The Offy

Shaznia, aged 19 is married to Mohammed, aged 21. They have lived in England for 10 years when their parents left Pakistan. They live with Mohammed’s parents and they own and all work in an off licence based on a busy main road. Shaznia is worried about attending antenatal clinic at the local hospital as she has never been ill before. She is worried as to what the midwife may say as she knows herself she is overweight, as she often eats sweets and snacks from the shop during the day, as they work long hours and often miss meals in the day but all eat as a family later in the evening. She is also worried about seeing a male doctor at the hospital as she has only ever met a female GP about any health worries.

 

  • What benefits may Shaznia claim as she is self-employed?

 

  • What specific health and safety issues should the midwife advise Shaznia 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 Shaznia’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 Shaznia “booked” with her community midwife?

 

Shaznia is 160 cms tall.

Shaznia weighs 70kg

 

What is her BMI?

 

Resources www.nhs.uk

Calculation of BMI (McDonald S & Johnson, G. (2017:520).

 

Shaznia is unsure of her LNMP date as her menstrual cycle is “erratic” but averages at 35 day intervals.

 

Using Naegle’s rule (McDonald S & Johnson, G. (2017:514) calculate her EDD if her last LNMP was

7th October 2019.

  • What care pathways may the midwife suggest as Shaznia is overweight?

 

  • List any additional risk factors due to her ethnicity?

 

  • What additional screening tests would you offer Shaznia later in the pregnancy?

 

Resources:

https://pathways.nice.org.uk/pathways/diabetes-in-pregnancy

https://pathways.nice.org.uk/pathways/antenatal-care-for-uncomplicated-pregnancies

 

 

  • What other multi-disciplinary agencies could the community midwife encourage Shaznia and her family to contact to support them?

 

  • How can a midwife allay her anxieties about going into hospital?