Midwife's Role: Fetal Heart Rate & Anemia in Pregnant Women

This assignment addresses two key aspects of prenatal care: the issues associated with attempting to auscultate the fetal heart rate too early and how a midwife should counsel a woman experiencing physiological anemia during pregnancy. The first section discusses the potential for inaccurate results due to incomplete fetal development and the risks of physical harm to the fetus from early auscultation. It highlights the importance of explaining the auscultation technique to the mother to ensure informed consent. The second part focuses on the role of a midwife in guiding a woman with physiological anemia. It emphasizes the importance of a balanced diet rich in iron, folate, vitamin B12, calcium, and protein to support healthy red blood cell production and meet increased oxygen demands during pregnancy. The midwife should also advise regular checkups, exercise, and proper hydration to maintain optimal health. Both sections are supported by relevant research and provide practical insights into managing these critical aspects of pregnancy care.

ISSUES AROUND ATTEMPTING TO AUSCALTATE FETAL HEART RATE TOO EARLY 1
ISSUES AROUND ATTEMPTING TO AUSCULTATE THE FETAL HEART RATE TOO
EARLY
Student’s Name
Institutional Affiliation

ISSUES AROUND ATTEMPTING TO AUSCALTATE FETAL HEART RATE TOO EARLY 2
Fetal monitoring during pregnancy is of essence as it helps predict fetal outcomes and
provide insight on possible developmental anomalies of the fetus. Fetal heart monitoring is
particularly of importance as it measures the fetus’s heart rate and rhythm and help detect
abnormality (Martis et al, 2017). The baby’s heart beat can help indicate whether they are in
distress or at physical risk. WHO recommends intermittent auscultation of the fetal heart rate
with either Doppler ultrasound device or a pinard fetal stethoscope for healthy pregnant women
in labor. The fetal heart beat can be detected as early as 12 weeks into gestation by specialized
devices. There are however several issues around attempting to auscultate the fetal heart rate too
early. Attempted early auscultation may give false results as the heart might not have fully
developed thus giving a false impression of the current health state of the fetus (Muhunthan &
Arulkumaran, 2017). Risk of inducing harm to the developing fetus is high on attempted early
auscultation as the fetus is vulnerable to physical harm within the uterus (Wisner & Holschuh,
2018). Internal fetal heart rate monitoring is associated with increased risk of infections and
direct fetal injury and is thus discouraged. Adequate explanation about the auscultation technique
should always be given to the mother before it is done in order to ensure that possible risks are
well understood.

ISSUES AROUND ATTEMPTING TO AUSCALTATE FETAL HEART RATE TOO EARLY 3
REFERENCES
Martis, R., Emilia, O., Nurdiati, D. S., & Brown, J. (2017). Intermittent auscultation (IA) of fetal
heart rate in labour for fetal well‐being. Cochrane Database of Systematic Reviews, (2).
Muhunthan, K., & Arulkumaran, S. (2017). Auscultation of the fetal heart rate. Elsevier.
Sun, D., McLeod, A., Gandhi, S., Malinowski, A. K., & Shehata, N. (2017). Anemia in
pregnancy: a pragmatic approach. Obstetrical & gynecological survey, 72(12), 730-737.

ISSUES AROUND ATTEMPTING TO AUSCALTATE FETAL HEART RATE TOO EARLY 4
HOW SHOULD THE MIDWIFE COUNSEL A WOMAN WHO HAS
PHYSIOLOGICAL ANEMIA ABOUT BEING HEALTHY DURING PREGNANCY?
During pregnancy, there are several changes that occur in the woman. One of these
changes involves increased blood supply to support the developing fetus. It is normal to have
mild anemia in pregnancy due to the increased demand of oxygen supply to both the pregnant
mother and fetus. Anemia results from low hemoglobin count that is responsible for transporting
oxygen in blood (Sun et al, 2017). In order to maintain adequate red blood cell count and meet
the increased oxygen demand in pregnancy, it is important for the pregnant mother to maintain a
balanced diet and take dietary supplements of iron and folate. The midwife should therefore
counsel the woman on the need to have an iron and folate rich nutrition in addition to other
nutrients such as vitamin B12, calcium and protein. These nutrients help maintain healthy red
blood cell production and meet the increased oxygen demand (Tunkyi & Moodley, 2018). In
addition to this, the mother should be advised on having regular checkups that monitor blood
counts in order to maintain the required hemoglobin levels in pregnancy. Regular exercises as
well as proper hydration should also be imposed to maintain health in pregnancy.

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REFERENCES
Tunkyi, K., & Moodley, J. (2018). Anemia and pregnancy outcomes: a longitudinal study. The
Journal of Maternal-Fetal & Neonatal Medicine, 31(19), 2594-2598.
Wisner, K., & Holschuh, C. (2018). Fetal Heart Rate Auscultation. Nursing for women's health,
22(6), e1-e32.