Application for Temporary perinatal health midwife
There is increasing awareness of perinatal mental health as a public health issue. The Government is keen for midwives to further develop their role in public health. Midwives need to be adequately prepared to take on a more developed role in perinatal mental health if practice improvements are to be made. I am aware that death from psychiatric causes has been the leading cause of maternal death for the last few years. Although the most recent Confidential Enquiry into Maternal and Child Health indicated that this is no longer a leading cause, mental health problems before and after childbirth have a significant impact on the health of women, family relationships and children’s subsequent
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I am a naturally creative person who enjoys implementing evidence based practice change at a strategic and operational level. I am very excited about the opportunity to be potentially involved with designing an E-learning package. Whilst working with other experts in this industry I have gained some knowledge in the process of elearning development. I think that routine antenatal and postnatal care present an excellent opportunity to screen the mental health of pregnant women and women with a new baby. To do this effectively however, requires working more collaboratively across different professions to meet the needs of our patients. Having the post of a specialist midwife in mental health could allow me to provide focused care to pregnant women with mental illness. This could include co-morbid substance & alcohol misuse problems. I envisage the role as working closely with a perinatal psychiatry team at W.M.U.H and as an important point of liaison between the other midwives, especially safeguarding and case loading midwives, obstetricians, health visitors, child and family social services, obstetricians in the hospital, and mental health services. A useful means to achieve partnership working would be for the S.M.M.H to attend the weekly midwifery team meeting. Here, all midwifery community and labour ward teams meet to discuss the caseload and update the antenatal progress notes. This provides a valuable opportunity for potential referrals
Postpartum depression can have serious consequences for the health of both mother and child. Indeed, a recent study of 10, 000 postpartum women found 19.3% of women with postpartum depression had considered hurting themselves (5). In the United Kingdom suicide is the leading cause of maternal death in the postpartum period (6). Even in less severe cases, postpartum depression may compromise caregiving practices (e.g., are less likely to use car seats, breastfeed, or ensure that their child receives up to date vaccinations); (7;8) and maternal-infant bonding (e.g., are less responsive to their infants, engage in less face-to-face interactive play and participate in fewer enrichment activities); (7;9;10). These factors may be partly responsible for delayed cognitive, intellectual, social, and emotional development of the child (11-15). Given the negative consequences of postpartum depression, prevention and treatment is imperative.
This means recognizing each woman’s social, emotional, physical, spiritual and cultural needs. It also acknowledge that a woman and her newborn baby does not exist independently of the woman’s social and emotional environment. This includes incorporating an understanding in assessment and provision of health care (Yanti et al., 2015). The fundamental principles of women-centred care ensures a focus on pregnancy and childbirth as the start of family life, not just as isolated clinical episodes. These motherhood phases take into complete account the meaning and the values of each woman. Providing women centred care helps women make an informed choices, being involved in and having control over their own care, this also includes their relationship with their midwives (Johnson et al., 2003). This demonstrates that midwives are able to attend for women during pregnancy, childbirth and in early parenting years. In addition to this, midwives also provide education for women in order to have a healthy lifestyle (Woods et al.,
The ANMC states that midwives should promote safe and effective practice. This competency standard involves: Applying knowledge, skills and attitudes to enable woman centred care, provide or support midwifery continuity of care and manage the midwifery care of women and their babies. Midwives providing continuity of care are able to provide safe and effective practice. They know there patients well from the woman’s blood test results to the woman’s birth plan. The midwife can provide safe and effective practice because she knows the woman best. Midwifery Continuity of care is associated with a reduction in the rate of a number of interventions, without compromising safety of care (Spiby &
Being a midwife refers to a profession where the midwife would work in partnership with the women throughout her pregnancy, labour and the postpartum period. Not only is being a midwife women-centred, however, their role also includes ensuring the partner and family members are prepared and aware of the process. Within a women’s health, the midwife should focus on health, family planning, nutrition, domestic and other health issues as the main priority is the
This essay demonstrates significant factors, a midwife and the women may face within Australian public hospitals. As a midwife the key skills are understanding of what supports and impacts the normal physiological process of labour and birth. This essay will discuss two influencing factors that have a negative effect on the normal progress of labour and birth. This will be seen, firstly by discussing the cultural and environmental impacts of labour and birth. Then, examining how the midwife may best support and facilitate the adverse effects of normal physiological process. This essay also discusses a positive labour and birth environment within the Australian standard model of care.
Maternal mental health (MMH) disorders occurs in one out of 10 women during pregnancy and within the first year after birth (Maternal Health, 2016). Current law in California states no requirement for perinatal or postpartum screening. AB 244 proposes to create a pilot program to increase the healthcare providers capacity and training to manage MMH conditions to serve pregnant and postpartum women up to one year after delivery (California Legislative Information, 2017). The purpose of this paper is to increase management of MMH disorders, support of bill AB 244 and Assemblymember Cristina Garcia’s opinion, how a bill becomes a law, and how nurses can impact current law.
