The Introduction of Innovative Nursing and Midwifery Roles
Added on 2020-01-21
13 Pages4652 Words40 Views
Midwifery
INTRODUCTIONMidwifery is a branch of health science that deals with pregnancy, prenatal care, post-partum time and intensive care of the new born child (Schneider and Whitehead, 2013). Midwiferyis an independent health profession which includes direct specialization in obstetrics. A person whois specialised in midwifery is known as midwife. Midwives are highly trained to deliver a childnormally but more trained high professionals are required to handle pregnant ladies with severecomplications. A midwife helps in assisting the patient throughout the gestation period so that theyare aware of development and complication if it arises in any situation (Henshaw, Clarke and Long,2013). They follow a basic assessment criteria which helps them in determining variousphysiological and mental condition of an individual. A regular ultrasonography is done to examinegrowth taking place in the foetus.The overall report will be based on a case study which includes a pregnant women who isunder the influence of substance misuse from a very long period of time. The report will includeoverall history of the women such as family background, history of previous medical condition anddifferent complexities which are addressed by her. It will also include gestation records anddevelopment of foetus during the overall period. The report also aims to consider her psychological,social and physical state of mind which is affected due to the influence of alcohol and several drugs.Lastly the report will also address the role of midwife and multidisciplinary team which can help insuccessfully taking care of the patient.Summary of the Case studyThe case study in this report is based on 29 year old married woman who has completed 10weeks of gestation period. She is reported to be under the influence of alcohol and drug before andduring her pregnancy period (Gilkison and et.al, 2015). Over the time she has developed differentcomplexities which provoked her to continue substance misuse. After discussing her family historyit was familiar that her parents separated when she was a teenager due to mutual incompatibilities.As she was attached to her parents she could not accept there separation and started developingpsychological issues which tempted her to consume alcohol and drugs to a greater extent.She resides in Cardiff city UK, with her partner and a 3 year old boy (Butler and et.al, 2014).She is reported to suffer miscarriages and pregnancy termination previously due to her poorphysical and mental health. Her husband is a full time employ in one of the private sectors of UK.During the initial period of her gestation, a thorough check-up of body was done and she was foundto develop liver ailment due to excessive drinking and sniffing habits. She also suffers from variousmental problem due to the separation of her parents. She is strictly advised to quit drinking andmisuse of drugs as it is directly affecting the health of both mother and the developing foetus(Withnall Bourgeois and Hill, 2015).
Role of midwife in the case studyIn this case the patient is reported to be misusing alcohol and illicit drug during herpregnancy period which increases the risk of complications during the delivery of child (Joseph,2015). Further it has an adverse effect on well-being of both child and the mother. The woman isfound to be a poly drug user who is addicted to alcohol, cocaine and several other drugs includingbenzodiazepines. According to a UK survey 6% of women are addicted to illicit drugs in therepregnancy whereas 21% of women are reported to consume alcohol during their gestation period.Some percentage of individuals are also reported to smoke cigarettes during pregnancy (Personalcharacteristics and skills required by midwifery team, 2016). All these habits ultimately have adrastic and life threatening impact on growing foetus and on mother's health. The case describes that the woman is addicted to different substances due to her bad andbitter past were her parents separated because of different reasons and issues (Clayton, Rolland andBosanquet, 2015). Parting away from her parents during her teenage years developed a sense ofinsecurity and less attention which she wanted from her parents. Later on she also startedexperiencing anxiety and depression due to loneliness in her life. All these reasons were somehowresponsible for developing drinking and substance misuse habits in her. In such cases it is the roleand responsibility of midwife to guide and take care of her so that she do not face any complicationduring and after the post-partum process (Slater, 2015). There are numerous roles andresponsibilities of midwife which needs to be addressed so that she maintains her physical andmental health properly. Different roles of midwife related to the case study have been discussedbelowIt is the duty of midwife to have a detailed report of the patient which includes, familyhistory, individual background, medical history and complexities which affects her mentalphysical and emotional health (Dip, 2015).During the verbal conversation with the patient, the midwife should enquire about presenceof history of substance misuse so that they can plan a proper strategy to reduce the habit ofdrug abuse.A team of midwifery should include at least one midwife who is specialized in substancemisuse during the gestation period (Bridgett and et.al, 2015).The patient who is exposed to drugs and alcohol should be encouraged to attend the prenatalprograms so that they are aware of there benefits and results. The assigned midwife shouldalso book a prior appointment with the consultant or the paediatric physician so that a properplan of child's well-being is prepared in advance.
The prenatal care appointments should be individually discussed by midwife and theprofessional so that they can easily plan a growth chart and can carry the necessarydiagnosis of this patient (Watson and et.al, 2016).As this woman is reported to consume high amount of drugs and alcohol it is very necessaryto perform a regular ultrasonography scan at the end of every four weeks so that she can bechecked of any deformity.The midwifery team should also perform various test on her to detect hepatitis C,Band othersexually transmitted diseases caused due to the over consumption of alcohol and drugs(Cornthwaite, Alvarez and Siassakos, 2015). If the results drawn from those diagnosisproves to be positive then it is the responsibility of midwifery team discuss a properobstetric plan to prevent these diseases.As she is experiencing anxiety and depression a more special attention and care should begiven to her so that she is able to recover from her trauma and depression very easily.Midwife should encourage to develop a positive behaviour and attitude which can helpduring the time of delivery of the child (Hunter and Segrott, 2014). If she do not maintain positivity in her mind then she is likely to face many complicationssuch as increase or decrease in in levels of blood pressure, heart palpitations and othermental issues.A down syndrome test should also be performed on the patient because it is effective indetecting different types of abnormality present in the child (Scott and et.al, 2015). It isusually used to determine deformities caused due to gene mutation in the foetus due to drugsand alcohol.It is very important to develop an effective birth plan after considering her cultural andreligious vies of the woman. As she is exposed to substance misuse and alcoholconsumption, a copy of birth plan should also be submitted to community drug and alcoholteam.A prior discussion of mother's breastfeeding should also taken into account after 33 weeksof gestation period (Connelly and et.al, 2013). This will allow the implementation of anyspecific plan for mother if the normal breastfeeding procedures fail.As he is a vulnerable patient and is at higher risk of getting traumatized it is the duty ofmidwifery team to maintain an alert form which will provide special antenatal care to themother till the time of delivery.
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