Saturday, March 30, 2019

A Midwifery Community Profile Health And Social Care Essay

A tocology community Profile wellness And Social Cargon EssayThis company profile is based on an atomic number 18a in the outskirts of Glasgow and the objective is to identify the current provisions of gestation extent c be and new(prenominal) wellness c atomic number 18 service, which cater for the claim of the local commonwealth in the physical, emotional, intellectual and social needs for groups in the lodge, addition comp exclusivelyowelyy, commenting on any deficits in care. health promotions abide been identified as resources that pull up stakes enhance the health of this specific communitys health and are included in the profile. Also, the agency and contri exclusivelyion of the accoucheusery services is explored, a vast with a nonher(prenominal) primeval healthcare providers and how they use team puzzle out to de screwr healthcare to the community. Professional and ethical issues abide been discussed by dint ofout the profile and as all aspects of hea lth are unrelated and interdependent, (Ewles Simnett, 1992 Ch1 p7), a holistic and professional view has been taken to evaluate the needs, and health services of this community.The RCM believes that truly muliebrity-centered care must encompass midwifery-led care of convention maternal(p) quality, ancestry and the postnatal period and services that are planned and de sufferred stringent to women and the communities in which they live or work, (NHS Evidence, 2008). This statement shows the importance of a community midwife, as their role is to not only provide the clinical skills, but oerly be accessible for support and advice at the snip of very much adjustment for a woman. If the midwife can be act a incision of the womans community, getting to know the woman and her family to a greater extent personally, learning to understand their lives and the reputation of the life around them, she will be able to be more responsive and ground to them as individuals, and move away from the depersonalization of the institution. individualist societies each ware their own specific needs and characteristics, and it is vital for a midwife to know her area well in pasture to react appropriately, along with poverty levels and racial mixes (Fraser and Cooper 2009, p. 43). Community-based care can be in the home or in community hospitals and centers, but is a process that emphasizes consultation, collaboration, and referral to the professionals who are close to appropriately prepared to meet the womens needs (Walsh, 2001). It is likewise vital that women are educated and women should be effrontery appropriate, accu ordinate and unbiased in categoryation based on research that would appropriate and encourage them to make informed choices in relation to their care (Baston Green, 2002). Women from distinct backgrounds, and areas can often arrest very contrasting education levels and as a midwife, it is essential to know your neighborhood well in order to tak e these into con human faceration when communicating with a woman.The area chosen for this community profile is in the south west of Glasgow, which will now be referred to as area X, with a population of 10,024 (RDC Registrar Generals Census, 2001).Table 1 Age Distribution firmament XIndicator issuing piecePopulation aged 0-152,40023.9%Population ages 16-646,46364.5%Population aged 65+116111.6%The absolute majority of the population is in the age range 16-64 years and the relevant health care services in the community for this group are the prenatal clinics, family planning and screening clinics.Graph 1 Hospital admissions for heart disorder field of view XWith measure to the social and economical characteristics of the area, this graph shows the meretriciousness of practised deal admitted to hospital for heart disease in knowledge base X. softheartedness disease is more high-fidelityly described now as a disease of social and economical disadvantage and poverty (Blac kburn, 1991Ch2 p36) and the major risk of exposure factors contributing to heart disease are sess and diet. These lifestyle factors also may echo a life associated with starting timeer social course of study (Bond Bond, 1994 Ch 4 p 70).Nearly half of the houses in bailiwick X are owner occupied, and that amount can be split into dickens ex-council houses and private living accommodations estates. The other half are tenanted homes, rental either from the council or private renting. Almost a quarter of all homes in the area suffer from overcrowding. These statistics mention there are some occupants of tenement flats and these tend to be low-income families who have little or no choice about the type or standard of accommodation they live in (Blackburn, 1991). Higher income groups tend to live in the private lodgment sector, and have choices in the location and type of heating which are chief(prenominal) influences affecting the health of families (Lowry, 1991).Table 2 Hous ing Area XIndicatorNumberPercentageOwner Occupiers1,85141.1%Overcrowding1,00022.2%(RDC Registrar Generals Census, 2001).Glasgow is home to the most workless households in the UK, according to the Office for National Statistics, (ONS). Figures measured in 2007 indicate 29% of households in the Glasgow City council area had members of working age who were laid-off (BBC, 2009). Area X also has a high percentage of mess unemployed according to Scotlands Census from 2001, with both those who are unemployed and claiming and those who are economically inactive. Long-term unemployment can be a self-perpetuating cycle that leads to low morale and poor health (NHS Greater Glasgow, 2005). Other effects of unemployment are the increased rates of depression, particularly in the young-who form most of the group who have never worked (BMJ, 2009). It is obvious from this that unemployment can alter both our psychic and physical state, and in Area X almost 40% of the population of children live in a workless household, which would also have an influence on these childrens quality of life.Table 3 