Q: What does the word ‘midwife’ literally mean?
A: According to the Baby Centre (no date), the word midwife literally means “with woman”. Q: Which regulatory body exists to safeguard the wellbeing and health of the public?
A: The Nursing and Midwifery Council is the regulatory body that exists to safeguard the wellbeing and health of the public (The Nursing and Midwifery Council, 2010). Q: Molly is a low risk primigravid woman presenting for antenatal care at 6 weeks gestation. According to the NICE Antenatal Care Guidelines (2008) how many antenatal midwife appointments other than the booking appointment are recommended? http://www.nice.org.uk/CG62
A: A schedule of antenatal appointments should be determined by the purpose of the appointments. For a woman who is nulliparous (has not given birth to a child) with an uncomplicated pregnancy, a scheduled 10 appointments should be adequate. For a woman who is parous (has given birth before) with an uncomplicated pregnancy, a scheduled 7 appointments should be sufficient (National Institute of Clinical Excellence, 2008). Q: What blood tests would you offer and carry out with Molly’s consent?
A: If Molly chooses to have screening at the booking appointment, blood tests should be arranged to check her blood group, her rhesus D status, and she should additionally be screened for haemoglobinopathies, anaemia, red cell alloantibodies, hepatitis B, HIV, rubella susceptibility and syphilis. Ideally this would be before the 10 weeks gestation (National Institute of Clinical Excellence, 2008). At Molly’s next appointment, (at around 16 weeks’ gestation), the results from these blood tests will be reviewed and discussed. Therefore, if there is cause for concern, her planned pattern of care may be reassessed in order to provide additional care. If at this 16 week gestation appointment it is identified that Molly’s haemoglobin level is low, this may need to be investigated further and an iron supplement maybe considered (National Institute of Clinical Excellence, 2008). Additionally, at the 28 week gestation appointment, a second blood test should be offered. This is to screen for anaemia and atypical red-cell alloantibodies. This will be reviewed at the 31 week gestation appointment and if it is identified that Molly’s haemoglobin level is low as a result, this again may need to be investigated further and an iron supplement maybe considered (National Institute of Clinical Excellence, 2008). Furthermore, Molly will be offered screening at her booking appointment to assess her risk of developing gestational diabetes. This is done by asking questions relating to any risk factors. Therefore, if it is identified that Molly has any one of these risk factors, she will be offered a test for gestational diabetes. Gestational diabetes is detected by using an oral glucose tolerance test (OGTT) or a random blood glucose test. These test the amount of glucose (sugar) in a sample of blood taken from a vein in your arm (NHS Choices, 2010). Q: Dietary advice is an important part of the role of the midwife. What advice would you give if Molly told you she followed a vegetarian diet? http://www.eatwell.gov.uk/agesandstages/pregnancy It is vital that Molly eats a healthy balanced diet during her pregnancy in order to provide enough nutrients to maintain her own health, and the health of her developing baby. Molly is a vegetarian, so she needs to ensure that she is getting sufficient amounts of iron and vitamin B12, as these are usually found in meat and fish (NHS Choices, 2011). Good sources of iron for vegetarians can be found in pulses, dried fruit such as apricots, dark-green vegetables, wholemeal bread,...
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