Critical Thinking

Maternity require through any stage of the pregnancy,

Maternity Care Support Assignment 1 By Michelle Carey?Table of Contents• Philosophy of Maternity Care• Physical, Emotional and Social Needs of a Mother during Pregnancy • Physical, Emotional and Social Needs of a Mother during Labour and Delivery • Physical, Emotional and Social Needs of a Mother during Post Partum• Personal Hygiene and Comfort of the Mother• Baby Hygiene and Positioning• Needs of Family when Baby is diagnosed with Congenital Abnormalities• Needs of Family unit when affected by Miscarriage Philosophy of Maternity CareThe Philosophy of Maternity Care is based on the principle of “woman centered care”. Woman centered care is making sure women receive the care they require through any stage of the pregnancy, labour or after birth.• It is allowing for the continuity care from the same medical team throughout the pregnancy, the labour and the after birth.• It is also allowing the women to make their own decisions about their care and labour and how it progresses. • This is when they give informed choices on the mothers options available during pregnancy, labour and after birth. Maternity care is not just a delivery service: it makes a major contribution to family wellbeing and wider public health. Pregnancy and childbirth represent a physical, psychological and social change for prospective parents. (Nmbi.ie, 2018)The philosophy of maternity care has many strategies or principles that the health care team follow and carry out. All of these are based on the researched evidence that is available to the public.1. Clinical Excellence – The midwives are there to encourage and support the normality in pregnancy and birth. The women deserve a chance to be treated fairly and equally. 2. Normality – The midwives will be able to carry out their practice as a normal physiological process whilst trying their best not to give unnecessary medical procedures, medication and / or treatment. 3. A Community Organisation – This is led by a team of midwives who carry out the majority of the services. This services will carry across both community and acute setting to provide the continuity of care throughout the pregnancy and the labour. ?4. Public Health – This allows for the midwives to have an active commitment to the reduction of maternal and neonatal effects, health education, support for women with disabilities and will be in constant contact with agencies outside of the health system.5. Services which are Easy Access – This is when expectant mothers or mothers will need some extra help and are able to use the services for free. When this arises, I.e. cultural issues, then an advocacy service is available for those who don’t speak English as their first language. 6. A Service which allows Women to Speak and to be Heard – This allows for the woman to be in charge of her care and to be involved in the planning, development and monitoring of your pregnancy, labour and after birth.?Physical, Emotional and Social Needs of a Mother during PregnancyPhysical Needs :1. Nutrition – It is very important for an expectant mother to have a good and well balanced diet as it will help to develop a healthy baby and reduce the possibility of any effects on the baby. It is important to increase folic acid into the expectant mothers diet as it can help prevent neural tube defects such as spina bifida. (BabyCenter, 2018)2. Shape – As the foetus grows so does the womb which then means that the abdomen stretches into a round shaped bump. This bump can be small and stay small or it can grow big depending on the size of the baby near the end of the pregnancy or if there is multiple babies.3. Blood Count – Even though this is not visible to the eye, it is a change within the   body. The blood count increase between 25-40%. This is because the vital           organs adapt to its needs and the blood is also giving food to the baby. (BabyMed.com, 2018)Emotional Needs : 1. Hormones –  The pregnancy hormones that are released into the body increase their sensitivity to topics such as crying for no apparent circumstances. The hormone HCG or Human Chorionic Gonadotropin, is produced. It is made from cells within the placenta and is evident from 11 weeks pregnant. It rises the levels of progesterone and estrogen. (American Pregnancy Association, 2018)2. Support – The support of a partner or family throughout a pregnancy is a necessity. This is because this can be a worrying and stressful time for the expectant mother and she needs the encouragement and her mind to be at ease. She can get the support also from the midwife, they will offer their own advice and provide services that could help to the expectant mother.3. Relieve Maternal Stress – The idea of becoming a new mother, especially if it is your first, is a scary thought. Maternal stress can be seen as a teratogen to the body. A teratogen is a harmful substance that enters the body which can cause harm to the baby. Stress can reach the baby and if it is high levels then it can impact the development of the baby’s brain.Social Needs :1. Exercise – Doing regular exercise whilst pregnant has positive effects on both the expectant mother and unborn baby. It helps to improve the mothers blood circulation and prevents constipation, which can be quite unpleasant and uncomfortable.  (American Pregnancy Association, 2018)  Doing exercise whilst pregnant can increase your chance of having a peaceful sleep as this is something a pregnant women can suffer with sleepless nights. It can also give you the endurance you need to get through the labour process. 2. Confidence – Doing exercise allows you to have a healthy image of themselves which therefore allows you to improve your self-confidence. It is highly recommended that an expectant mother attends classes, I.e. antenatal and parenting classes. These can help the mother through her worries and show her how to look after the baby correctly and safely.?Physical, Emotional and Social Needs of a Mother during Labour & DeliveryPhysical Needs : 1. Monitoring – It is vital for the mothers vital signs to be checked regularly as it can indicate any problems within the mother that can potentially harm the baby or put it into stress. These vital signs will include both the baby and mother pulse rate, the mothers temperature, respirations and blood pressure.2. Hygiene – It is essential that the hygiene standards are met during labour and delivery. As the woman’s vagina is being examined, she should be satisfied that the midwife is using sterile gloves and sterile equipment for each examination. If this is not met, then the mother is open to infections at a higher risk as her vagina contracts and widens. Emotional Needs :1. Companion in Labour – This is both for physical, emotional and even social support throughout the delivery. The mother should pick someone who she feels will be her birth partner, I.e. the partner / father of the baby. This person is there to help them through the contractions, help her with her breathing and to rub her back or anywhere where she needs to help soothe her. She should be able to trust this person and for them to be able to listen and help the mother through the delivery without having her to worry.2. Assurance and Encouragement – The mother should be giving words of encouragement of how strong she is and how she is able to do the labour. This reassurance can help calm the mother a little bit. This also helps her to gain confidence in herself to get through the labour and delivery process.?Social Needs :1. Communication – Effective communication can help put the mother at ease as to what is ahead of her in the delivery process. The mother needs to be told what is happening and what they hope to happen ( I.e. hitting goals that can show the mother she is getting closer and closer to meeting her baby) during labour. It also allows for the mother to put her mind at ease and try to calm a little throughout the process as it is a rewarding one even with all the pain and some stress. 2. Familiar Attendance – The familiar family members / friend being there to allow for the mother to have a slightly normal social life by being able to talk to them and have a laugh or even to have lunch in the hospital room together. It also takes the mothers mind off what she is going through even for the shortest of time it can help greatly.?Physical, Emotional and Social Needs of a Mother during Post – PartumPhysical Needs : 1. Care – Not only does the mother take care of the newborn baby but she also has to take good care of herself. This includes personal hygiene (keeping the vaginal area clean as the muscles are relaxing and are returning back to its original shape and size) and looking after her mental health. This means not being tuck inside all the time with the baby that she is able to go outside and get fresh air or even be able to have friends over for a chat and not be alone all the time.2. Sleep – It is important that the mother gets a huge amount of sleep post partum as this affects her overall health in general. Not getting enough sleep or even rest can lead to feeling exhausted during the day and can lead to post partum depression. This can happen because of her being physically exhausted means she might not be able to function properly during the day which can lead her into feeling mentally unwell. Emotional Needs : 1. Love and Support – This should come from the partner. The partner should be involved in the taking care of the baby as it is an equal and shared job as parents. The partner should also take responsibility of the baby when the mother is tired as she needs as much rest as possible. The partner should also show a little affection to the mother buy buying her flowers or having couple time when the baby is asleep to show that you still love her.2. Bonding – It is probably the number one priority that the mother and baby have formed a bond. This is because the mother is the provider of food whether she is breast feeding, pumping or making bottles. It also means that she is a comforter to the baby if he or she is in distress or needs looking after.?Social Needs :1. House Maintenance – Whilst her main priority is looking after the baby, she will also feel the need to clean the house. In doing this, she will ot be able to get the rest she needs. This is where she can ask her partner or even family members to help out with keeping the house in order until she feels fit and ready to tackle the house herself.  