DELAYED CHILDBIRTH.   Term Paper ID:27052 Click to get this paper

Essay Subject: Examines reasons for, advantages & disadvantages of, pregnancy outcomes & nursing interventions related to woman's decision to have children until she is 35 years or older.... More...

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Paper Abstract: Examines reasons for, advantages & disadvantages of, pregnancy outcomes & nursing interventions related to woman's decision to have children until she is 35 years or older. Paper Introduction: DELAYED CHILDBIRTH Introduction According to O'Reilly-Green and Cohen (1993), delayed childbirth is a changing trend in parenting consisting of the decision to put off pregnancy until one is 35 years of age or older. This report examines the phenomena of delayed childbirth. The topics discussed in the paper include: factors influencing delayed childbirth; the advantages of delayed childbearing; the disadvantages of delayed childbearing; various pregnancy outcomes associated with delayed childbirth; and nursing interventions designed to assist mature women in increasing their chances of having healthy pregnancies and healthy babies. Factors Influencing Delayed Childbirth Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. American Journal of Obstetrics and Gynecology, 17 (5,Pt.2), 1489-1494. DELAYED CHILDBIRTH Introduction According to O'Reilly-Green and Cohen (1993), delayed childbirth is achanging trend in parenting consisting of the decision to put off pregnancyuntil one is 35 years of age or older. Further, the birth rate for women aged 4 -45 yearsrose 2 percent between 199 and 1995, and increased 74 percent from 1981to 1995. O'Reilly-Green, C. (1998) Cesarean risk higher in older mothers. Perry, L.E. All women in the study (both the experimental andcontrol group) delivered their babies during the same two year periodduring which the study was conducted. Because older women also have a greater risk for developingcomplications that can lead to disability in children, Cowan (1994) reportsthat nursing interventions should involve prevention efforts such aseducating parents to the increased risks associated with delayedchildbirth. Papalia and Olds (1995) cite several factors for this delay inraising and rearing children. Study participants were 75 mothers of different family types,including mothers who belong to the Single Mothers by Choice organization.Results indicated that children from different family structures did notdiffer significantly from those in the normative group on the measuresused. Moreover, they often have greater financial and familialresources than do younger moms and so can better provide for theirchildren's needs. Findings collected for almost 25, women showed high rates ofcesarean delivery. Overall, first births among women over 3 rose to a record 22 percent of all births in 1995, as opposed to 5 percentof births in 1975. Papalia, D.E. Cnattingius, S., Forman, M.R., Berendes, H.W. Also, older moms tend to spend more time parenting and to get moresatisfaction from it than do younger moms. Disadvantages of Delayed Childbirth On the other hand, there are some clear disadvantages associated withdelayed childbirth, one of the most important of which is physicalcomplications associated with both pregnancy and childbirth. In thisregard, there is a higher risk of cesarean births for older mothers(Lawton, 1998). (1994). Ingeneral, these studies show higher physical risks to mother and/or baby formature women. Family structure, parenting style, and otherfactors in relation to healthy child adjustment. Among women aged 35 to 39 years, the adjusted odds ratio wassignificantly higher for very low birth weight, moderately low birthweight, very preterm birth, moderately preterm birth and small forgestational age infants. Concerning parent-child interaction for older mothers, an interestingstudy was conducted by Lindman (1998). Nurses, Cowan states, should also be involved in helping olderparents with genetic counseling, immunizations, and reducing lifestylerisks such as smoking or drinking alcohol. Childbearingbeyond age 4 : pregnancy outcome in 24, 32 cases. This report examines the phenomenaof delayed childbirth. Also, grandparents, who can play a critical role in earlychildhood development, often have become too old to participate in thatrole or have died. (1998). Preconception care: a health promotionopportunity. In another study that examined morbidity and mortality associatedwith pregnancy, Grimes (1994) reported that an analysis of recent nationaldata drawn from the U.S. Stanhope &J. The developmentally disabled