Maternal and Child Health

Nursing (MCN 107)

Joel D. Federico, RN, MAN
Instructor
 Introduction

Maternal and Child Health refer to philo-mother and child

relationship to one another and consideration of the entire
family as well as the culture and socio-economic environment
as framework of the patient.
 It involves the care of the woman and family throughout
pregnancy and childbirth and the health promotion and illness
care for the children and families.
 Goal of MCH
 To ensure that every expectant and nursing mother maintains
good health, learns the art of child care, has normal delivery
and bears healthy child.
That every child, wherever possible lives and grows up in a
family unit with love and security, in healthy surroundings,
receives adequate nourishment, health supervision and efficient
medical attention, and is taught the elements of healthy living
(Reyala, 2000).
Promotion and maintenance of optimum health of the women
and newborn.
 Philosophy of MCN

 Is community-centered
 Is family-centered
 Is based on nursing theory
 Protects the rights of all family members
 Uses a high degree of independent functioning
 Places importance on promotion of health
 cont… Philosophy of MCN

 Is based on the belief that pregnancies or childhood

illness are stressful because they are crises.
 Is a challenging role for the nurse and is a major
factor in promoting high level wellness in families.
 Pregnancy, labor and delivery and the puerperium are
part of the continuum of the total life cycle
 cont… Philosophy of MCN

Personal, cultural and religious attitudes and beliefs

influence the meaning of pregnancy for individuals and
make each experience unique.
Maternal-child nursing is family centered. The father of
the child is as important as the mother.
 Community Health Nurses’ Roles

1. Disease prevention specialist

 Community health nurses focus on long- and short-term care for disease
prevention.
2. Community educator
 As educators, community health nurses focus on presenting materials in a clear
and understandable format. They provide information to individuals, families,
and communities that create a framework for healthy living and healthy
choices.
3. Leader
 Community health nurses use evidence to implement policy changes and
quality-based practices. They lead collaborative efforts to produce successful
health outcomes and provide critical medical and social services in
communities.
 Community Health Nurses’ Roles

4. Researcher
 As researchers, community health nurses collect and use evidence to execute positive
changes for better health. Research is used to validate funding for public health
programs, reduce inequalities in healthcare, and increase access to services.
5. Advocate
 Public health nurses advocate to provide better access to healthcare, protect funding
for public health programs, and reduce or eliminate health disparities.
6. Caregiver
 Community nurses cross cultural, language, and literacy boundaries to shape the health
and well-being of children and adults. They provide prenatal care and education for
expectant mothers, including information about maternal nutrition, referrals for
childbirth classes, and postpartum assistance. They also provide resources for parents
to understand proper childhood development and discipline techniques.
 FEMALE REPRODUCTIVE SYSTEM

I. EXTERNAL STRUCTURES ( VULVA/ PUDENDUM)

A. MONS PUBIS OR MONS VENERIS

ROUNDED, SOFT FATTY LOOSE TISSUE OVER THE SYMPHYSIS PUBIS.

DARK & CURLY PUBIC HAIR GROWTH IN TYPICAL INVERTED PYRAMID

B. LABIA MAJORA (“MAJOR LIPS)

LENGTHWISE, TWO THICK FOLDS OF FATTY SKIN EXTENDING FROM

THE MONS TO THE PERINEUM THAT PROTECTS THE LABIA MINORA,
URINARY MEATUS AND VAGINAL MUCOSA.
 FEMALE REPRODUCTIVE SYSTEM

I. EXTERNAL STRUCTURES ( VULVA/ PUDENDUM)

C. LABIA MINORA (MINOR LIP)

THINNER, LENGTHWISE FOLDS OF HAIRLESS SKIN, ENCIRCLING THE

CLITORIS ANTERIORLY (PREPUCE) AND UNITE POSTERIORLY (
FOURCHETTE) WHICH IS HIGHLY SENSITIVE TO MANIPULATION AND
TRAUMA, THE REASON WHY IT IS OFTEN TORN DURING DELIVERY.

D. VESTIBULE

 FLATTENED SMOOTH SURFACE INSIDE THE LABIA MINORA. IT IS THE

NARROW SPACE SEEN WHEN LABIA ARE SEPARATED
FEMALE REPRODUCTIVE SYSTEM
 FEMALE REPRODUCTIVE SYSTEM

I. EXTERNAL STRUCTURES ( VULVA/ PUDENDUM)

 E. GLANS CLITORIS

SMALL ERECTILE STRUCTURE LOCATED AT THE ANTERIOR JUNCTION OF

THE LABIA MINORA. CONTAINS MORE NERVE ENDINGS, SENSITIVE TO
TEMPERATURE AND TOUCH. IT IS THE SEAT OF SEXUAL AROUSAL AND
EXCITEMENT. IT IS THE MOST SENSITIVE PART OF A WOMAN’S BODY.IT
IS ALSO THE STRUCTURE THAT GUIDES THE NURSE TO THE URINARY
MEATUS.
 FEMALE REPRODUCTIVE SYSTEM

