Complexities in Midwifery Care

Running head: MIDWIFERY 1
Midwifery
Student’s Name
Institutional Affiliation

MIDWIFERY 2
1. Explain why the woman's pregnancy, labor/birth, the postpartum period was
considered complex, Evaluates complexity about the woman's experience. A high
level of analysis and connection are demonstrated. All significant areas are
comprehensively covered, with information synthesized
There are many factors which can make a pregnancy either complex or healthy. Some of
the factors comprise of the health conditions, the age of the mother, the health issues, together
with the lifestyle of the mother. In this case, Sam’s pregnancy was considered complex because
of the highlighted factors below. As per Sam’s pathology results at 25 weeks of pregnancy, it
was confirmed that she had low Iron in the body. This might be because she had a heavy
menstrual cycle. In that case, she could experience low birth weight, preterm birth or perinatal
mortality (Al-Momen, Al-Meshari, Al-Nuaim, Saddique, Abotalib, Khashogji & Abbas, 2016).
The pregnancy is also considered complex since even though Sam maintained exercise
regime and followed GDM diet, but still there were so many complications. She was referred to a
dietician for proper guidance on how to take meals. Accordingly, Sam’s blood glucose level was
erratic just after she started taking insulin. As an illustration, if the body cannot produce
sufficient insulin, then it means the pregnant woman may develop gestational diabetes and might
also become more resistant to insulin. Under those circumstances, she commenced insulin to
help control the glucose level since a woman’s body usually requires a lot of insulin during
pregnancy. At this period of time, the placenta typically produces a lot of glucose (Biro,
Waldenström & Pannifex, 2015).
Despite all the recommendations, Sam experienced intrauterine growth restrictions,
which means that the baby in the womb was smaller than it was supposed to be. This could result

MIDWIFERY 3
in a baby with the following feature; low birth weight, low resistance to infection, low blood
sugar, or issues with body temperature. The pregnancy was also complicated in the sense that she
started swelling, had frontal headache together with floating spots in her eyes. Some of the
causes of frontal headache in pregnant women are usually due to dehydration, low blood sugar,
or stress (Brown, von Chamier, Allam & Reyes, 2014).
Sam started using antihypertensive during pregnancy in order to correct blood glucose
level. This situation also reveals how complex was her pregnancy. This shows that she was
having a hypertensive disorder, which could cause long term disability and even morbidity. She
was also taking Labetalol 100mg to control blood pressure. The high blood pressure in Sam
might have been due to the first time pregnancy being obese. Accordingly, at around eight
months, Sam was having abnormal placental functioning, which required the artificial
stimulation of the uterus to start labour (Dhar & Sokol, 2016).
The labour and birth of Sam was complex in the manner explained below. To start with,
there was an artificial rupture of the membranes. This was to speed up the dilation, to try
stopping bleeding during labor. Some of the risks involved here are that there are high chances of
infection due to the opening of the amniotic cavity to pathogens. The physicians were to make
sure that the cord does not end up below the head during this process. She also had only three
hours of labor before she progressed to normal vaginal birth (Goldman & Glei, 2016).
The complications during the postpartum period were that there was a gush of blood as
the placenta is born. As an illustration, the postpartum haemorrhage is reported to be the most
contributing factor of maternal mortality. In this case, a lot of precautions has to be taken
because it also reported that Sam was bleeding heavily which reduced her weight (Le Bouteiller,

MIDWIFERY 4
Solier, Pröll, Aguerre-Girr, Fournel & Lenfant, 2014). There was also poor uterine tone which
occurs when the uterus fails to contract after delivery of the baby. However, this condition can
also lead to a life-threatening condition (Wladimiroff & Campbell, 2016). There was also a
heavy PPH despite the uterine compression; therefore, the bimanual compression was done.
Accordingly, there was a risk of losing a lot of blood after the return of the uterus.
Pregnancy is a powerful and sophisticated time in a woman's life, and she faces multiple
physical changes and processes which are different, unique, and could be life-altering. Therefore,
the role of the practitioner or provider involves promoting health promotion through emotional
support and client education. Unhealthy habits can affect both foetus and mother even before the
mother know that she is pregnant (Pringle, Kind, Sferruzzi-Perri, Thompson & Roberts, 2015).
2. Describes how the woman's physical, social, and emotional wellbeing was impacted
upon by the complex care situation and complex needs of her baby.
Common social-emotional adjustments in pregnancies include mood swings, hormonal
changes, cravings, and adapting to the ability of bonding with the child while still in the womb.
In that case, Sam might develop cravings for salty items when pregnant. Furthermore, she
become overly emotional and began being frustrated things she wouldn't usually (Mitchell,
Peiris, Kobayashi, Koh, Duncombe, Illanes & Salomon, 2015).
Jay had a very complex care situation. As an illustration, he was taken to the neonatal
intensive care unit because of prematurity. In that case, the baby has to feed with tubes where
these tubes enter through the mouth or nose. Physically Sam loosed weight since she had to
pump the milk regularly to provide the expressed breast milk for her son. This usually happens
when the baby is ill or premature (Burnyeat, 2015). Sam was also stressed since Jay being in