population. For example,certain feminist philosophies have strongly upheld the need for women tocarve out a career for themselves and earn their own money rather thanrelying solely on their husband's income. Gilbert, Nesbitt and Danielsen (1999) also observed that the birthweight of infants delivered by older nulliparous women was significantlylower than that among nulliparous controls. Document available at:www.cdc.gov/nchswwa/data/sr13_122.pdf. Grimes, D.A. Delayed childbearing and the outcome of pregnancy. Thus, some women have decided tomake sure that their career paths are firmly established before they havechildren. First, it is noted that more women now wishto finish their education before having their first child and so they areputting off pregnancy until they have at least graduated high school. (1999). Data from the nationalhealth Survey NO. Pregnancy Over 35. However, their higher levels of concern do not necessarilyhave negative consequences for their experience of childbirth or for theirpostnatal emotional well-being. The foregoing review of literatureindicates that while there are certain advantages associated with thedecision to bear children later in life, there are also some cleardisadvantages, many of them physical. Advantages of Delayed Childbirth Berkowitz, Shovron, Lapinski & Berkowitz (199 ) report that there arecertain advantages that are associated with delayed childbirth. In addition, a study conducted by Windridge and Berryman (1999) foundthat older women tend to be more worried about giving birth and about theirbabies' health during pregnancy as well as during labor and birth thanyounger women---and this is true despite a positive health status for theolder woman. In this regard, theauthors report that older parents in general may complain of having lessenergy to devote to young children or may be at a stage in their careers inwhich they have less time for family participation than when they wereyounger. However, nursing interventionsinvolving careful medical monitoring, begun before conception and continuedthroughout pregnancy, can reduce the risks associated with these conditionsand, in most cases, result in a healthy pregnancy. Fourth, another reason that the age at which mothers have their firstchild has risen has to do with the improvement of contraception methods.This improvement has helped women to successfully put off childbearinguntil they feel more ready for it. The topics discussed in the paper include: factorsinfluencing delayed childbirth; the advantages of delayed childbearing; thedisadvantages of delayed childbearing; various pregnancy outcomesassociated with delayed childbirth; and nursing interventions designed toassist mature women in increasing their chances of having healthypregnancies and healthy babies. Obstetricsand Gynecology, 92, 935-939. al that: Nulliparous women age 4 or over have a higher risk of operative delivery (cesarean, forceps, and vacuum deliveries: 61%) than do younger nulliparous women (35%). Rates of premature delivery andstillbirth are also said to increase, as does the chance of having multiplebirths (e.g., twins, triplets or higher order births). Pregnancy Outcomes For Mature Women Diverse pregnancy outcomes have been researched for mature women. Furthermore, older moms are moreaffectionate with their babies and more sensitive to their needs than areyounger moms as well as more encouraging of desired behavior (Berkowitz,Shovron, Lapinski & Berkowitz, 199 ). Further, there weresimilar significant increases among older multiparas compared with youngermultiparous controls. Human development (6th ed.) NY:McGraw-Hill. Whereas mean birth weight inthe group of older multiparas was no different than that among youngermultiparous controls. Gilbert, W.M., Nesbitt, T.S. (1992 .Delayed childbearing and risk of adverse perinatal outcome: A population-based study. Labour outcome of low-risk multiparas of 4 years and older. In addition, rates of birth asphyxia, fetal growthrestriction, malpresentation, and gestational diabetes were significantlyhigher among older women, especially older nulliparas. Obstetrics and Gynecology Clinics of North America, 2 (2), 313-331. Outcome measures included: late fetal and early neonatal death rates;rates of very low birth weight and moderately low birth weight; moderatelypreterm and very preterm delivery, and small for gestational age infants.Findings of the study showed that compared with women aged 2 to 24 years,women aged 3 to 34 years had significantly higher adjusted odds ratios oflate fetal deaths, very low birth weight, moderately low birth weight, verypreterm