Care Access
Inadequate prenatal care affects obstetric outcomes
Poor obstetric outcomes are linked to inadequate prenatal care. Individuals with a lower socioeconomic level (SES) tend to obtain prenatal treatment less often and have a greater risk of obstetric problems. Low SES affects care access in pregnant women and increases the risk of adverse pregnancy outcomes. Kim et al. (2018) found that 29.4% of women had insufficient prenatal care, compared to 11.4% of women with health insurance. Previous studies have revealed that low SES is associated with pregnancy complications such as abortion, preterm delivery, and preeclampsia. (Kim et al., 2018). Therefore, as a nurse leader, one may lead their staff in advocating for insurance coverage of prenatal mothers, which will enhance care access.
Long work hours affect care access
Occupational variables, such as long work hours and physical effort, are likely to influence obstetric outcomes. Inadequate prenatal checkups, which are directly related to serious issues such as preeclampsia, may be impeded by longer workdays. To enhance pregnancy outcomes for low-socioeconomic-status (SES) pregnant women, nurses should campaign via the national government for social initiatives that target deeper and more distal determinants of health. The patient’s right to refuse therapy that may be good for the outcome of the pregnancy for the fetus is a possible ethical dilemma that might emerge while obtaining care. Therefore, the choice of a pregnant woman capable of making decisions to decline proposed medical or surgical procedures should be honored.
Nutritional Issues
Prenatal women rarely adhere to dietary requirements
Pregnant women, particularly those with a low socioeconomic background, rarely adhere to dietary requirements. Unfortunately, low SES populations appear to have the lowest adherence to dietary standards among pregnant women (Beulen et al., 2020). Interventions that improve the nutritional quality of mothers in low-SES groups are the most effective and lasting ways to create favorable health benefits and minimize intergenerational health disparities. In such treatments, diet quality in aspects of compliance with dietary guidelines, including supplement usage and energy balance in connection to pregnancy weight gain, should be evaluated. Successful uptake of a healthy food intake relies not only on prenatal women’s nutrition knowledge but also on their capacity to decide and maintain a healthy nutritional intake.
Pregnant women rely on nurses’ advice
The majority of pregnant women rely heavily on nurses for nutrition-related advice. Conducting a comprehensive nutritional evaluation to get insight into the food consumption of low-SES pregnant women in NYC is one potential solution to the issue. Getting informed consent from a patient before carrying out a nutritional examination is not only an ethical thing to do but also a legal requirement. Prior to the research study, all prenatal mothers will be informed of the study objectives, length of interviews, data processing and storage, the optional nature of participation, and their ability to withdraw at any time.
Educational Level Issues
Education impacts income and, consequently the, health
Education has a direct impact on one’s earning potential, career path, and, ultimately, health. Education also represents the aspect of knowledge, which may be the reason why education is associated with certain abilities, such as the ability to comprehend messages pertaining to public health. Pregnant women in NYC with low levels of education may have trouble obtaining better occupations; instead, the majority hold positions that do not offer health insurance. In research by Manuck (2017), maternal education was revealed to be one of the greatest predictors of preterm delivery when compared to other socioeconomic factors. Education raises awareness of behaviors that may increase the likelihood of unfavorable pregnancy outcomes.
Prenatal care promotes equality and social justice
Providing prenatal care oriented on the mother based on her vulnerability settings is a means of promoting equality and social justice. A nurse leader is responsible for ensuring that each team member maintains a positive attitude while caring for pregnant women, particularly those with a poor level of education. To aid low-educated women in appreciating the significance of prenatal visits, nurses must provide them with relevant information and assistance (Hudon et al., 2022). Negligence is a possible legal and ethical problem when working with prenatal mothers with low levels of education. If a mother’s conduct causes harm to her unborn child, there are legal and ethical issues about whether she should be restrained or penalized.
Chronic Health Issues in Pregnancy (Diabetes)
Preexisting diabetes increases birth-related injuries
The risk of birth-related injury is doubled for infants born to mothers with preexisting diabetes. In the United States, between 1% and 2% of pregnant women have juvenile or type 2 diabetes, while between 6% and 9% develop gestational diabetes (CDC, 2022). Pregnant mothers have an increased likelihood of cesarean delivery and an increased risk of newborn intensive care unit (NICU) admission. In order to detect gestational diabetes, nurses must recognize the necessity of assessing pregnant women. Early detection of gestational diabetes is crucial because it reduces fetal harm and prevents birth complications such as fetal macrosomia.
Managing diabetes enhances healthy pregnancies
Managing diabetes may assist women in having healthy pregnancies and children. Since women with gestational diabetes are much more likely to acquire type 2 diabetes later in life, it is crucial that they get checked for type 2 diabetes shortly after the birth of their child and then frequently throughout their lives. This enables professionals to deliver optimal diabetic management. Estimates from the Centers for Disease Control indicate that rates of postpartum diabetes testing are low (CDC, 2022). To alleviate this problem, nurses may encourage mothers to do diabetes screenings throughout hospital stays. In addition, they may continue postpartum treatment by urging mothers to return in six weeks for a second test to reduce the risk of Type 2 diabetes.
Substance Use During Pregnancy
Smoking increases chances of fetal complications
Smoking during pregnancy raises the chance of health complications for growing infants, such as premature delivery. Additionally, it is unsafe to use e-cigarettes and other nicotine-containing tobacco products during pregnancy. Nicotine is a health hazard for pregnant women and growing infants and may harm the developing brain and lungs of an infant (CDC, 2019). Low-socioeconomic-status individuals tend to overuse drugs like nicotine and marijuana, and women are no exception. According to the CDC (2019), smoking during and after pregnancy raises the risk of sudden infant death syndrome (SIDS). Any potential injury to the fetus may be mitigated by early intervention by health professionals, particularly nurses.
Quitting smoking is achievable yet difficult
Quitting smoking might be difficult, but it is achievable. Quitting smoking is one of the most important strategies to safeguard one’s health and that of one’s unborn child. It is better to quit smoking before becoming pregnant or as soon as possible, but it is never too late to stop. Nurses may play a significant role in stopping smoking by providing advice, support, and service referrals. Substance misuse may result in prenatal harm and thus has legal and ethical issues (Aderemi, 2016). In some instances, pregnant mothers who caused injury to their unborn children have been sentenced to jail. Numerous state laws mandate reporting evidence of prenatal drug usage, which may result in negligence and child endangerment penalties against the pregnant mother.
Summary
The study of the socioeconomic status of prenatal women is crucial since it is one of the most important factors associated with pregnancy outcomes. A low socioeconomic level has been shown to be associated with an increased risk of unfavorable pregnancy outcomes. It is imperative that more effort be put forth in order to lessen the likelihood of fetal and maternal mortality due to poor socioeconomic factors. Therefore, the authorities in charge of health care should do research into the many types of obstacles that are present and the variables that contribute to these unequal results. According to the findings of the investigation, it is possible that resolving socioeconomic disparities might result in an improvement in the child survival rate in New York City.
References
Aderemi, R.A. (2016). Ethical issues in maternal and child health nursing: challenges faced by maternal and child health nurses and strategies for decision making. International Journal of Medicine and Biomedical Research, 5(2), 67–76. Web.
Beulen, Y. H., Geelen, A., de Vries, J. H., Super, S., Koelen, M. A., Feskens, E. J., & Wagemakers, A. (2020). Optimizing Low–Socioeconomic Status Pregnant Women’s Dietary Intake in the Netherlands: Protocol for a Mixed-Methods Study. JMIR Research Protocols, 9(2), e14796. Web.
Centers for Disease Control and Prevention. (2019). Substance Use During Pregnancy. CDC. Web.
Centers for Disease Control and Prevention. (2022). Diabetes During Pregnancy. Web.
Hudon, É., Hudon, C., Chouinard, M.-C., Lafontaine, S., de Jordy, L. C., & Ellefsen, É. (2022). The Prenatal Primary Nursing Care Experience of Pregnant Women in Contexts of Vulnerability. Advances in Nursing Science, 45(3), 274–290. Web.
Kim, M. K., Lee, S. M., Bae, S.-H., Kim, H. J., Lim, N. G., Yoon, S.-J., Lee, J. Y., & Jo, M.-W. (2018). Socioeconomic status can affect pregnancy outcomes and complications, even with a universal healthcare system. International Journal for Equity in Health, 17(1). Web.
Manuck, T. A. (2017). Racial and ethnic differences in preterm birth: A complex, multifactorial problem. Seminars in Perinatology, 41(8), 511–518. Web.