Antenatal Care

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Aims of Antenatal Care: Introduction

The World Health Organisation (2003) defines antenatal care as “care before birth”, and includes education, counselling, screening and treatment to monitor and to promote the well being of the mother and baby. According to Johnson and Taylor (2000) the aim of antenatal care is to assist women in remaining healthy, monitoring the progress of pregnancy in order to support normal fetal development and thus aid the health of the unborn. Antenatal care should also provide support and guidance to the woman and her partner to help them in their transition to parenthood. The midwife can provide sufficient antenatal care by developing a partnership with the woman, providing a holistic approach that meets her individual needs, exchanging information with the woman and her family to enable them to make informed decisions about pregnancy and birth and to recognise complications of pregnancy and facilitating the woman and her family in their preparations to meet the demands of birth. Henderson and McDonald (2004) believe that an essential aim of antenatal care is the role of the midwife in being an advocate for the woman and her family during pregnancy, and supporting her right to chose care that is appropriate for her own needs and those of her family. This paper will focus on the role of the midwife in antenatal care and provides a good insight on health promotion during the antenatal period. Areas such as smoking, alcohol, diet, and exercise are explored in detail with attention also given to the role of the midwife in antenatal classes and the promotion of breastfeeding. The frequency of antenatal visits is also explored as well as the importance of foetal development.

Antenatal Visits:

Antenatal care should be sought early in pregnancy. It should be provided by a small group of carers with whom the woman feels comfortable and there should be continuity of care throughout the antenatal period. Antenatal visits should occur monthly up to 28 weeks, fortnightly from 28-36 weeks, weekly from 36-40 weeks and twice weekly 40 weeks plus (WHO 2003). The first visit is important as it is an introduction to the maternity services. The initial visit focuses on the exchange of information and it is vital that the midwife provides a friendly positive approach to develop a partnership between the woman and the midwife (Lee 2006). Bowdon and Manner (2006) believe there are a number of objectives for the first visit. These include assessing levels of health by taking a detailed history and to offer appropriate screening test, to record baseline recordings of blood pressure, urinalysis, and fetal development to be used as a standard for comparison as the pregnancy progresses, to identify risk factors by taking accurate details of past and present medical and personal history, to provide an opportunity for the woman and her family to express and discuss any concerns they might have about the current pregnancy, and finally to give public health advice in order to maintain the health of the mother and the healthy development of the baby. Such advice should include advice on the dangers of smoking and alcohol consumption, and also advice on diet and exercise.

Smoking

Smoking can have detrimental effects on both mothers and babies. There are numerous research pieces available on the harmful effects of smoking in pregnancy. Mothers who smoke throughout pregnancy are more likely to deliver a baby prematurely and smaller in weight. The average reported weight reduction can fluctuate between 120g to 430g or more depending on the number of cigarettes consumed (Barnes and Bradley 1990). Premature babies are more at risk of developing autism and epilepsy and face developmental delays, and in addition low birth weight has been linked in later life with a greater risk of hypertension, coronary heart disease and impaired glucose tolerance (Floyd 1993). Finally cigarette smoking in pregnancy increases the risk...
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