The international Confederation of Midwives (ICM) defines the midwife as a person who has successfully completed a nationally recognized midwifery education program, is qualified for registration, and competent to practice in midwifery. As a midwifery student, I will explore the philosophies of this profession whilst working with my first continuity of care experience woman and her family. In this essay, I will examine the roles of the midwife, the scope of the practice for midwives and midwifery students, and search the value of the midwifery partnership and the importance of the woman centered care. I will also clarify the legal, professional and ethical responsibilities of the midwife in accordance with national standards and code. Analyzing
In this article, the authors explored the continuity of midwifery care using the caseload approach that was established in Queensland. This was to address the development of care for women experiencing inequalities and to improve birth outcomes. The authors objective was to investigate midwife’s responsibilities within their scope of practice when applying a caseload model (Midwifery Group Practice [MGP]).
Often the time after birth is a filled with joy and happiness due to the arrival of a new baby. However, for some mothers the birth of a baby leads to some complicated feelings that are unexpected. Up to 85% of postpartum woman experience a mild depression called “baby blues” (Lowdermilk, Perry, Cashion, & Alden, 2012). Though baby blues is hard on these mothers, another form of depression, postpartum depression, can be even more debilitating to postpartum woman. Postpartum depression affects about 15% (Lowdermilk et al., 2012) of postpartum woman. This disorder is not only distressing to the mother but to the whole family unit. This is why it is important for the nurse to not only recognize the signs and symptoms of a mother with postpartum depression, but also hopefully provide preventative care for the benefit of everyone involved.
Postpartum psychiatric disorders, particularly depression, has become the most underdiagnosed complication in the United States. It can lead to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development (Earls, 2010). Over 400,000 infants are born to mothers that are depressed. One of 7 new mothers (14.5%) experience depressive episodes that impair maternal role function. An episode of major or minor depression that occurs during pregnancy or the first 12 months after birth is called perinatal or postpartum depression (Wisner, Chambers & Sit, 2006). Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others (Postpartum Depression). The six stages of postpartum are denial, anger, bargaining, depression, acceptance and PTSD. These stages may affect any women regardless of age, race, ethnicity, or economic status. However only a physician can diagnose a woman with postpartum depression. It does not occur because of something a mother does or does not do, it’s a combination of physical and emotional factors. After childbirth, the levels of hormones in a woman’s body quickly drop; which may lead to chemical changes in her brain (Postpartum Depression). Unbalanced hormones may trigger mood swings.
Identifying and treating physical health issues of the baby after birth is a natural part of follow-up care, but emotional well-being care of the mother generally is not. In an article titled “Panel Calls for Depression Screenings During and After Pregnancy”, author Pam Belluck argues that screening all expectant women should be recommended due to the high probability of mental health issues emerging afterwards. “The recommendation, expected to galvanize many more health providers to provide screening, comes in the wake of new evidence that maternal illness is more common than previously thought…” (2016). If more screening took place for women in the after care of pregnancy, there could be a reduction of pregnancy induced mental illnesses, since those affected would be identified earlier and
Public health is defined by the World Health Organisation as ‘all organised measures to prevent disease, promote health, and prolong life among the population as a whole’ (WHO, 2015). Within this role of public health, the midwife has an essential role. They are in the best position to be able to guide
According to two recent studies, 7-13% of all postpartum women suffer from depression. Even more alarming, the prevalence of postpartum depression (PPD) in mothers who have pre-term infants rises to 30-40% according to a recent review (Robertson E, Grace S, Wallington T, Stewart DE., 2004; Schmied V, Johnson M, Naidoo N, et al., 2013). Mood and anxiety disorders, specifically PPD, are severe, yet common complications in women of reproductive age. Undertreated depression in postpartum women is associated with health risks for both the mother and infant, making the goal of euthymia a top priority in the care of postpartum women. Current practice regarding PPD focuses on the triad approach of early detection and prevention, the use of pharmacotherapy, and the use of psychotherapy. However, the treatment of mental illness during pregnancy requires weighing the benefits of pharmacological treatment for the mother, to the risk of the medications on the growth and development of the fetus as well as the theoretical risks associated with undertreated depression. However, many studies are showing that the risks of postpartum depression to both the mother and infant significantly outweigh the risks of pharmacological treatment during pregnancy. Also, due to the ethical issues surrounding trials of pharmacotherapy during pregnancy, further research to determine evidenced-based methods of treatment are still necessary. The most important intervention to date is a
Perinatal mental illness is a collective term used to describe mental illnesses experienced by at least 10% of women during pregnancy and up until a year after birth (Hogg, 2014). Mental health is with paramount importance to the role of the midwife (National Institute for Health and Clinical Excellence (NICE), 2014) as mental illness is a significant threat to the lives of mothers and can have a huge effect for their babies and families (Knight et al., 2015). Between 2009 and 2013 there were 161 maternal deaths related to mental health problems, one of the leading causes of maternal mortality in the United Kingdom (UK) (Knight et al., 2015). The main types of mental health disorders, signs and symptoms along with possible treatments
In today's society, the midwife has more roles and responsibilities than ever before. A midwife is someone who has to be able to provide women with the essential care, supervision and advice during their pregnancy, labour and postpartum period, and to care for both mother and child (International Confederation for Midwives 2011). As autonomous practitioners, they act as an advocate for the woman by supporting her and encouraging her to make her own independent decisions (Royal College of Midwives 2008). Midwives care for families from different social, psychological and physical backgrounds and work as part of a multi-professional team so excellent communication is vital. The number of women with complex social and physical needs such as drug and alcohol misuse are increasing, and a midwife needs to adapt to these situations and communicate effectively (Midwifery