Ending the midwifery-woman partnership

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This is a very brief overview of some of the things a midwife has to consider when discharging a mother and baby from her care in the post natal period

This is a very brief overview of some of the things a midwife has to consider when discharging a mother and baby from her care in the post natal period

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  • 1. Ending the partnership http://www.flickr.com/photos/reverb/2111203297
  • 2. Physical examination
    • Breasts - ensure adequate lactation; talk about breast exam.
    • Abdominal scar (if woman has one) - healed
    • Fundus - involuted
    • Lochia - minimal
    • Perineum - healed; refer if woman is having painful sexual intercourse
    • Bladder/bowels – returned to normal pattern
    • BP - normalised
    • Evidence of post natal depression – lack of sleep, poor appetite, unsettled or depressed state of mind
  • 3.
    • 6 week baby check
    • Head to toe
    • Heart and lungs
    • Length and head circumference
    • Hip check
    • Feeding
    http://www.flickr.com/photos/spamily/296925400/
  • 4. Associated information
    • Cervical smear at 3 months if required
    • Sexual intercourse – recommence when comfortable
    • Contraception
    • ?Rubella immunisation if not immune
    • ?Physical check with general practitioner – some mothers may prefer midwife to do it, as opposed to GP
    • ?Referral to other health providers eg mental health, child health nurse
  • 5. Information given to woman
    • Child health nurse and clinics
    • Immunisation
    • Post natal support groups
    • Financial help
    http://www.flickr.com/photos/spudnik06/208131052/in/photostream/
  • 6. Ending the partnership
    • Make sure woman is warned of your last visit
    • Will you be continuing a relationship?
    • Debrief about labour and birth
    • How will you evaluate your care and get the woman’s feedback?
    • Make sure the woman has a copy of her notes
    • Pass on discharge information to GP/child health nurse
    • How do you bring the partnership to end?
  • 7. http://www.flickr.com/photos/eyeliam/3097749651/