Marianne’s Antenatal Care
Introduction
In healthcare, reflection entails adjusting and enhancing life as a healthcare professional. According to the Nursing and Midwifery Council (NMC), midwives are expected to utilise feedback from patients or other practice areas as a learning and reflection opportunity to improve practice (Nicol and Dosser 2016, 34). Reflection allows midwives to access their patients’ records and make decisions that will affect their current and future well-being. Additionally, according to the NMC revalidation process, practitioners need to provide examples of how they used to achieve their reflective goals to ensure practitioners understand reflection, necessary skills, and the approaches for carrying a successful reflection.
According to NMC standards for midwives’ proficiency, reflection is ideal because it nurtures accountability and autonomous professional midwife. It promotes and provides continuity of health care services (Fenech 2016, 310). The reflective analysis utilises Professor Gary Rofle’s reflective framework. The reason is its subsections of what, so what, and know what makes the reflection report simple and clear to comprehend (Skinner and Mitchell 2016, 12). To ensure confidentiality, reflective analysis will constitute pseudonyms.
What Exactly Happened?
Maternity care constitutes all episodes from pregnancy, delivery, post-delivery, and new-born care. In Marianne’s reflective analysis, the best care episode for the midwife Leah to evaluate is antenatal care as the patient is eight weeks pregnant. Antenatal care or prenatal care is a preventive quality care healthcare process, which involves various routine elements such as screening to diagnose ailments or potential obstetric conditions that lack symptoms (World Health Organization 2016, 19). According to the analysis through the obtained detailed medical history, the antenatal care element she underwent was blood screening in Marianne’s case. Blood screening is essential as it will pick up possible complications such as anaemia, which Marianne was a victim of in her previous two pregnancies, and allow for the problem to be treated accordingly, ensuring the safety of Marianne and her child. It compares blood tests for haemoglobin, sexually transmitted diseases, blood group determination, and rubella immunity (Waller et al., 2016,191). Moreover, knowledge of the blood groups is necessary for instances whereby blood transfusion may be required. A comprehension of the haemoglobin levels is critical because it illustrates the body’s iron levels, which produce the haemoglobin that transports oxygen. Determining the possible presence of sexually transmitted diseases will ensure the appropriate preventions are taken so that the child does not get infected. Blood screening will identify rubella immunity because rubella, also known as German measles, is a dangerous ailment that can result in blindness or deafness in an infected unborn baby (World Health Organization 2016, 20). Therefore, the midwife chose to analyse antennal care, particularly blood screening tests, to identify essential aspects such as haemoglobin levels, blood group, sexually transmitted diseases, and rubella immunity.
Like any other healthcare practice, antennal care, especially blood screening, is encompassed by several communications issues. In most instances, pregnant mothers rarely discuss with others the process (Doughtery, Stammer, and Valient 2018, n.p). Hence various communication issues occurred around the blood screening antenatal care element; these included a proper explanation of the blood screening need, entailing every element that continues the medical process, such as the number of tests, and if there is a need for routine testing. The patient raised concerns about the procedure such as why blood screening was necessary, the healthcare professional she will be continually seeing during the process, what exactly will be happening during the blood screening process, the number of appointments she will need, whether her partner is required to be present during the process, and if he also is to be tested. As the midwife and the primary healthcare professional in charge of the antenatal care, Leah utilised effective communication skills to ensure Marianne’s concerns were answered and that she had detailed information about the blooding screening procedure as it is her medical right. Leah used verbal communication, which ensured she obtained detailed information of Marianne’s medical, obstetric, and family history before suggesting the need for blood screening. Additionally, Leah accurately and with adequate details discussed with Marianne the various antenatal tests, and she ensured to let the patient understand that the blood screening was to be done only after her approval. Leah also incorporated non-verbal communication skills when she offered Marianne a medical booklet to supplement the information she had verbally provided.
