Maternal-child health: Working with perinatal, infant, toddler, and preschool clients

Maternal-child health clients are an important population group to P/CHNs because their physical and emotional health is vital to the future of society. The United States does not fare well in comparison to other developed nations on maternal-child health indicators. Problems of substance abuse, sexually transmitted diseases, and teen pregnancy can lead to less than optimal outcomes for newborns. Complications of pregnancy and childbirth, such as hypertension, gestational diabetes, postpartum depression, and fetal or infant death, offer opportunities for P/CHNs to provide education, outreach, and support. IMRs are no longer declining. Toddler and young child mortality and morbidity are often related to unintentional injuries. Worldwide, toddlers and preschoolers are at risk for accidents (falls, drowning, burns, and poisoning); acute illnesses, particularly respiratory illnesses; and nutritional, dental, and emotional ailments. Violence against children and deaths from homicide elicit valid concerns. These problems create major challenges for the P/CHN who seeks to prevent illness and injury among children and to promote and protect their health. Health services for children span three categories: preventive, health protecting, and health promoting. The P/CHN plays a vital role in each. Preventive services include immunization programs, along with quality day care and preschool. Health protection services include accident and injury prevention and control, as well as services to protect children from child abuse. Health promotion services include infant development through effective parent-child interaction, developmental screening, and services to children with special needs. The role of P/CHNs include providing interventions to serve young children's health needs, such as educational interventions for the young child that include nutrition teaching to provide information and encourage parents to act responsibly on behalf of their children to assist in healthy habit formation for a lifetime. Other interventions involve encouraging age-appropriate immunizations or cessation of smoking during pregnancy, and P/CHNs may employ persuasive tactics to move clients toward more positive health behaviors. With reporting and intervening in child abuse, nurses practice a form of professional coercion to protect children from threats to their health.