Promoting and Facilitating Informed Choice

2866 Words12 Pages
Promoting and facilitating informed choice. Women who face care decision dilemmas. This essay will explore the care received by a woman during her pregnancy, with particular reference to the application of Lesley Page’s (2000) five steps (Appendix I). In accordance with the Nursing and Midwifery Council (NMC), 2004 guidelines on confidentiality, the woman’s name has been changed. [pic] Finding out what is important to the woman and her family. As Page (2000) states, in providing woman centred care, it is important to understand the woman together with her values, worries and hopes for her pregnancy. In Jill’s case, it was important for the midwife and student to approach her as a pregnant woman and not as woman with diabetes who…show more content…
The St Vincent Declaration (1989) provided a five year target to realise pregnancy outcomes for the diabetic woman nearing those of the non-diabetic. However, (CEMACH, 2002-03), illustrates that, 14 years later, the aims of the St Vincent Declaration have not been met. For Diabetes sufferers, perinatal mortality rates are four times higher and congenital abnormality rates up to ten times higher. Suboptimal care is quoted as an underlying factor along with poor multi-disciplinary referral. The National Service Framework for Diabetes: Standards (NSF, 2001) also recognises the risks of diabetes in pregnancy and the high incidence of adverse outcome but suggests that, if the woman is empowered and involved in her own care, medicalisation need not be frightening or implicate loss of control. Jardine-Brown et al, 1996, highlight many areas of substandard care and indicate the lack of specialist maternity services for the diabetic woman with resultant increases in poor pregnancy outcome. Even though improvements in care for the pregnant diabetic woman have been made over the last decade, the statistics provided by the NSF (2001) and CEMACH (2002-03) suggest insufficiency. In the search for safety and a reduction in mortality/morbidity rates, the professional must use the best available evidence for care decisions (Page, 2000). A diabetic woman whose glycaemic
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