I. EXTERNAL STRUCTURES ( VULVA/ PUDENDUM)

F. URETHRAL MEATUS
THE EXTERNAL OPENING OF THE URETHRA. SLIGHTLY BEHIND AND TO
THE SIDE ARE THE OPENINGS OF THE SKENE’S GLANDS
(PARAURETHRAL GLANDS); THE SECRETIONS OF WHICH HELP TO
LUBRICATE THE EXTERNAL GENITALIA
G. HYMEN
A TOUGH BUT ELASTIC SEMICIRCLE OF TISSUE THAT COVERS THE
OPENING TO THE VAGINA
 FEMALE REPRODUCTIVE SYSTEM

I. EXTERNAL STRUCTURES ( VULVA/ PUDENDUM)

H. VAGINAL ORIFICE / INTROITUS

EXTERNAL OPENING OF THE VAGINA, COVERED BY A THIN MEMBRANE (

HYMEN) IN VIRGINS.LOCATED LATERAL TO THE VAGINAL OPENING ON
BOTH SIDES ARE THE BARTHOLIN’S GLANDS ( VULVOVAGINAL
GLANDS). IT LUBRICATES THE EXTERNAL VULVA DURING COITUS AND
THE ALKALINE PH OF THEIR SECRETION HELPS TO IMPROVE SPERM
SURVIVAL IN THE VAGINA.
 FEMALE REPRODUCTIVE SYSTEM

I. EXTERNAL STRUCTURES ( VULVA/ PUDENDUM)

I. FOURCHETTE

 THIN FOLD OF TISSUE FORMED BY MERGING OF THE LABIA MAJORA

AND LABIA MINORA BELOW THE VAGINAL ORIFICE.
J. PERINEUM
MUSCULAR SKIN COVERED AREA BETWEEN VAGINAL OPENING AND
ANUS. CONTAINS THE PUBOCOCCYGEAL MUSCLES AND LAVATOR ANI.
 FEMALE REPRODUCTIVE SYSTEM

I. INTERNAL STRUCTURES

A. VAGINA

 HOLLOW MEMBRANOUS CANAL, 3-4 INCHES LONG, LOCATED POSTERIOR TO THE

BLADDER AND ANTERIOR TO THE RECTUM; CONTAINS RUGAE (WHICH PERMITS
CONSIDERABLE STRETCHING WITHOUT TEARING).ITS UPPER PORTION IS SEPARATED
FROM THE RECTUM BY THE CUL-DE-SAC OF DOUGLAS.

 PASSAGEWAY OF MENSTRUATION

 PASSAGEWAY OF FETUS

 ORGAN OF COPULATION
 FEMALE REPRODUCTIVE SYSTEM

I. INTERNAL STRUCTURES

** DODERLIEN’S BACILLUS MAINTAINS THE NORMAL FLORA OF THE

VAGINA, WHICH MAKES THE pH OF VAGINA ACIDIC, DETRIMENTAL TO THE
GROWTH OF PATHOLOGIC BACTERIA.

B. UTERUS

HOLLOW, MUSCULAR PEAR SHAPED ORGAN LOCATED IN THE PELVIS. IT

IS 3 INCHES LONG, 2 INCHES WIDE, 2 INCHES THICK AND WEIGHING
50-60 g IN A NON-PREGNAT WOMAN. HELD IN PLACE BY BROAD
LIGAMENTS. ABUNDANT BLOOD SUPPLY FROM UTERINE AND OVARIAN
ARTERIES.
 FEMALE REPRODUCTIVE SYSTEM

I. INTERNAL STRUCTURES

a. ORGAN OF IMPLANTATION ( NIDATION) AND

MENSTRUATION

b. RECEIVES THE OVA FROM THE FALLOPIAN TUBE

c. FURNISH PROTECTION FOR A GROWING FETUS

 FEMALE REPRODUCTIVE SYSTEM

DIVISIONS OF THE UTERUS

1.CERVIX
LOWER PORTION CALLED THE NECK
a. EXTERNAL CERVICAL OS = DISTAL OPENING TO THE VAGINA
b. CERVICAL CANAL = THE CAVITY
c. INTERNAL CERVICAL OS = OPENING TO THE UTERUS
2. FUNDUS
UPPER PORTION WITH TRIANGULAR PART ( FUNDUS) AND CAN BE PALPATED TO
DETERMINE UTERINE GROWTH DURING PREGNANCY AND FORCE OF
CONTRACTIONS
 FEMALE REPRODUCTIVE SYSTEM

 MOST VASCULAR PORTION

 NORMAL IMPLANTATION SITE

3. CORPUS

 CENTRAL PART CALLED THE BODY

4.CORNUA – THE UPPER PORTION WHERE THE FALLOPIAN TUBES ARE ATTACHED.