2. Needs of Other children – If the mother has children previous to this birth then she will need to spend some quality time with them away from the baby to show the children that they have not been forgotten with the new addition to the family. She could also get the children involved of taking care of their new sibling by assisting with the feeding, dressing and allowing the siblings to hold their new sibling if they wanted to.?Assisting Mothers in Caring for Themselves and their BabiesPersonal Hygiene and Comfort There is a list of things that you would recommend to the mother before she leaves the hospital. These are to ensure the mother takes extreme care about herself as it is just as important as the babys care. You would recommend :• Keep the perineum clean and dry as it becomes swollen and painful during labour as the baby was pushed out. The perineum is the area between the rectum and vagina.• Change your pad every time you go to the bathroom or at least 4 times a day.• Take baths regularly as they help clean the vagina and it promotes the healing of wounds.• Try not to use tampons for the first 6-7 weeks as they can cause an infection in the vagina.(Unitypoint.org, 2018)• If she is suffering with cramps, then she should either apply heat, lie face down or take a warm bath to relieve pain or discomfort. Experiencing cramps are normal because the uterine wall is relaxing and is returning to its original shape.• If struggling with bowel functioning (normal not to pass anything within the first 3 days post delivery), she should try to massage the abdomen, drink plenty of fluids and eat a diet full of high-fibre.(Hopitalmontfort.com, 2018)?Baby Hygiene and PositioningBefore the mother is released from the hospital with the baby, they will give her the information she needs to look after her baby properly. She will be given this information even if she has been to classes.For baby hygiene, you would recommend : • For bathing : have your towels, nappy and clothes etc. ready before you start. Do the bath at a quiet time so it is not rushed. Close all windows and doors to prevent any coldness or draughts coming in. Never leave your baby unattended or with a child. Always put cold water in first followed by warm water to allow for an even spread of both temperatures. The water level should only reach babys tummy. Use both hands to move the baby in and out. Hold the babys head at all time in the bath for support. (Ireland’s Health Service, 2018)• Umbilical Cord : Wash hands before and after the cleaning. Clean around the bottom of the cord with a cotton ball. Keep the area dry at all times and make sure the nappy is not covering the cord as it can get caught in it.(Ireland’s Health Service, 2018)• Nappy Changing : your baby should have 5-6 wet nappies per day. Check the nappy before each feed. When changing the nappy, remove the nappy and wipe the skin from front to back whilst making sure the contents do not spread. If nappy rash is present, gently wash and dry it and use a cream recommend by the doctor scarcely on the bum.For the positioning of the baby, you would recommend :• Place the baby on their back.• Keep them in the same room as you.• Try not to have loose bedding in their cots.• Avoid having them being over heated.• Place them at the base of the cot.?Special Needs of a Family Unit When a Baby is Born with Congenital Abnormalities and Those Affected by MiscarriageA congenital abnormality is also known as birth defects that have a variety of causes from the pregnancy or birth complications and malformations.The needs of the family would be :• To inform all family members of the condition and to research and ask questions that they have worries about and adapt the house to suit the condition. • Mothers usually become the primary carer of the child and this can also lead to mental health issues because they feel overwhelmed and feel that they cannot manage the child themselves and this puts stress and a lot of worry on them. • Fathers may also feel the strain of emotions because they believe they are there to protect the baby and because of its condition they feel like they have not and it is their fault.• Their social life and needs will be put aside if the baby requires surgery or long hospital visits.Miscarriage is a very common and an unfortunate thing to happen to a woman. It happens one in every four women. Miscarriage can happen at any point in the pregnancy for any number of reasons: 1. chromosomal problems that make it impossible for baby to form properly, 2. obesity, 3. alcohol and drug use etc. The mother, in particular, will feel like it was all her fault. The needs of the family unit are very important when a miscarriage happens. They will need someone to listen to them as they cry and talk about their feelings and what they think happened. They need to be listened to and not to be judged. For example, counselling. The family will need time to grieve and this might be a long process but they will eventually be able to come to a point where they can cope with the loss every day.  The family will need support from other members of the family to assist in looking after the children, the home and emotional support aswell. 

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