Antenatal Care in Normal Pregnancy

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Antenatal care is the ongoing assessment of a mother and fetus during pregnancy, for the purpose of obtaining the best possible outcome for the mother and child. Throughout the antenatal period a midwife can monitor the progress of the pregnancy which will enable her to support both the maternal and fetal health and development. In 2003 the National Institute for Clinical Excellence (NICE), published the original Antenatal Care Guideline. The aim of the guideline was to “Offer information on best practice for baseline clinical care of pregnancies and comprehensive information on the antenatal care of the healthy woman with an uncomplicated singleton pregnancy.” NICE (2008) By following this guideline, a midwife can ensure that she offers best practice advice on the care of healthy pregnant women and ensure that within her care, a women has choice, access and continuity of care within a safe and effective service. (Department of Health, D.O.H 2007) This essay will discuss and evaluate the Antenatal Care provided to a nulliparous woman throughout her pregnancy focussing particularly on the Booking interview, Combined Screening and the monitoring of a women and fetus during the antenatal period to include emotional well being. To satisfy the requirements of the Nursing and Midwifery Council Code of Conduct 2008 (NMC), consent has been gained and pseudonyms will be used to ensure confidentiality. The midwife will be referred to as Rachael and the client as Rebecca. Rebecca is a 26 year old nulliparous women. She works as a flight attendant for a long haul flight company and lives with her partner, Scott who works as a long haul pilot. Rebecca is in good health and was very surprised when she discovered that her usually regular menstrual cycle was late. Both Rebecca and Scott were very anxious as they knew there lives were about to change and even though the pregnancy was not planned, both were very eager and keen to continue. Rebecca and her partner are both have a secure and supportive family network. Rebecca was still in her first trimester when she went to see her GP who confirmed her pregnancy and referred her to the midwife, Rachael. seven days later, Rebecca received an information pack from Rachael with an appointment. Rebecca attended her appointment and a booking history was taken. The reason for the booking interview is so that proper antenatal care can be initiated. By doing this a midwife is given every opportunity to discuss and provide a woman with valuable information such as lifestyle choices, dietary information, family history and antenatal screening. (NICE 2008). At the point of booking, Rebecca was 9 weeks pregnant according to her dates. As recommended by NICE (2008), a booking history should be undertaken within the first 10 weeks of pregnancy to allow adequate time for antenatal screening, blood tests etc. Although, Sanders (2002) suggest that some women feel the need to undertake antenatal care much earlier to ease anxiety. Effective communication is also fundamental to all aspects of midwifery but particularly during the antenatal period. During the booking of a woman, a midwives influence can assist in making the appointment a positive experience. By a woman having early and more importantly, regular antenatal care, pregnancy outcomes can be improved. Expectations will differ between women with regards to what antenatal care can do for them. For instance, Hildingsson et al (2002) suggest that women relate fetal morbidity as being preventable with good antenatal care. However, women have to receive realistic information and be clear that reproductive technology has limits. There are range of different ways that a woman can be cared for during pregnancy from shared care for women that may have a reason to visit a consultant or obstetrician or in Rebecca’s case, midwife-led care. This is when a woman is deemed to be low-risk and should have no reason to have any additional appointments with other...
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