birth and small for gestational age infants. Nurse Practice, 21(11), 24-26. (1993). Third, Papalia and Olds (1995) report that women are now marryinglater in life than they did a generation ago. Wong, S.F. 385. & Berryman, J.C. This increase occurs in spite of lower birth weight and gestational age and may be explained largely by the increase in other complications of pregnancy. Prenatal care is already recognized as a valuable intervention toimprove pregnancy outcomes, and the increased risk to older mothers makesthis an important area for nursing intervention. References Berkowitz, G.S., Shovron, M.L., Lapinski, R.H. The rising birth rate along with the increasing number of women inthis age group means that there were more babies born in 1995 to mothers intheir 4 s than in any year since 1966. Second, the authors state that the general public notion of "theideal age" at which to have a first baby has risen due to certain feministand psychobehavioral views of child rearing roles and tasks. Further, the authors report thatnurses can work to help mothers take a variety of helpful screening testssuch as tests related to serum levels, genetic risks to the baby, and soforth. March of Dimes. (1996). & Berkowitz, R.L.(199 ). A case-control study. Masters Abstracts, 37(1),p. Nursing Interventions In America, deferment of marriage and postponement of child-bearingin marriage are resulting in unprecedented numbers of couples who desirepregnancy relatively late in life. It is further notedthat since about half of all pregnancies for all women in the United Statesare not intended, including in women over 35, it is very important that allwomen of reproductive capacity follow guidelines to promote reproductivehealth and pregnancy. These disadvantages requireinterventions to make sure that mothers and babies remain healthythroughout their pregnancy, during delivery and afterward. According to O'Reilly-Green and Cohen (1993) another disadvantage ofdelayed childbirth involves parents' energy levels. Lancaster (eds.), Community health nursing: Process and practice forpromoting health (3rd ed.) (pp. Based onfindings it was concluded by Gilbert et. In order to investigate the effect of advancing maternal age onpregnancy outcome among healthy nulliparous women, after adjustment fordemographic characteristics, smoking, history of infertility, and othermedical conditions, Cnattingius, Forman, Berendes and Isotalo (1992)conducted a population-based cohort study using a sample of nulliparousSwedish women (N = 173, 715). Both older women and women ofminority races were found to have higher risks of death than were women inthe control populations. Pregnancy in women aged 4 and older. Factors Influencing Delayed Childbirth The National Center For Health Statistics (1999) reports thatcontemporary women are having fewer children and having them later in lifethan their mothers' generation. In other words, if mothers delay childbearing until they over 35years of age, the nature of their interaction with children tends to remainthe same regardless of whether they are married women, never married women,or divorced women. (1995). The control population consisted of women who delivered betweenages 2 and 29 years. Lawton, S. Based on findings, it was concluded that delayedchildbearing is associated with an increased risk of poor pregnancyoutcomes after adjustment for maternal complications and other riskfactors. & Olds, S.W. & Cohen, W.R. 122). (1999). This finding suggests the strong degree of stabilitypresent in more mature women. Regarding the nurse's role, the authors note that nurses shouldmake sure that preconception care includes a comprehensive health historyand physical exam with initiation of health promotion interventions; ifpossible, such interventions are recommended even prior to conception. Journal of the American Medical Association, 268(7), 886-89 .Cowan, M. Louis: Mosby/Year Book. The New EnglandJournal of Medicine, 322, 659-664. Wong and Ho (1998), in their study of labor and perinataloutcomes, found that older mothers tend to have longer first stage labor,greater intrapartum fetal distress, and need more intramuscular analgesia. Obstetrics andGynecology, 93(1), 9-14. & Isotalo, L. In their discussion of disadvantages associated with delayedchildbirth, the March of Dimes (1995) reports that women over 35 becomingpregnant for the first time are at increased risk for infertility andmiscarriage, gestational diabetes, bleeding complications, hypertensivedisorders of pregnancy, cesarean section, and for chromosomal abnormalitiesand growth retardation in babies. Noting