Eliza is 20 years old. She is in the 2nd year of a psychology degree course at the local University. She attends the antenatal clinic at the student health centre today alone and is clearly very distressed.
She starts by saying
“she met a guy called Ezra at a festival in the Summer and you know one thing led to another and …we… you know we got caught up in the moment and had unprotected sex and whilst we met up a few more times it was only about 2 months ago that realised I must be pregnant! I am not regular anyway so sorry for being so vague but as I say must be about 2 months gone at least.”
When asked if Ezra are her are still in a relationship she becomes very distressed and says
“No..well….he kicked off about it actually and wants a DNA test once the baby is born before he’ll even get involved.. although maybe not. I was thinking though if you perhaps book me in for a scan he might come with me, and y’know feel different then? I hope so as whilst I am happy about being pregnant just not sure how I’m going to manage on my own? My parents are going to be so mad.”
Heath Visitor focus
Antenatal Visit
As her named midwife you advise her that a HV will be contacting her to undertake the 28 weeks pregnancy check.
Eliza is clearly anxious and asks “Why is that – what will she ask me”?
You explain that the health visitor is called Heidi and undertakes this 1st visit at 28 weeks pregnancy as a Health Promoting Visit and this antenatal check is the first time that the health visitor will meet with you. “Together you will complete a health needs assessment covering physical health such as whether you smoke or not and the benefits of breastfeeding and discuss your mental and emotional health. The health visitor will also discuss becoming a parent and how to enhance that parent-child bonding experience and how you and Ezra can help your baby’s early development, such as what equipment you might need to buy.”
Eliza says “Well I’ve heard mixed things about what to expect, some friends said it’s just so that they can get to know you beforehand, others though that they go through your entire house to make sure it’s suitable!” ” I am really pretty broke what with tuition fees, rent and now got to buy baby things.”
You can reassure her that “the purpose of the visit is to make an assessment of family health needs – in practice yes, this means asking what can be considered ‘nosy’ questions but this then allows the HV to offer/facilitate the appropriate level of support you may need.”
“This first visit will give you as a mum-to-be the opportunity to talk about your emotions prior to your baby’s birth, help you get to know Heidi who is going to be your health visitor for the next 5 years, especially as you’re a first time mum. The whole purpose of the antenatal visit is that those families who might need more support and intervention will be able to receive it earlier, so it is a fairly new idea that you meet the health visitor before pregnancy but sure you will find it really helpful.”
Activity 1:
Review: Department of Health (2009) Healthy Child Programme: Pregnancy and the First Five years of Life.
Reference: https://assets.publishing.service.gov.uk/government/uploads/system/file/550487/2000.pdf
Activity 2: Make a list of all the information that the health visitor will discuss at this 28 week health promotion visit?
Activity 3: What support can Eliza access at her local Children’s Centre?
a) antenatally
b) postnatally
Communication between all members of the multi disciplinary team (MDT) is crucial to offering high standards of care and to reducing risks of misinformation.
Activity 4:
List all members of the MDT and others agencies and the circumstances where information would be shared about Eliza.
List all the opportunities for discussion about Eliza between the members of the multi disciplinary team
a) antenatally
b) postnatally
References.
Nursing & Midwifery Council. (2018). The code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. London: Nursing & Midwifery Council.