Unemployment Area XIndicatorNumberPercentageUnemployed Claimants3605.8%Economically inactive3,12843.6%Children in workless households1.01038.9%(RDC Registrar Generals Census, 2001).The role and contribution of midwifery services in Area X are vital in supporting vaginal birth women and their families, through a holistic approach. It is very in-chief(postnominal) that midwives had a good understanding of social, cultural and scene differences so that they can respond to the womens needs in a bod of care settings This is attained by an integrated midwifery service be part of an expert multidisciplinary team, allowing midwives to draw on other organizations to meet the holistic needs of individual women and providing a complete range of services. (Fraser Cooper 2009, p. 7).Midwives in Area X use the local hospital, and local health centers for antepartum and postnatal clinics, as well as parentcraft classes, working along side hospital doctors and GPs. The GP normally confirms the gestation and thereafter, an appointment is given to the woman to be introduced to the community midwife for a Booking blab, as these midwives often better understand social situations through working in the area. The women are generally referred, by the GP, to either the local hospital or a nearby health clinic to meet one of the midwives who work in Area X. These midwives work in teams of around 5, covering 2 or 3 certain postcodes in Glasgow each, and each team named after a emblazon to make it simple for women and their families to understand which group of community midwives they will be receiving care from, e.g. The Blue Team. This system also works well as it allows a certain degree of continuity as each woman will only be seen by the community midwives in her allocated team. persistency of carer and care has been a key policy principle since the early 1990s. interr ogation turn out demonstrates that women value continuity of carer in the antenatal and postnatal period (Waldenstrom Turnbull 1998, Homer et al 2000, Page 2009). Working in Area X requires a high level of continuity in care as it has a lower social class and inhabits problems related to gestation such as 49.9% of the population of Area X are smokers. Other statistics for Area X include 38.6% of women take during pregnancy, a total of 160 women over a 3 year total.It is well known by midwives and obstetricians that smoking in pregnancy is associated with well recognized health problems and as midwives usually have the most professional contact with pregnant women, they have an important role in providing this advice and support (Buckley, 2000). Glasgow has a very well-organised network of smoke-free pharmacy services who provide NRT for smoking cessation services. They monitor light speed monoxide levels on a weekly basis and only dispense NRT if the breathing room test i s negative (Mcgowan et al, 2008). Smoking cessation services are provided for Area X by specialist midwives, allowing continuity during pregnancy. These midwives speak to the woman and let them know what is available, without pushing them into quitting, and find out what their thoughts and feelings are, focusing on how good it is when women want to stop smoking. The chief executive of ASH Scotland, Sheila Duffy, stated in 2010 life expectancy, health problems, smoking rates, and deaths from smoking are all markedly different between Scotlands richest and poorest communities. Research in Scotland has found that smoking is a greater source of health inequality than social class. This shows clearly that deprive areas such as Area X are at the greatest risk of being affected by smoking issues. 43% of adults who live in deprive areas smoke, compared with 9% in the least take areas and this is shown in the prevalence of tobacco related diseases and deaths. 32% of deaths in Scotlands mo st deprive areas are due to smoking compared to 15% in the most soaked (Duffy, 2010). This is also reflected in the rates of newborn deaths as the death rate for newborn babies is more than twice as high in deprived towns compared with affluent areas and the high rate of deaths in poor areas was strikinged to wrong delivery or birth defects (BBC, 2010). This leads on to why so many a(prenominal) pregnant women smoke in deprived areas, such as Area X. Smokers typically report that cigarettes calm them down when they are stressed and financial aid them to concentrate and work more effectively (Jarvis, 2004), and this prospect could be exceedingly desirable to those suffering from stress and anxiety due to financial problems and other socio-economic factors such as low employment, high crime rates, poor housing and poor health care.Graph 2 Nicotine intake and social deprivation. selective information from health survey for England (1993, 1994, 1996)As reported in the recent toc ology Practice Audit 1996-1997 (END, 1997), midwives are the lead professionals in providing care for childbearing women. However, midwives need to acknowledge that other health-care professionals also contribute to each womans experience. Midwives work together with other professionals within the primary health-care team, providing integrated approaches to care delivery. Midwives have to use their own skills and expertise with the knowledge of how to access the expertise of other practitioners when required, allowing the women to receive holistic care (Houston S M, 1998). In the recent plan of work Midwifery 2020, a statement was made that women should be cared for in a multi-agency and multi-professional environment and NHS providers should have a collaborative working race with all other agencies based on mutual trust and respect to ensure that women and families receive optimum support. They should also ensure clear understanding of roles and facilitate effective communication between professionals and other agencies (Midwifery 2020, 2010). The first conflict visit for antenatal care is important and a successful visit lays the foundation for building that special relationship between mother and the midwifery services on which so