By Helen Baston; Jennifer Hall
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Additional info for Antenatal
The NICE guidance on improving nutrition for pregnant and breastfeeding mothers (NICE Health in pregnancy 2008) highlights the prevalence of malnutrition, particularly in low-income households, with one-ﬁfth of adults having small meals or skipping them altogether. Women with low incomes are eligible for Healthy Start vouchers to enable them to buy fruit and vegetables (Department of Health 2004). A systematic review (Kramer 2000) found that dietary supplementation with both calories and protein resulted in both maternal weight gain and increased birthweight with a subsequent decrease in small for gestational age infants and lower perinatal mortality.
Psychological difﬁculties Signiﬁcance May impact on ability to cope with the stress of pregnancy or undertake parenting role ● Taken folic acid? 4 mg folic acid daily pre-conceptually and during pregnancy in the ﬁrst trimester recommended to reduce the risk of neural tube defects by 75% (MRC Vitamin Study Research Group 1991). ● Thrombosis Signiﬁcance Needs prophylactic anticoagulation therapy during pregnancy and special monitoring Current medical history Women may become pregnant with an underlying medical disorder.
What must the midwife do if she detects an abnormality in Joanna’s pregnancy? How is the midwife keeping up-to-date with changes in antenatal care? Team working Joanna has already been in contact with four people in relation to her pregnancy: the pharmacist who did her pregnancy test, the GP receptionist who made her GP appointment and who referred her to the midwife, the GP and the midwife by letter. Questions that arise from the scenario might include: How can team 33 Midwifery Essentials Antenatal working in primary care be enhanced?