LAYERS:

1.ENDOMETRIUM

INNER LAYER, HIGHLY VASCULAR,SHEDS DURING MENSTRUATION AND

FOLLOWING DELIVERY
FEMALE REPRODUCTIVE SYSTEM

2. MYOMETRIUM

MIDDLE LAYER , EXPELS FETUS DURING BIRTH PROCESS THEN

CONTRACTS AROUND BLOOD VESSELS TO PREVEMT HEMORRHAGE (
OXYTOCIN SITE)

3. PERIMETRIUM

 OUTERMOST LAYER OF THE UTERUS; OFFERS ADDED STRENGTH AND

SUPPORT TO THE STRUCTURE
 FEMALE REPRODUCTIVE SYSTEM

C. FALLOPIAN TUBES / OVIDUCTS / UTERINE TUBES

 TWO SLENDER MUSCULAR TUBES WHICH ARISES FROM EACH OF THE

UPPER CORNER OF THE UTERINE BODY AND EXTEND OUTWARD.
PROVIDES A PLACE FOR FERTILIZATION ( CONCEPTION, FECUNDATION,
IMPREGNATION) OF OVA BY THE SPERM. IT IS ALSO THE COMMON SITE
OF ECTOPIC PREGNANCY, GONOCOCCAL INFECTIONS (ex. SALPHINGITIS)
 FEMALE REPRODUCTIVE SYSTEM

PARTS:

1.INTERSTITIAL = LIES WITHIN THE UTERINE WALL. IT HAS THE

SMALLEST LUMEN.

2. ISTHMUS = PORTION CUT OR SEALED DURING TUBAL LIGATION.

3. AMPULLA = LONGEST PORTION, EXACT SITE OF FERTILIZATION (

DISTAL 3RD, OUTER 3RD)

4. INFUNDIBULUM =MOST DISTAL PORTION; RIM OF THE FUNNEL IS

COVERED BY FIMBRAE THAT HELPS GUIDE THE OVE INTO THE FALLOPIAN
TUBE.
 FEMALE REPRODUCTIVE SYSTEM

D. OVARIES

TWO ALMOND –SIZED ORGANS ON EITHER SIDE OF THE UTERUS THAT

MEASURES 4 BY 2 CM IN DIAMETER AND 1.5 CM THICK.

RESPONSIBLE FOR THE PRODUCTION, MATURATION AND DISCHARGE

OF OVA AND SECRETION OF ESTROGEN AND PROGESTERONE

ORGAN OF OVULATION
 FEMALE REPRODUCTIVE SYSTEM

LAYERS OF THE OVARY:

1. TUNICA ALBUGINEA
 THE OUTERMOST PROTECTIVE LAYER SURROUNDED BY A SINGLE LAYER OF
CUBOIDAL EPITHELIUM.
2. CORTEX
 THE FUNCTIONAL LAYER WHICH IS THE SITE OF OVUM FORMATION &
MATURATION. IT CONTAINS THE PRIMORDIAL FOLLICLES, GRAAFIAN FOLLICLES,
CORPUS LUTEUM & CORPUS ALBICANS.
3. MEDULLA
 LAYER WHICH CONTAINS THE BLOOD VESSELS, LYMPHATICS, NERVES & MUSCLE
FIBERS.
 FEMALE REPRODUCTIVE SYSTEM

UTERINE LIGAMENTS:

1.CARDINAL LIGAMENT – LOWER PORTION OF THE BROAD LIGAMENT. IT

IS THE MAIN SUPPORT OF THE UTERUS.DAMAGE TO THIS LIGAMENT WILL
RESULT TO UTERINE PROLAPSE.

2.BROAD LIGAMENT – SUPPORTS THE SIDES OF THE UTERUS & ASSISTS

IN HOLDING THE UTERUS IN ANTEVERSION.

3. ROUND LIGAMENT – CONNECTS THE UTERUS TO THE LABIA MAJORA.

GIVES STABILITY TO THE UTERUS.
 FEMALE REPRODUCTIVE SYSTEM

4. UTEROSACRAL LIGAMENT – CONNECTS UTERUS TO THE SACRUM

5. ANTERIOR LIGAMENT –PROVIDES SUPPORT TO THE UTERUS IN

CONNECTION WITH THE BLADDER. OVERSTRETCHING OF THIS LIGAMENT
WILL LEAD TO HERNIATION OF THE BLADDER TO THE VAGINA (
CYSTOCELE).

6. POSTERIOR LIGAMENT – FORMS THE CUL-DE-SAC OF DOUGLAS.

DAMAGE TO THIS LIGAMENT WILL LEAD TO HERNIATION OF RECTUM TO
THE VAGINA ( RECTOCELE).
FEMALE REPRODUCTIVE SYSTEM