1. Section Editor(s): Hanson, Lisa PhD, CNM, FACNM
  2. Perinatal Guest Editor
  3. Verklan, M. Terese PhD, CCNS, RNC, FAAN
  4. Neonatal Guest Editor
  5. Bakewell-Sachs, Susan PhD, RN, PNP-BC, FAAN
  6. Neonatal Editor

Article Content

This issue of The Journal of Perinatal & Neonatal Nursing contains a variety of articles pertinent to intrapartum nursing. Dr Kathleen Rice Simpson presents a compelling article, "Labor Management Evidence Update: Potential to Minimize Risk of Cesarean Birth in Healthy Women." Since the rate of cesarean births is considered unnecessarily high, nursing care that includes accurate interpretation of fetal monitoring and appropriate interventions to prevent fetal acidemia is critical.


The article "Laboring Down or Bearing Down: Strategies to infuse Evidence-Based Second Stage Care Into Practice" by Drs. Kathryn Osborne and Lisa Hanson presents current evidence on second-state labor care and the Ottawa Protocol as a viable option for translation of science to practice. The unique feature of this protocol is that the practice of laboring down is applied to women with and without epidural anesthesia.


Drs Ellise Adams and Donna Sauls contributed the original research article, "Reliability and Validity of an Instrument to Measure the Beliefs of Intrapartum Nurses." The development of an instrument to accurately measure the beliefs of nurse who care for women in labor is needed to assess and improve intrapartum nursing practice.


Jennifer Torres, Dr Raymond De Vries, and Dr Lisa Kane Low present the findings of a qualitative study in their article, "Consumer Information on Fetal Heart Rate Monitoring During Labor: A Content Analysis." Given the limits of available information, laboring women need to rely on nurses for accurate information about the benefits, risks, and limitations of continuous electronic fetal monitoring as well as the alternative of intermittent auscultation.


The special contribution, "Supporting Labor Progress to Promote Normal Physiologic Birth," which I coauthored with Drs. Lisa Hanson and Leona VandeVusse, presents the recent evidence on labor progress to promote normal physiologic birth. The very recent American College of Obstetrics and Gynecologists and Society for Maternal-Fetal Medicine consensus statement includes evidence-based recommendations1 that should lead to significant practices changes, reduction in cesarean delivery, and more normal births. However, the development of this statement was done without the inclusion of representatives from organizations such as the American College of Nurse-Midwives or the Association of Women's Health, Obstetric and Neonatal Nurses. Interdisciplinary collaborative practice including midwives and nurses is essential to prevent primary cesarean births and to promote normal physiologic births.


Transition to extrauterine life is the focus of the neonatal manuscripts in this issue, a critical time of great physiological change as the fetus adapts to neonatal life. Dr Terese Verklan is the guest editor for this volume.


The continuing education article, by Dr Carol Botwinski, provides a review on transition to postnatal renal function. During fetal life, the placenta is primarily responsible for homeostasis of fluid and electrolyte balance. In the successful transition from intrauterine to extrauterine life, the neonatal kidneys assume that responsibility. Maturation of glomerular filtration is incomplete at birth, but the term newborn's kidneys can sustain homeostasis. Stressors during the perinatal and neonatal periods can limit renal function. Knowledge of the physiology and threats to successful transition to extrauterine renal function is critical for neonatal nurses.


Dr Debra Armentrout's article focuses on transition to extrauterine life for the extremely preterm infant. Prematurity of the organ systems delays full adaptation and extends the period of transition to neonatal physiology. Care during this time requires knowledgeable assessment of respiratory, cardiovascular, gastrointestinal and neurologic functioning, and the provision of supportive interventions, which are reviewed in the article.


We also want to introduce and welcome Dr Katherine Gregory, as she assumes the role of Expert Column editor, with her first column in this issue. Dr Gregory is an associate professor at Boston College School of Nursing and a Haley Nurse Scientist at Brigham and Women's Hospital. She has been a member of the Journal of Perinatal & Neonatal Nursing neonatal editorial board, contributing as a reviewer and an author. She received her master's degree in nursing from the University of Pennsylvania in 1998 and doctorate from Boston College in 2005. Dr Gregory's clinical background is as a neonatal intensive care nurse. Her research interests pertain to aspects of nutrition and gastrointestinal disease of the premature infant. She is especially interested in how clinical factors influence early intestinal colonization and the microbiome among premature infants. Dr Gregory is positioned well to bring her expertise as a scientist and clinician to the expert column, continuing the tradition of connecting readers to expert knowledge and opinion on current neonatal topics. Please join us in welcoming Dr Gregory to this new role.


-Lisa Hanson, PhD, CNM, FACNM


Perinatal Guest Editor


College of Nursing, Marquette University


Milwaukee, Wisconsin


-M. Terese Verklan, PhD, CCNS, RNC, FAAN


Neonatal Guest Editor


University of Texas


Medical Branch School of Nursing and Graduate School


of Biomedical Sciences Galveston, Texas


-Susan Bakewell-Sachs, PhD, RN, PNP-BC, FAAN


Neonatal Editor




1. American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine. Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery. Obstet Gynecol. 2014;123:693-711. [Context Link]