiet place to nurse or feed your baby in a busy airport can be like finding a needle in a haystack, luckily we’ve done some research for you, here’s a look at the Top 5 US Airport Mother’s Lounges/Lactation Rooms. Continue reading →