The care episode illustrates the patient’s feelings of concern for her health and her child’s. Also, it shows that Marianne felt uneasy about doing random medical tests without adequate information from the healthcare professional. She is worried about recommendations such as iron supplements that resulted in severe constipation in her prior pregnancies. Testing of blood samples requires effective and efficient precaution measures to be undertaken; in the blood screening procedure, various care was observed, including the lab equipment used were up to date, the midwife ensured she put on protective gear like wearing gloves and a lab coat. Besides, because testing of blood is a task requiring extra caution, more care was provided like a proper sampling of the samples to ensure no mix-up with other patients’ blood, using of properly sanitised collective tools, a new injection, and proper discarding of medical equipment like the injection after use (Brunnstorm et al., 2020, 7). Pregnancy results in phenomenal psychological changes like hormonal and metabolic changes; thus, all antenatal care producers like blood screening are integral. In the study, blood screening impacted both Marianne and her unborn child as it leads to the identification of blood groups, which is crucial during delivery in instances of a need for blood transfusion. Besides, it identified Marianne’s rubella immunity status to ensure the accurate steps are taken if it is low, saving Marianne’s child from potential danger (Alkhatib 2018, 282). Moreover, a potentiality of sexually transmitted diseases was identified, which is critical in ensuring the unborn baby does not get infected during feeding or not at birth; knowledge of the haemoglobin levels through assessing the level of iron in the body was necessary because Marianne and her child require ample oxygen for a normal, healthy living, and if the oxygen levels are low, it puts the child and mother at high risks. The blood screening antenatal process resulted in various elements like Marianne exhibiting several emotions such as worry, care when handling blood tests like sanitising the required medical equipment, using a new injection, the midwife wearing the appropriate gear, and using the latest types of testing equipment. The blood screening procedure also impacted Marianne and her unborn baby. It ensures necessary tests were carried out, like identifying blood groups that provide the required information during emergencies like a blood transfusion.
So What?
Communication is a fundamental aspect of antenatal care practice. One of the elements that influence effective communication is the environment; aspects of the environment like temperature have to be conducive to offer the pregnant woman comfortability so that she can listen with ease. The midwife must also choose an effective mode such as a mixed approach of verbal and non-verbal communication skills to ensure the patient obtains the information accurately and clearly to make her antenatal care experience comfortable (Baston and Hall 2017, 10). The midwife must ensure to maintain direct eye contact and illustrate appropriate body posture as body language ensures effective communication. Moreover, the midwife can apply documented communication techniques like using simple language that the patient can easily comprehend, appropriate tone, and keenly listen to the patients’ questions to answer them accordingly (Baston and hall 2017, 11). Communication between the midwife and the expectant woman must be effective as it influences the childbearing experience; if the communication between the two is bad, then the appropriate antenatal care procedures cannot be followed that ensure the mother is comfortable during her pregnancy. Besides, the mother will not be able to communicate with the midwife in instances where she feels worrying symptoms, and it can lead to a worse medical condition.
Furthermore, as the midwife plans to suggest any antenatal care element to the expectant mother, she must provide the patient with adequate information so that it is under an informed choice if the patients decide to go ahead with the service. Communication can be barred by various elements like language barriers and distractions. Individualised care refers to a healthcare practice where the patient is at the centre, as the healthcare professional meets all the physical, social, and psychological needs (Younger, Hollins-Martin, and Choucri 2015, 266). The midwife illustrates individualised care as she puts Marianne’s psychological needs to be the primary focus of her antenatal care element. World Health Organization (2016, 19) shows the need for blood screening in antenatal care, thus proving the midwife’s option was accurate. If Marianne got to deal with a known caregiver, it would help effective communication because they have a prior relationship.
Now What?
In the study, Marianne obtained the necessary antenatal care that was centered on her psychological needs, as the communication with the midwife was done accordingly. Leah, the midwife, showed her support for Marianne by ensuring effective communication between the two, which helped Leah formulate the ideal antenatal care element that will ensure Marianne has a comfortable childbearing experience with minimal to no health complications. The case study teaches various integral aspects of quality healthcare services, such as the need for an effective communication strategy between the healthcare provider and the patient. It also teaches the appropriate way a medical professional should act, which is putting the needs of the patient before anything, and the significance of the patient making an informed choice. These lessons, such as effective communication skills, can be implemented in any healthcare practice to ensure accurate information collected from the patients, ensuring quality healthcare service. Nonetheless, to ensure adequate antenatal care in the future, the midwife needs to include the father, particularly when doing blood screening to determine blood groups and sexually transmitted disease. It will help ensure the child is safe from any potential health complications (Forbes et al., 2018, 145). Moreover, the midwife should continually pay attention to barriers of effective communication like differences in class with the patient, cultural and religious diversity to ensure she maintains competence in her services (Škodová 2016, 506). Therefore, the study teaches various integral healthcare aspects like effective communication that is critical in any healthcare implementation to ensure high service quality.
Conclusion
The reflective analysis looks into Marianne’s case study, who is eight weeks pregnant, and her midwife, Leah. Using Rofle’s reflective model, the analysis commences with looking at what exactly happened, which constitutes antenatal care, and the element of blood screening. Under the so what section, the reflective evaluation researches on effective communication, which aspects affect it, and the barriers. In now what category, the analysis incorporates all the lessons learnt and offers several improvement techniques.
