Angharad (43) lives alone. She is the marketing director of an IT company. Angharad works long hours and commutes over 20 miles daily and often works away nationally and internationally. She met an ex colleague at one such event a few months ago and had a brief relationship with him. She knew he was married and as he works for a rival company and she is not in contact with him now.
At a recent important meeting she felt violently sick and had to leave the meeting. After a few days she took a self pregnancy testing kit and was really shocked to see it confirm a pregnancy.
She is under a lot of pressure to meet end of year targets and write up reports so it is a few weeks before she makes an appointment with her GP.
Using a PISCES model think of one thing that may affect each of the following in relation to Angharad’s wellbeing in the antenatal 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 Angharad “books” with her community midwife?
Angharad is very worried re the screening tests on offer at the hospital because of her age?
- How can we help allay these anxieties?
- What sources of information can we direct Angharad to?
Angharad feels guilty about not taking any folic acid but she wants to start taking it today.
- What dosage of folic acid is recommended?
- What are the major foodstuffs that contain folic acid?
Angharad is a vegetarian.
- What additional nutritional advice should you recommend?
- What specific safe eating guidelines would you discuss with Angharad in view of her employment?
Angharad asks you about whether it is safe to travel later in the year as she is expected to attend an international conference in New York as part of her job?
- Where can you as a midwife obtain up to the minute advice re safe travel in the World and what vaccinations/ precautions recommended for travelling whilst pregnant?
- What other multi-disciplinary agencies could the community midwife encourage Angharad to contact to support her once the baby is born?