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MIDW127 - Beginning the Journey > Week Six > Flashcards

Flashcards in Week Six Deck (11):

Aim of Antenatal Care

- 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


Midwifery Assessment Objectives

- 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


Antenatal Care

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


When to take a history

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


Basis of Midwife-Woman Relationship

- 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


Why take a health history?

- 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


Types of Data

- 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)


What should be included?

- 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


Comprehensive History

- Regular or Irregular
- 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


Risk Assessment

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


What might impact on successfully completing a health history?

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