Heather (40) and Bruce (42) have been living together for 5 years. They have both been married before. Bruce keeps in touch with his ex partner, Karen, as they have 2 children, aged 8 and 9, who live with their mother in the week but stay with Bruce and Heather most weekends. Heather has one teenage son, Rick, who lives with them full time but he is aged 16 and wants to leave home. Neither have contact with her ex partner as that was an abusive relationship that ended acrimoniously soon after Rick was born. Heather meets her community midwife and is clearly shocked at finding out that she is already 13 weeks pregnant stating that “everything is different this time and I was certainly not planning this and I am not happy and I told him to sort this out.”
Both Heather and Bruce smoke between 10-20 cigarettes a day and admit than when no children are there also use recreational drugs occasionally. Heather works as a part time cleaner but since Bruce was made redundant has struggled to find full time work but sometimes helps his friend on his market stall.
• What are likely to be Heather’s main concerns when she meets her midwife at 13 weeks to “book?”
• What specific health and safety issues should the midwife advise Heather 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 Heather’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 Heather “booked” with her community midwife?
• What other multi-disciplinary agencies and services could the community midwife encourage Heather to contact to support her once she has had the baby?