Public Release: 

Innovations in the care of women during pregnancy and labor

Nurses encouraged to practice family-centered maternity care; birth plans causing tension among nurses, patients

Blackwell Publishing Ltd.

April 6, 2006 - The March issue of Journal of Obstetric Gynecologic and Neonatal Nursing is challenging nurses who care for pregnant and laboring women to reconsider family centered maternity care.

In four articles in the Clinical Issues section of the journal, guest editor Merry-K Moos, brings together experts who explore new innovations in caring for pregnant women and their families to improve the birthing experience for not only the mother, but also the healthcare provider and the institution. "...these articles were written to promote reflection on current efforts to alter the care dynamics for pregnant women in this country" writes guest editor Moos. "I am hopeful that they will stimulate you to examine the current and potential energy in your practice setting to encourage family-centered maternity care"

In the first article Prenatal Care: Limitations and Opportunities, Moos, explores the limitations of the way pregnant women are currently cared for and presents three promising alternatives to the dominant medical model: the comprehensive prenatal care approach illustrated by many publicly funded prenatal clinics; the prenatal empowerment model as exemplified by midwifery care; and the prenatal group model as illustrated by Centering Pregnancy.

The second article, Zohar Massey, Sharon Schindler Rising, and Jeannette Ickovics take a closer look at the model of Centering Pregnancy. In Centering Pregnancy: Relationship-Centered Care the authors explain the philosophy behind this innovation of prenatal care provided in a group setting which is changing the fundamental nature of how health care professionals and women interact during gestation. It is suggested that in group prenatal care, women come together for support and empowerment, with positive effects on babies and families.

The last two articles in the series explore strategies to decrease tensions that sometimes arise when laboring women are perceived by nursing staff as trying to control professional practices in labor and delivery units. In Birth Plans: The Good, The Bad and The Future, Judith Lothian discusses the genesis of birth plans, once thought to improve the birthing experience, but are now seen to hinder communication. This article will attempt to untangle the issues surrounding birth plans and propose new ways of thinking about, developing, and using birth plans.

Finally, in Nurses and Doulas: Complementary Roles to Provide Optimal Maternity Care Lois Eve Ballen and Ann J. Fulcher explore the role of the doula - a healthcare professional that provides emotional and physical support to the laboring women. Despite positive research on the impact of doulas on womens' labor experience, the relationship they have with hospital staff can sometimes be strained. This article presents models for a partnership between the doula and the nurse to improve labor and delivery care.


These papers are published in the Journal of Obstetric, Gynecologic, & Neonatal Nursing. Media wishing to receive a PDF of the any of the articles should contact:

About the Authors
Merry-K. Moos, RN, FNP, MPH, FAAN - Professor, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill. She can be reached for comment or interview at

Zohar Massey, BA, - research associate at the Yale School of Public Health, New Haven, CT.

Sharon Schindler Rising, MSN, CNM, FACNM, is the executive director of the Centering Pregnancy and Parenting Association, Inc., Cheshire, CT.

Jeannette Ickovics, PhD, - associate professor of Epidemiology and Public Health and of Psychology at the Yale School of Public Health, New Haven, CT.

Judith Lothian, PhD, RN, LCCE - Associate Professor, at the College of Nursing, Seton Hall University, South Orange, NJ.

Lois Eve Ballen, RN, CNM, MSN, IBCLC teaches nursing at Durham Technical Community College and is Program Manager of UNC Birth Partners, Volunteer Hospital-Based Doula Program, at University of North Carolina, Chapel Hill, NC.

Ann J. Fulcher, CD, CLE, is a program manager of the UCSD Hearts & Hands Volunteer Doula Program, University of California, San Diego (UCSD) Medical Center.

About the Journal of Obstetric, Gynecologic, & Neonatal Nursing
JOGNN is the official journal of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). A leader among the nation's nursing associations, AWHONN serves and represents more than 22,000 health care professionals in the U.S., Canada and abroad. AWHONN members are committed to delivering superior health care to women and newborns in hospitals, in home health and ambulatory care settings. AWHONN members' rich diversity of skills and experience make AWHONN the voice for women's health and neonatal nursing. AWHONN received a 2005 Associations Advance America Award from the American Society of Association Executives for Promoting Health Among Hispanic Women through Toda Mujer, a Spanish language publication distributed free of charge to over 500,000 women through their nurses. For more information about AWHONN, go to

About Blackwell Publishing
Blackwell Publishing is the world's leading society publisher, partnering with more than 665 academic, medical, and professional societies. Blackwell publishes over 800 journals and, to date, has published close to 6,000 text and reference books, across a wide range of academic, medical, and professional subjects.

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