that very few studies haveincluded the growing population of those mothers who have delayedchildbearing while gaining an education and building a career, Lindmanconducted research designed to objectively measure the adjustment ofchildren of intact families, divorced, families, and never-married mothers.Instruments used in this study were the Child Behavior Checklist, the Piers-Harris Children's Self-Concept Scale, the Parent-Child RelationshipInventory, the Parental Authority Questionnaire, and a demographic dataform. In thisregard, it can be noted that age-related declines in fertility may be due,in part, to less frequent ovulation, or to problems such as endometriosis,in which tissue similar to that lining the uterus attaches to the ovariesor fallopian tubes and interferes with conception. Also, Cowman (1994) informs that these families need diverse types ofsupport from nurses such as information, referral and encouragement.Further, for many mature women, doctors recommend amniocentesis and nursescan help them to understand the procedure as well as its purpose and value.Moreover, if parents discover that their risks are extremely high, they areoften faced with the decision to abort and here nurses must be skilled soas to make sure that they support whatever decision parents make. These factors can serve to increase older women's risk of anunsuccessful pregnancy or birth or they can operate to hamper childrearingefforts. Lindman, L.S. Older moms,for example, tend to be more at ease with their children than younger moms. Australian/New Zealand Journal ofObstetrics and Gynaecology, 38(4), 388-39 .----------------------- 13 The morbidity and mortality of pregnancy: stillrisky business. Thus, some couples who marry in their 3 s or 4 s may have toeither wait longer until they are able to conceive or undergo a period oftreatment for infertility before they are able to conceive a child. Preexisting health problems can also influence pregnancy outcomes.While, at any age, a woman should consult her health care provider beforeattempting to conceive, the older woman is far more likely to have apreexisting health problem (March of Dimes, 1995). In another study of pregnancy outcomes, Gilbert, Nesbitt andDanielsen (1999) used data from the California Health Information forPolicy Project to study pregnancy outcomes in women who delivered at age 4 or over. Finally, O'Reilly-Green and Cohen (1993) report that part of growingolder involves dealing with certain developmental stages such as midlifecrisis; further, there can be more medical problems arising at this time oflife. According to Perry (1996),this intervention can be introduced during routine health screening,through patient education literature, and in group health promotionclasses. In this regard, O'Reilly-Green and Cohen (1993) reportthat the nurse can assist in identifying the degree of patient risk thoughcollecting data on obstetric history, family situation, the use ofreproductive technologies and so forth. Windridge, K.C. (1994). For example, diabetes and high blood pressure are much more common inwomen in their 3 s and 4 s than in younger women, and can endanger thepregnant woman and her developing baby. Birth, 26(1), 16-23. In addition to the benefits associated with the superior parent-childinteractions for older mothers, Papalia and Olds (1995) report that coupleswho delay having their first child until the mother is 35 years of age orolder tend to be relatively stable both psychoemotionally and in terms oftheir marriage. Document available:http:// www.modimes.org/ HealthLibrary2/ faq/ Pregnancy_Over_35.htm National Center for Health Statistics (1999). With respect to the foregoing, one area in which nursinginterventions can be of assistance to older women who are pregnant isthrough assessment. 56 -577) St. Gestational age at delivery was significantly lower among oldernulliparas than for nulliparous controls, and similarly lower among oldermultiparous women compared with younger multiparous controls. (1995). Centers for Disease Control and Prevention,(including vital statistics from the National Center for HealthStatistics), found that about 22 percent of all pregnant women arehospitalized before delivery because of complications such as thosedelineated in the aforementioned studies. Women's experiences ofgiving birth after 35. & Ho, L.C. In this regard, the authorsalso report that the decision to marry later can lead to delayed childbirthnot only because of the age factor but also because infertility increaseswith age. & Danielsen, B. In M. If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.