The following assignment will examine the role of the midwife within antenatal care. Firstly, looking at the changes that may affect pregnancy which could then impact on the midwives role, for example, conditions such as breech or gestational diabetes. To then continue to discuss the process of risk assessment and the importance of protecting pregnant women.
Next, the impact of the midwife meeting the needs of the pregnant woman and her family: physically, socially and psychologically will be discussed.
Moving onto exploring the role of the Nursing and Midwifery Council with regards to the midwives role, and then to analyse The Code with regards to antenatal care.
Finally, to discuss the role of the supervisor of midwives in supporting maternity services, examing the changes throughout time and the reasons behind these changes. With the role recently being removed from regulation, the supervisor role still has a part to play in supporting midwives in carrying out their duties of care this is to be discussed.
Pregnancy occurs over three periods, known as trimesters. The first trimester sees both the baby (foetus) and mother go through rapid changes. For the foetus, this period is when it is most vulnerable yet sees all the major organs and systems develop, fully formed at the end of this trimester. For the mother, the changes which can occur to name a few are; the breasts enlarge, becoming tender and veins more prominent, an increase in hormones potentially cause mood swings, irritability and morning sickness (Summa Health, 2018).
The attendance of the first midwife appointment (booking appointment), ideally takes place by week 10 of pregnancy in the first trimester. At this appointment the midwife will ask questions to assess the needs of the expecting mother; discussing physical and mental health, health issues within the family, whether family support is available and also whether any substances are consumed such as drugs, smoking or alcohol. This appointment also sees tests take place for the monitoring of both the mother and baby, blood is taken to measure whether HIV, syphilis or hepatitis B are present as these pose a risk to the baby. Further discussion may take place to determine whether there is a need for another blood test to see if blood disorders sickle cell or thalassaemia are present. The height, weight and BMI of the mother will be measured as will their blood pressure and urine, for any signs of pre-eclampsia. The midwife will discuss and pass on information with regards to; nutrition and diet (as there are certain foods to be avoided) and the recommendation of vitamins folic acid and vitamin D, the development of the baby throughout the pregnancy, the tests and scans to be offered during pregnancy, exercise and pelvic floor exercises, breastfeeding and information on antenatal classes. The appointments with the midwife are the opportunities to discuss any worries or concerns, issues which could affect the pregnancy: domestic violence, abuse or female genital mutation (FGM), the midwife is there to provide guidance, advice and support. By the end of the first appointment, the midwife will have created a handheld book of notes, necessary for the recording appointments, test results and health. The pregnant woman is to carry around this book with her at all times should urgent care be needed at any point during pregnancy (NHS, 2018).
From the moment the woman discovers she is pregnant, from the first booking appointment through to the day the baby is born plus a few weeks beyond, the midwife is there to support the woman. A wide range of information and support from nutrition, antenatal classes, child care and preparing for the birth itself, is covered by the midwife. Meeting the physical needs of the woman, the midwife will discuss nutrition advice, recommendations for exercise and discuss the importance of rest and sleep. Physically the pregnant woman may experience symptoms such as heartburn, constipation and morning sickness and the midwife can provide advice for such conditions, for example, the suggestion of the use of Gavison for heartburn as is this safe during pregnancy.