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

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Ending the midwifery-woman partnership

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