The Model Of Maternity Care

The author is a nurse in a level two trauma facility in a community of approximately fifty thousand people in Oregon. The community is a college-town surrounded by a large agricultural area. There is a minimal ethnic diversity within the community. The diversity present occurs mainly from internationally students and faculty from the college. There is a growing population of women who desire low interventional births in the community. The author has worked on the labor and delivery unit of the hospital for the last 14 years. The hospital is the only one in the area to offer trial of labor services to women who have previously undergone a cesarean section. The unit on average experiences around 1000 deliveries annually.

From the results, it is evident that the interventions were effective in increasing ANC coverage and improving other pregnancy related issues that emerged as a result of lack of or insufficient ANC. They addressed the common problems that affected the utilization of ANC, these included: maternal knowledge, accessibility to health care facilities and financial difficulties. Accordingly, as doctors and future practitioners, it is imperative that as we provide maternal and antenatal care, we structure the health care services we provide around the patient and cater to a patient's individual preferences, needs and concerns. We are advised to accommodate the patient as much as we can, which means providing them with care that is specific to them

Kildea (2006) says that maternity care based on principles of Western models of health care have not been able to improve maternal or perinatal outcomes and Molly Wardaguga, an Aboriginal health worker and respected elder, states that inappropriate maternity care is responsible for the social dysfunction and loss of culture often seen in Indigenous communities (Kildea, 2006). Until this day Indigenous women have not had their voices heard or their knowledge recognised (Kildea, 2006). In order to improve maternal and perinatal health outcomes for Indigenous Australians holistic components from the Indigenous definition of health must be incorporated into maternity care and connection to country must be respected (Kildea, 2006). Maternity

Explain how access to health care can promote the health of women and their babies during pregnancy. Access to health carers such as midwives, doctors and obstetricians can promote the health of women and their babies during pregnancy. These professionals are able to provide support and information, as they monitor the mother’s health and wellbeing and that of the baby. In addition, they are able to identify special medical or personal requirements that the mother may need.

For hundred of years, women have wrestled with their womanhood, bodies, and what it means to be a woman in our society. Being a woman comes with a wonderful and empowering responsibility--giving birth. What sets us aside from other countries is that the process and expectations of giving birth has changed in our society; coming from midwifery, as it has always been since the early times, to hospitals where it is now expected to give birth at. Midwifery was a common practice in delivering babies in

Bernadette Ward RN, Midwife, Grad Cert Ed, MPHandTM, MHlth Sci Lecturer, Faculty of Health Sciences, La Trobe University, Bendigo, Australia. B.Ward@latrobe.edu.au Glenda Verrinder RN, Midwife, Grad Cert Higher Ed, Grad Dip Pub and Com Health, MHlth Sci Senior Lecturer, Faculty of Health Sciences, La Trobe University, Bendigo, Australia.

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]).

This essay will be relating to an episode of care that was provided to a woman, her partner and their baby on day five during the postnatal period. It will examine the role of the midwife in relation to breastfeeding and how this was not achieved in the case study which is shown in the appendix. Throughout the essay it will look at the following outcomes: the role and responsibility of the midwife within current maternity care provision, the importance of sensitive midwifery, key legal and ethical dimensions of the midwife's role and key sociological and psychological agendas impacting on current maternity care.

This discussion will address the importance of the first antenatal appointment and three important aspects of this experience; these are the gathering of the woman’s health history, undertaking a maternal assessment, and maternal screening. Furthermore, a critical comparison of the use of the South Australian Pregnancy Record with the more traditional practice of using the hospital record as the methods of documentation. The establishment of antenatal care was founded in 1920. Since then the practice of midwifery has changed and developed into what we know today, as the midwifery-led continuity of care model, which the first antenatal care visit should aim for. This is an important time where the midwife gets to know the mother, her physical

Vaginal birth after caesarean (VBAC) is the name used for identifying the method of giving birth vaginally after previously delivering at least one baby through a caesarean section (CS). A trial of labour (TOL) is the term used to describe the process of attempting a VBAC. An elected repeat caesarean (ERC) is the other option for women who have had a caesarean in the past. The rates of women choosing to deliver by means of an ERC has been increasing in many countries, this is typically due to the common assumption that there are too many risks for the baby and mother (Knight, Gurol-Urganci, Van Der Meulen, Mahmood, Richmond, Dougall, & Cromwell, 2013). The success rate of VBAC lies in the range of 56 - 80%, a reasonably high success rate, however, the repeat caesarean birth rate has increased to 83% in Australia (Knight et al., 2013). It is essential to inform women of the contraindications, success criteria, risks, benefits, information on uterine rupture and the role of the midwife in relation to considering attempting a VBAC (Hayman, 2014). This information forms the basis of an antenatal class (Appendix 1) that provides the necessary information to women who are considering attempting a VBAC and can therefore enable them to make their own decision regarding the mode of birth.

Key Historical, Key political and Key socio-cultural influence that have shaped healthcare access in contemporary Australian society.

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.,

I believe as a Midwifery Student at Australian Catholic University (ACU) that childbirth is a natural life process. Within my philosophy, my aim is to provide a women-centred care based on evidence- based practice. Also the importance of supporting women with cultural variation, social circumstance and understanding other specific needs throughout the woman’s pregnancy. The women-centred care is an essential quality to a midwife as it ensure that the women is educated in healthy lifestyle choices within pregnancy, childbirth and during parenthood. This relationship of “women-centred care” is the key to midwifery practices as Australian College of Midwives (2009) refers to the philosophy of maternity care that promotes a holistic approach by recognising each women’s social, emotional, physical, spiritual and cultural needs. In retrospect, it is important to reflect on your past experiences during your midwifery practice but also your life beyond midwifery.

Woman-centred care requires a holistic approach and should encompass all a woman’s expectations from an emotional, physical, spiritual and cultural perspective (Fahy K 2012 & Australian College of Midwives (ACM) 2016). I believe that woman-centred care is of utmost importance in all aspects of midwifery care, and I am sure that many others in the profession would share my opinion. Simple principals of woman-centred care include but are not limited to: collaborative care between health professionals, continuity of care provider, care focused on the woman’s needs and expectations before those of the institution or health professionals and ensures the woman’s autonomy and ability to make informed decisions is supported and respected (Fahy K 2012 & ACM 2016). Unfortunately in some situations, woman-centred care is not always successfully implemented. A common example is when there is an indication for Electronic Fetal Monitoring (EFM), particularly in the intrapartum period

Prenatal care is widely accepted as an important element in improving pregnancy outcome. (Gorrie, McKinney, Murray, 1998). Prenatal care is defined as care of a pregnant woman during the time in the maternity cycle that begins with conception and ends with the onset of labor. A medical, surgical, gynecologic, obstretic, social and family history is taken (Mosby's Medical, Nursing, and Allied Health Dictionary, 1998). It is important for a pregnant woman as well as our society to know that everything that you do has an effect on your baby. Because so many women opt not to receive the benefits of prenatal care, our society sees the ramification, which include a variety of complications primarily