Midwifery focused option Essay Example | Topics and Well Written Essays - 1500 words

Midwifery focused option - Essay Example In this essay, the role of midwives in facilitating women centered care will be discussed through case analysis of a woman in labour through review of appropriate literature. Review of prenatal care On admission, the midwife taking care of Karen must review her prenatal history and antenatal care provided. Prenatal care is very important in any pregnancy. According to NICE guidelines (2003), all pregnant women who seek prenatal care must be given evidence-based information and allowed to take informed decisions about their care. Issues like "who will take care of the pregnant woman" and "where will the delivery be conducted" should be based on the pregnant woman's choice and after receiving enough information about various options available. Blood tests which merit importance are diabetes screening, serological tests for rubella, cytomegalovirus, toxoplasmosis, herpes, syphilis, hepatitis B and humman immunodeficiency virus, hemoglobin and thyroid function tests. During the antenatal check ups, drugs taken by the patient must be reviewed and in case the mother is consuming alcohol or is smoking, she must be motivated to refrain from them. Infact, these and other issues must be addressed much before the conception of the fetus and it is known as preconception care. One of the important strategies of preconception care is to take folic acid supplements to prevent neural tube defects in the baby (Atrash et al, 2006). Labour Karen is a primigravida mother with term gestation. Karen awaited onset of labour at home. The midwife gave her adequate information as to when to contact the midwife. When Karen was in early labour, she was assessed away from the delivery unit. There is evidence that such a practice results in less number of interventions during active phase of labour (McNiven et al, 1998). The midwife must discuss the plan of birth with Karen and make her comfortable. After Karen gets admitted in the hospital, unnecessary digital examination must be avoided t o prevent infection (Hannah et al 1996). Fetal heart must be monitored using a sonicaid. The descent of the presenting part, color and quality of the liquor and various other maternal observations must be assessed and recorded. There are four dimensions of support which women need to be given in labour and they are informational support, emotional support, physical support and advocacy (Hodnett, 1996). There is enough evidence to point that provision of continuous support in labour shortens the course of labour, decreases the use of pharmacological analgesia and decreases the use of forceps during delivery (Hodnett, 1996). The midwife must help Karen in choosing nonpharmacological methods of pain relief because they are safe for both mother and baby (Watson, 1994). The most commonly used nonpharmacological method of pain relief is exercise therapy which must be taught in antenatal classes. The requirements of pain medications are less in those who are prepared well in antenatal clas ses (Watson, 1994). Karens's progression of labour must be monitored through vaginal examination. Progression of labour involves moving of cervix from posterior position to anterior position, ripening or softening of cervix, effacement of cervix, dilatation of cervix, rotation, flexing and moulding of head and descent of fetus (Simkin & Ancheta, 2000). Vaginal examinations are painful and a source of distress (Simkin &