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Anjuna

Anjuna and Hassan have been married since they were 16 and 18 years respectively. Both families have known each other for many years as their parents are related. All were delighted when Anjuna announced she was pregnant after 6 months together. They all live with Hassan’s parents in a 5 bedroomed house on the outskirts of town and are supported by the family takeaway business. There are currently 3 shops with plans to expand to another shop soon. All of the family work in the family business except Hassan’s mother but she can then help look after Anjuna’s baby when she returns to work especially as Anjuna works every weekend and often late into the evening.

What benefits may Anjuna claim as she is self-employed?
What specific health and safety issues should the midwife advise Anjuna 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 Anjuna’s wellbeing in the postnatal period when you meet her?

PHYSICAL
INTELLECTUAL
SOCIAL
CULTURAL
EMOTIONAL
SPIRITUAL

Using the latest NICE Guidelines identify what are the key things the midwife needed to ask when Anjuna “booked” with her community midwife ?
What are some of the issues when a women “books” when relatives may be related?
What other multi-disciplinary agencies could the community midwife encourage Anjuna and her family to contact to support them?

At this 1st antenatal visit as the named midwife you will be expected to offer and carry out a number of tests and procedures today.

The last LNMP for Anjuna was 1st September 2018.

Calculate her EED?

Calculation of BMI:

BMI=weight in kilograms

———————————————

(Height in metres)2

Her height is 165 cms

Her weight today is 70kgs

This is classed as overweight.

What are some of concerns re being overweight and pregnant?

Review NICE guidelines Clinical guideline [CG62]

Antenatal care Quality standard [QS22]

What are some of the possible reasons for being overweight?

On further discussion Anjuna is very conscious of her weight and shares that she has suffered from bullying in the past.

What blood tests will be offered to Anjuna today?
When taking her blood pressure today and at subsequent visits are there any additional considerations?

After a subsequent scan in her pregnancy Anjuna is obviously anxious when she rings you after her appointment at the hospital stating that she overheard someone at the hospital tell another midwife “that her baby is really big and she probably will need a c/section.”

Anjuna births a baby boy, Aadi at 40 weeks by elective caesarean section under epidural anaesthetic, after an induction of labour at the local hospital accompanied by Hassan.

Aadi weighs 4Kgs and both Anjuna and Aadi are transferred home on day 4.

Anjuna rings you on day 5 saying that Aadi is very sleepy and not wanting to take his bottle milk and that her breast are very uncomfortable.

Before you visit what questions would you ask Anjuna?
What would be your plan of care?

Using a

SBAR approach

Situation:

Background:

Assessment:

Recommendation: