Nurses continually face moral dilemmas and endure moral distress. As a result, nurses experience emotional, physical, and professional consequences. When nurses experience moral distress the nursing workforce is hurt, and patient outcomes suffer. The theory of Moral Reckoning is a framework to understand how nurses process the experience of moral distress. Theory critique is a tool to test the functionality of a theory. This brief theory critique of Moral Reckoning examines the theory's application value.
Nearly two-thirds of American women of childbearing age are classified as overweight or obese and nearly half of women, once pregnant, gain excessive weight [1]. Excessive weight gain in pregnancy and failure to lose weight postpartum are important predictors of lifelong obesity and are associated with such rising obstetric complications as preeclampsia, gestational diabetes and cesarean births [2–7]. Only half of pregnant women in all body mass index categories gain within the recommended range [1]. Various social stressors have been linked to excessive gestational weight gain (EGWG) and are believed to be factors in the increasing rates of the maternal/fetal health risks previously listed [1, 8–11]. In addition to these obstetric risks, there are numerous studies which document the significant elevations of psychological symptoms in pregnancy, including depression and anxiety [12–14]. Women with high pregnancy-related anxiety have been found to be 1.5 times more likely to have a preterm birth, when all other sociodemographic and medical/obstetrical risks were controlled [15]. Other implications of maternal anxiety are lifelong fetal neurodevelopmental changes caused by “fetal programming” of the HPA axis through activation of the maternal HPA axis [15–17]. Adverse effects later seen in the child and adolescent include learning disorders, behavioral disorders, and decreased gray matter density [15, 17].
