Midwiferey Care Study

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Midwifery Care Study of a Mother with a Normal Pregnancy at Ruiru Sub-District Hospital

October, 2012

1. Care Study of a Mother with a Normal Pregnancy at Ruiru Sub-District Hospital
This work describes the care study of an expectant mother (Irene Magiri Karuthui) comprising of the care processes carried out for the client throughout her antenatal visits, the delivery process and the postnatal period. The new approach to Antenatal Care (ANC) emphasizes the quality of care rather than the quantity. In fact, for normal pregnancies, World Health Organization (WHO) recommends only four antenatal visits through focused antenatal care (FANC) aimed at helping expectant women maintain normal pregnancies through identification of pre-existing health conditions, early detection of complications arising during the pregnancy, health promotion and disease prevention, and birth preparedness and planning for complication readiness. In this care study report, the care provided to Irene will be described against the background of the recommended FANC and the health care policies of public health institutions in Kenya.

Kenya introduced the comprehensive FANC service package as recommended by WHO, with additional components to respond to national health needs. The new components include Prevention of Mother-to-Child Transmission of HIV (PMTCT), intermittent presumptive treatment of malaria, developing an individual birth plan, tuberculosis (TB) screening, detection and treatment, and education on various topics, including rest, nutrition, and exercise in pregnancy, breastfeeding information, family planning, and planning for postpartum care, all of which were provided to the client in this care study with the exception of intermittent malaria treatment and TB screening. The work covered in this care study includes the ANC profile of the mother, the health care and education provided during the ANC visits, the prenatal home visit, the delivery process, and the postnatal period including the postnatal home visit before the professional relationship established at the beginning of this care study was terminated. 2. Client’s Profile

Maternal Profile
Name:Irene Magiri Karuthui
D.O.B:November 13, 1982
Age:29 years
Phone Number:0714477146
ANC Number: 1796/11
Marital status:Married
Occupation:House Wife
Level of Education:Secondary
Residence:Gitambaya, Ruiru
Parity:1+0
Next of kin:James Karuthui
Last Menstrual Period:July 2, 2011
Expected Date of Delivery:April 9, 2012
Health Facility Attended:Ruiru Sub-District Hospital

Gynaecological History
Age When Menarche Began:16 years
Type of Menstrual Flow:Moderate Flow
Frequency of Menstrual Flow:Regular
Duration of Menstrual Flow:4 days
Length of Menstrual Cycle:28 days
Last Menstruation:July 2, 2011

3. Prenatal Period
3.1 First Prenatal Visit
The client attended her first Antenatal Clinic visit for this second pregnancy on December 7, 2011. Her maternal profile was established and recorded as shown in the client’s profile. This was the second pregnancy for this client. She had never had any miscarriage or abortion. She had one male child who was born on December 18, 2009 with 3.2 kilograms weight through spontaneous vertex delivery. The child is alive and healthy. As far as the second pregnancy was concerned, Irene had her Last Monthly Period on July 2, 2011, thus making her Expected Date of Delivery to be April 9, 2012. Family and Social History

Irene is the second born in a family of seven siblings. She is married to James Karuthui with whom she has one other child, and they were expecting their second born in this pregnancy. There is no history of twins from both the paternal and the maternal sides. The client neither smokes nor abuses alcohol or any other substance. There is no history of allergies, chronic illnesses or genetic diseases in the family....
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