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MID524 Challenges In Midwifery Practice 4 :Ivy is a 22 year old multigravida, G3P1

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MID524 Challenges In Midwifery Practice 4 :Ivy is a 22 year old multigravida, G3P1

Ivy is a 22 year old multigravida, G3P1, whose pregnancy was confirmed at 8 weeks gestation. Ivy is one of the women in your Continuity of Care Experience. At her 12 week routine antenatal check Ivy is identified as being in the overweight range with a BMI of 29. Ivy is married to Tony and lives in a small rural town with a population of 1500 and limited medical services.  It is a town based on agriculture predominately cropping of wheat, canola and with livestock making up the mixed farming approaches. 

Their daughter Susie is 3 years old. Susie was born at 37 weeks weighing 3450 grams via a caesarean section for failure to progress after approx 15 hours of labour. Ivy breastfed Susie for 14 months. 

Ivy had a stillborn death at 23 weeks gestation 15 months ago. Ivy started putting on weight after the stillbirth and postnatal depression was diagnosed at a postpartum check up with her GP, and was prescribed Sertraline (Lustral) as well as referral to a grief counsellor. Ivy remains on Sertraline. Ivy is interested in finding out about some complementary and alternate therapies to assist with her pregnancy. 

Tony is a business owner and owns the local CRT branch (Agricultural supplier) and Ivy helps in the business. Tony is a smoker, stating he smokes approx. 1-1.5 packet per day. Ivy states she is a non- smoker and that Tony never smokes in the house or near Susie, he goes outside. They both state they have a few drinks, upon further questioning Ivy states she has one glass of wine 3-4 times per week and a few more if they are socialising. They are both anxious about this pregnancy after the previous stillbirth. Ivy’s parents live on large properties outside town and her sister lives in the same town. Tony’s parents live on a large property outside the town and his 2 brothers live in a regional city 75km away.

You are to examine, explain and evaluate the implications for midwifery care in the case study in relation to the following:

  • Describe the midwifery care and services you would provide and utilise to support Ivy and Tony in relation to the environmental and occupational risk factors affecting their pregnancy and postpartum period  (LO2);        
  • Evaluate maternal nutrition, diet and BMI during pregnancy, identify risk factors and identify relevant local and national referral support services and programs (LO1, LO2);
  • Identify and interpret risk factors of smoking and alcohol consumption during pregnancy including outlining how you would support abstinence/decreasing tobacco and alcohol intake with Ivy and identification of support services and programs available (LO1);
  • Summarise how to assess, plan, provide and evaluate safe and effective midwifery care for the newborn with complex needs related to the possible effects of smoking, an overweight mother and include discussion on infant feeding options (LO1, LO6, LO8).

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