Jaswinder is 22 and Raghan is 24 years old. They have lived in England all their lives as both sets of grandparents arrived here from Uganda in the 1960’s. They live with Raghan’s parents and brothers’ families. The family own the local Chemist in Montfort and both work in this family run business, having both graduated from the local University with 1st class degrees in Pharmacy. The business is very successful with well-established links to the local health centre, a home delivery service and out of hours service. This means that that both Jaswinder and Raghan both work long hours and often miss meals in the day, snacking in the day, although prioritising a family meal in the evenings. Jaswinder is aware that she has gained weight since starting University and whilst she is very excited to be pregnant attending Antenatal clinic today she is worried that the midwife will say she is overweight.
- Calculate her BMI if she is 183 cms tall and weighs 65Kgs. Is she over weight?
She is anxious also that she was at University with the midwife and is a family friend and wonders if this will affect their friendship if she asks for another midwife to care for her today as she is worried about confidentiality issues.
When discussing her birth plan at 28 week visit Jaswinder says that now she has talked to some of the parents in the shop she was wondering if she could arrange to birth in Manor Birth Centre?
- List some of the questions that you as her named midwife will need to ask when discussing this birth option?
Baby Raja is born at manor Birth Centre at 40 weeks gestation, weighing 3.5kgs and in good condition after a short labour using Entonox and a TENS machine only. Both families are delighted.
As the midwife you have a responsibility to examine Raja 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 immediately after birth.
You notice a blue darker patch of skin at the base of the spine when examining Raja.
- How would you discuss this with the parents and where and how do you record your findings ?
- Menage, D. Chapman, M. Raynor, M. Essat,Z. & Wells,R. (2021) De Colonising Midwifery Education: Part 2. The Practising Midwife. 24:06. pp45-49.
Jaswinder wants to breast feed Raja and he feeds well and they return home a few hours after the birth.
On day 5 baby Raja is weighed and found to have lost more than 10% of his birth weight.
- What questions would you ask Jaswinder at this visit?
- What support groups are available to help support Jaswinder with breast feeding issues?