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Clarissa
Clarissa (37) and Jonathan (39) have been married for 15 years. They are both school teachers and have recently moved here after both were promoted to Head of Department roles. As they both now work the same hours in adjacent schools they sold one car and commute together. Both have undergone investigations for infertility in the past and were therefore surprised yet delighted to find that Clarissa was indeed 8 weeks pregnant even though she had thought she was being sick as a result of a stomach bug that had affected many in her class in recent weeks when she visited here GP. Their parents live in Scotland and New Zealand and so they rarely meet up but Clarissa has one sister who lives in London.
- What are likely to be Clarissa’s main concerns when she meets her midwife at 12 weeks to “book?”
- What specific health and safety issues should the midwife advise Clarissa about whilst pregnant in view of her job?
- Using a PISCES model think of one thing that may affect each of the following in relation to Clarissa’s wellbeing in the antenatal period?
PHYSICAL
INTELLECTUAL
SOCIAL
CULTURAL
EMOTIONAL
SPIRITUAL
- Using the latest NICE Guidelines identify what are the key things the midwife needed to ask when Clarissa “booked” with her community midwife?
- What other multi-disciplinary agencies and services could the community midwife encourage Clarissa to contact to support her once she has had the baby?
- What are your responsibilities when discussing her birth plan at 32 weeks visit Clarissa says that now she has left work she has read a lot and was wondering if she could arrange a home water birth.
- List some of the questions that you as her named midwife will need to ask when discussing this birth option?
- What equipment would Clarissa need?
- Undertake some research into equipment hire such as costs, returns and health and safety aspects.
- What equipment does a midwife carry with her when attending a home water birth?
- Review local and national guidelines re home water births.
Baby Oliver is born at home at 40 weeks gestation, weighing 3.5kgs and in good condition. Both parents are delighted.
As the midwife you have a responsibility to examine Oliver and record your findings.
- Record how you would undertake an examination of the newborn?
- Describe what considerations you need to make when examining a new baby at home immediately after a water birth.
- How does the midwife dispose of the placenta after a home birth?
Clarissa wants to breast feed Oliver and for the 1st 2 days all is going well.
On day 3 however Clarissa rings you and sounds very distressed, saying she has not slept all night and wants to give up breast feeding as it is too painful.
- What questions would you ask Clarissa when deciding what advice to give before prioritising a home visit?
- What support groups are available to help support Clarissa with breast feeding issues.