Introduction
All women regardless of their location have a possibility of multiple pregnancy; still, in the USA this rates increased greatly in the recent years. Professionals who deal with pregnancy care and childbirth education notice that just between 1995 and 2000 the number of multiple gestations increased for almost 20% (Montgomery et al., 2005). Today a little bit more than 3% of all children born in the USA are at least twins. Of course, having a child is usually considered to be an extremely happy event in the life of a woman and her partner. Still, evidence reveals that a multiple pregnancy can be entailed by the negative consequences that are often treated too lightly. That is why healthcare providers need to educate future mothers and their families regarding pregnancy and possible complications. Nurses should take into consideration their condition and ensure that women receive all they need, and healthcare staff monitors and controls their condition regularly.
Concept of Multiple Gestation
As a rule, women give birth to one child at once but in some cases, they can have two or even more fetuses. Such condition is commonly known as a multiple gestation. Professionals believe that the main reason why it became so widespread today deals with the appearance and common usage of fertility technology for infertility treatment (Montgomery et al., 2005). Now women who were previously claimed to be unable to have children become pregnant in this way. They all initially have several fertilized ova, as the risk of losing them is very high. Maintaining delayed childbearing and being more than 45 years old is one more condition that causes a multiple pregnancy. Singleton births are less dangerous and have lower miscarriage rates. In order to improve the situation but not affect the causes of having twins or triplets, as they are often treated positively by the society, professionals developed several treatment approaches that can be rather effective. They offer to refer to reproductive treatment cycles to reduce risks for both women and their children. Moreover, special guidelines exist for both healthcare professionals and future parents. They allow to plan various periods of life starting with the desire to have a child and ending with the pre-school years.
Signs and Symptoms. Treatment Modalities
Women can find out that they are going to have more than one child in deferent ways. Still, the most efficient and authoritative one is ultrasound confirmation. Realizing that a woman is going to become a mother for several children, they and their doctors should remember that the possibility of having a miscarriage increases greatly and it is critical to take under control one’s physical and emotional state. Women can often have high blood pressure and heavy maternal blood loss. Professionals encourage those who have preeclampsia to receive an antihypertensive therapy. Low-dose gonadotropin can help to limit the risks of a multiple gestation. The assisted reproductive treatment cycles are also offered. They allow to receive better access to follicles and embryos. A polycystic ovarian syndrome may be observed. Usually, it is treated with the help of gonadotropins. Finally, Practice Committee of the American Society for Reproductive Medicine (2012) suggests the multifetal pregnancy reduction (MFPR) that deals with the reduction of some fetuses so that only one child leaves. But such approach is not commonly used because it causes an enormous ethical dilemma for both parents.
Appropriate Nursing Actions
As healthcare professionals, nurses should assist patients with a multiple gestation. They are expected to define the indicators of pregnancy and make sure that they are normal. Professionals should provide approximate, date of birth and help women to adapt to their new condition. It would be beneficial if nurses also consider the reaction of the whole family but not only the client. They should help future mothers to cope with stress. The family should practice future roles and receive assistance in the resolution of child-related and carrier-related issues if needed. Nurses should gather family history to find out what to epact during and after the pregnancy and make a physical examination. All in all, they are expected to prepare the family for extension and make sure that the fetuses are going to be fine. Nurses can suggest their client to have a consultation with a particular professional when it is needed or offer attending special courses. They should maintain a physical assessment of mother and her child. Professionals should control mother’s condition. If one feels badly, they should offer her to have bad rest and to stay at home for some time. However, when identifying the main action of the nurse during one’s pregnancy, it can be claimed that nurses are expected to educate people.
Patients Education
Nurses need to start educating future parents on the prenatal stage. During it, professionals are expected to provide consumers with the most vital information that deals with pregnancy itself and a multiple gestation, in particular. They need to discuss the situation of having a multiple pregnancy, explaining its peculiarities and defining risks. They should also discuss possible treatment, such as fetal reduction. Then, it is critical to explain the patient what sources of information are available to one. For example, provide printed articles, links to the websites, and telephone numbers. They should explain why close monitoring is required and ensure that it is maintained regularly. Nurses should explain the couple that one or several fetuses can have an anomaly and tell them how it can be dealt with. They also can hold or recommend some parental classes that will focus on peculiarities of raising children. After the birth, nurses are to ensure that infants are labeled and examined. They should dress babies so that they can be easily identified and discuss co-bedding. Professionals should help the mothers during all feedings. It is also vital for them to consider the situation when one of the infants dies and get ready for it (Crosignani, 2000).
Effects on the Mother and Baby
Thus, it can be claimed that rather often a multiple gestation has a negative influence on the mother and fetus. Practice Committee of the American Society for Reproductive medicine (2012) claims that the main problems faced by the women are “preeclampsia, gestational diabetes, and preterm labor and delivery” (p. 826). Fortunately, severe high blood pressure and diabetes are likely to subside after the delivery. Still, miscarriages happen twice as often in this situation. Anemias are also possible. In order to control them and prevent, professionals recommend taking iron and folic acid on the everyday basis as well as to have a high-protein diet. Some women may also have too much amniotic fluid. Rather many mothers with a multiple gestation have bleedings before childbirth. Urinary tract infections are possible. The time of labor and delivery is also affected. In general, it can be said that the more children a woman has, the shortest pregnancy duration is. In this way, it is safer for the woman to be hospitalized and to receive all required assistance from the professionals. Because of the number of fetuses, they can be positioned differently, which would affect the process of childbirth. Thus, professionals often recommend having the cesarean section, which can cope with the abnormal position without any problems. Except for that, it can be mentioned that women with multiple pregnancies gain more weight than others, which can have the adverse effect on their physical condition.
References
Crosignani, P. (2000). Multiple gestation pregnancy. Human Reproduction, 15(8), 1856-1864.
Montgomery, K., Cubera, S., Belcher, C., Patrick, D., Eunderburk, H., Melton, C., Eastenau, M. (2005). Childbirth education for multiple pregnancy: Part 1: prenatal considerations. The Journal of Perinatal Education, 14(2), 26-35.
Practice Committee of the American Society for Reproductive medicine. (2012). Multiple gestation associated with infertility therapy. Fertility and Sterility, 97(4), 825-824.