How Does the Midwife Confirm That a Pregnant Woman Is in Good Health?

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How does the midwife confirm that a pregnant woman is in good health? Discuss the assessment of physical wellbeing of the woman and what the midwife does when there are deviations from the normal health for the woman.

Contents
Introduction3
The Role of the Midwife in Antenatal Care4
First Antenatal Booking Visit6
Return Antenatal Visits7
Normal Values and Deviations from Normal9
Signs of Deterioration10
Recognition of acute critical illness in pregnancy13
Conclusion15
Reference List16
Appendix 1: Maternity Observation Chart18
Appendix 2: National early Warning Scores19
Appendix 3: ABCDE observation chart21
Appendix 4: ViEWS & Glasgow Coma Scale22

Introduction
‘Midwives provide high quality antenatal care to maximise health during pregnancy and that includes early detection and treatment or referral of selected complications.’ (International Confederation of Midwives, 2010) This competency as stated by the ICM (2010) is the essence and answer, to what the midwife’s role and responsibility is to the woman and her unborn child during the antenatal period. For clarification, antennal care is described as, ‘care provided by midwives and obstetricians during pregnancy to ensure that fetal and maternal health are satisfactory, to enable early detection and treatment of any deviations from normal. (Tiran, 2008, p. 13) In this essay, many aspects of antenatal care will be addressed, from a healthy, low-risk pregnant woman to when complications arise in pregnancy. Whether minor disorders of pregnancy or emergency situations, these will all be discussed in relation to the role and skills required by the midwife, which include the midwife’s assessment of the woman, her documentation and diagnosis of the findings, and therefore the woman’s future management of care. This can mean the woman can either stay in midwifery-led care or might have to be referred to obstetric-led care. Even though some complicated or emergency situations in pregnancy may be discussed in this essay, it is vital to always remember that ‘pregnancy is a normal physiological process and that, as such, any interventions offered should have known benefits and be acceptable to pregnant women.’ ( NICE, 2010: p.6)

The Role of the Midwife in Antenatal Care
In ‘Maye’s Midwifery’ (2004), it gives a detailed summary of the aims of antenatal care, however, the aims specifically related to this essay are as follows: * The establishment of open communication and a relationship of partnership between the woman and the professionals involved in her care, ensuring that she has continuity of care and carer from her lead professional. * The provision of appropriate support to promote psychological, emotional and social well-being in pregnancy. * Health education to promote the maintenance and, where necessary, the improvement of health in pregnancy. * Regular monitoring of the maternal and fetal conditions in pregnancy to ensure early detection of any deviations from normal and the instigation of appropriate referral and management. (Henderson, 2004: p.242)

As a Member State of the European Union, midwives in Ireland not only have a responsibility to adhere to the practice standards in Ireland but also on a European (2005) and global scale (2011). An Bord Altranais, the Irish nursing and midwifery regulatory body, have adopted the definition of a midwife given by the International Confederation of Midwives. ‘The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the...
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