Week Six

Question 1

Aim of Antenatal Care

Answer 1

• Establishment of open communication and relationship of partnership
• Educate and provide information to enable women to make informed decisions
• Provide support to promote psychosocial, emotional wellbeing
• Provide health education to promote maintenance and/or improvement of health
• Monitoring of maternal and foetal wellbeing
• Detection of deviations from normal
• Preparation for labour, birth and parenting
• Preparation for successful infant feeding
• Antenatal screening
• Risk assessment

Question 2

Midwifery Assessment Objectives

Answer 2

• Comprehensive History
• Date the pregnancy
• Baseline observations
• Maternal and Foetal wellbeing
• Risk Assessment
• Antenatal Screens
• Education RE nutrition, obesity, smoking etc
• Models of care
• Plan care
• Develop a modwife-woman partnership

Question 3

Antenatal Care

Answer 3

• Is it ritualistic?
• Promoting health influences perinatal outcomes
• Promoting health influences infant health

Question 4

When to take a history

Answer 4

• Initial interview
• First presentation
• NICE recommendation - by 10th week of pregnancy

Question 5

Basis of Midwife-Woman Relationship

Answer 5

• Establish the interview within the context:
  ~ Introductions
  ~ Explanation of reasons for questions
  ~ Explanation of what will be done with the information shared
  ~ Development of trust - necessary for the woman to disclose information
• Opportunity to get to know each other

Question 6

Why take a health history?

Answer 6

• Provide a database (the focus is different to that of other health professionals)
• Provide a holistic view
• Identifies strengths and weaknesses
• A component of the total assessment that identifies real and potential problems and informs the development of an individualised plan of care
• Adds to information gathered by others

Question 7

Types of Data

Answer 7

• Subjective (Not observable or measurable. Can be collected from the patient interview/history, as well as form the family, other members of the health care team and health records)
• Objective (Observed, Measurable, Verifiable. Physical Assessment, Laboratory and Diagnostic Test Results, Case notes/summaries from other health professionals)

Question 8

What should be included?

Answer 8

• Demographic information
• Reason for presentation
• History for presenting reason
• Past medical history including medications
• Past surgical history
• Past obstetric history
• Perception of health/current medical history
• Family history
• Personal and social data

Question 9

Comprehensive History

Answer 9

LMP
 - Regular or Irregular
Conception
 - IVF Cycle, Embryo transfer (how many)/ Clomid
Planned or Unplanned
Obstetric History
 - Parity, mode of delivery, tears, complications
Gynaecological History
 - Subfertility, PID, ectopic
Medical History
 - Maternal & Paternal
Lifestyle Choices
Smoking or Drugs & Alcohol

Question 10

Risk Assessment

Answer 10

Low risk pregnancy
 - Healthy women having normal pregnancies
 - Very suitable for shared care
 - Primiparous or Multiparous
 - No prior medical or obstetric issues
High risk pregnancy
 - Maternal
 ~ Obesity
 ~ Underlying medical conditions - Cardiovascular, renal, essential HT etc
 ~ Previous obstetric or antenatal problem - GDM, PET, Preterm
 ~ Prior intrapartum complication - 3/4th tears, PPH's
 ~ Socio-economic
 - Foetal
 ~ Previous aneuploidy
 ~ Congenital abnormality
 ~ Stillbirth or neonatal death
 ~ Prematurity

Question 11

What might impact on successfully completing a health history?

Answer 11

• Patient Condition
• Environment
• Positioning
• Use of language (spoken and unspoken)
• Communication Skills
• Cultural dfferences
• Personal attributes
• Timing
• Trust
• Relationship