Jess and Jamie met at college and have known each other for 10 years and lived together for the last 5 years. They are both part of extended families and both parents and siblings live nearby. Jamie works with his father and brother in a family run plumbing business and plays football for the same team as his other brother at the weekend. They have a busy social life and holiday abroad two or three times a year and are part owners of a timeshare in Spain with the rest of the family.
They postponed having children whilst Jess established her own floristry business. She is so successful that she spends many weekends at weddings and as her business is also online as well as running a small shop involves work in evenings as well.
Jess has just discovered she is pregnant and both are delighted by the news.
At the antenatal booking visit at 10 weeks Jess has lots of questions.
As the midwife involved in her care your role and responsibility is to take a detailed booking history.
Questions:
Jess states she is very nervous about having blood tests? As the midwife responsible for her care what can you do to allay her fears?
What blood tests are usually undertaken at a booking visit and why?
At a subsequent antenatal visit at 28 weeks you spend some time discussing a birth plan with Jess and Jamie. They state they would like a home water birth.
What do you as the midwife leading on her care need to consider when a couple make this request.
Jess’ pregnancy is uneventful until 34 weeks.
Intrapartum:
She rang the hospital birth centre an hour ago and complained of severe pain.
You are the midwife in charge and take this call. What are your responsibilities in this scenario?
Jess states that she is alone at home as Jamie has been called away to work on an emergency call out at a house renovation.
Jess arrives on the delivery suite accompanied by her sister.
How can you as a midwife assess progress in labour?
What are your responsibilities when admitting Jess to the delivery suite?
What details are needed when adapting Jess’ plan of care ?
What are your responsibilities as a midwife in this scenario?
What are the roles of others in the MDT in this scenario?
Jess births a little boy called Jake weighing 2.7kgs 45 minutes after admission to delivery suite. Apgars are 5 @ 1 minute and 7 at 5 minutes.
A neonatologist was called to the birth and arranges for Jake to be admitted to NNU for observation and review as he needed some active resuscitation.
Jess is clearly upset as how events have unfolded and is very tearful. Jamie arrived just in time to see Jake being born but is visibly shaken by events.
Neonatal care:
What are your responsibilities to the baby before safe transfer to NNU?
Jess is keen to breast feed Jake?
How can you as the midwife involved in her care help facilitate successful breast feeding in this scenario?
Postnatal care:
Jess wants to stay in hospital with Jake and is transferred to a ward. She spends most of the night in NNU with her son as she is so anxious for his wellbeing and does not want to leave him. She is clearly distressed about “how everything has gone wrong” and needs a lot of support.
Jake is transferred from NNU to the ward on day 2 and both Jessa and Jake are transferred to the care of the community midwife on day 3.
What key details are needed when writing up notes for transfer to community midwifery team.