much depends (Cronk Flint, 1989ch2 p9). The visit enables the midwife to urinate any physical, mental or social needs that will form the basis of the womans plan of care. In area X, the booking visit also allows midwives to inform the woman about the healthy give-up the ghost programme. wellnessy Start is the Department of Health Welfare Food Scheme that helps pregnant women and suitable families, with children under 5, buy milk, fresh fruit and vegetables, infant feeding rule milk, and receive free vitamin supplements (NHSGCC, 2010). This is a clear example of how health services have integrated to allow women all the benefits they are entitled to, assist them achieve the best possible experience throughout their pregna ncy.As the pregnancy progresses, parentcraft education classes are offered to prepare women for the birth experience (Jamieson, 1993) and raise sensation to the advantages of breastfeeding, giving support to mothers who choose to breastfeed. Area X presents midwives with many juvenile pregnancies and antenatal services should be flexible enough to meet the needs of all women, bearing in mind the needs of those from the most disadvantaged, compromising and less articulate groups in society are of equal if not more importance (Lewis, 2001). As Area X is a deprived area, this contributes greatly to the teenage pregnancy statistics and throughout the developed world, teenage pregnancy is more common among young people who have been disadvantaged in childhood and have poor expectations of education or the job market. Teenagers see to be more likely to have sexual intercourse if they come from the lower social classes or unhappy home backgrounds. Another definition may be that many y oung people lack accurate knowledge about contraception, STIs, what to expect in relationships and what it will mean to be a parent (Allen, 2002). in that respect are also serious psychological concerns related to teenage pregnancy, which the midwives in Area X must manner of speaking while working with these girls. The teenage years are a time of much change and difficulty without the added stress and anxiety of a pregnancy, birth and finally motherhood. It is a midwifes duty to give the necessary advice and proper holistic care, hopefully improving the service provision and having a good obstetric outcome. Comprehensive holistic antenatal care programmes specifically for pregnant teenagers have been found to be effective in reducing poor maternal outcomes (Fullerton, 1997). For teenage pregnancies in Area X, there is a specific midwife who will be contacted at the booking visit and will be a support network for girls 18 and under, available at all times for advice, encouraging c ontinuity and individualized, specific care for young mums.To conclude, through writing this community profile on Area X, I have discovered how difficult it is to work as a midwife in the community, especially in a deprived area such as Area X. From reading a large variety of articles on the psychological and social effects of poverty on pregnancy, there is much evidence that poverty has a significant effect on midwifery practice, and these women need the best care plan possible to ensure a compulsive experience. By having an awareness of the restrictions poverty can inflict on pregnancy and childbirth, the midwife can adapt her skills and provide care accordingly, keeping in mind aspects such as smoking during pregnancy and teenage pregnancies (Salmon et al, 1998). There is a reoccurring trend throughout this community profile confirming the link between lower socio-economic status and adverse pregnancy outcomes, such as prematurity, and the midwife is ideally placed to help ident ify and manage stresses, as it has been a very important consequence for the health and wellbeing of both mother and infant (Alderdice Lynn, 2009). Working in Area X on clinical placement has given me an insight into the importance of individualized care, as every woman is in a different situation and consequently has different needs, socially and psychologically. Some women may need more specialize care and support than others, however they are all of equal importance. probe the role of the midwifery service in Glasgow has opened my eyes to how both the midwives and the primary health care team deals with problems, and how without integrating health services, it would not be possible to give women the best possible care. Only by working as an integrated team with users will health inequalities be reduced, social exclusion be limited and public health render relevant and cost-effective (Henderson, 2002). The importance of involving women in decisions about their care has long b een part of the everyday practice of midwives (Proctor, 1998), and the importance of communication has been highlighted to me clearly throughout this community study, and through my placement, forcing me to realize how important it is for a midwife to process her role.ReferencesNHS Health Scotland (2004) Greater Shawlands a community health and well-being profile Online on tap(predicate) at http// Accessed 16 declination 2010NHS Greater Glasgow, southwestern East Glasgow Community Health and Care Partnership (2006) Health proceeds Plan 2006-07 Draft Online in stock(predicate) at http// Accessed 20 December 2010NHS Evidence National Library of Guidelines (2008) Women centered care (position statement) Online unattached at http// Accessed 2 January 2011Griff in K, Maternity, Gateshead Health NHS (2009) Pregnancy Weight Matters Online for sale at http// Accessed 2 January 2011Fraser D M Cooper M A eds (2009) Myles Textbook for Midwives 15th ed. Churchill Livingstone, capital of the United KingdomNursing Midwifery Council (2008) The code in full Online usable at http// Accessed 2 January 2011Walsh L V (2001) Midwifery Community-Based Care During the Childbearing Year Saunders, USABaston H A Green J M (2002) Community Midwives role perceptions British journal of Midwifery, Vol 10, No1Community Councils Glasgow, Arden, Carnwadric, Kennishead Old Darnley (2008) Local history and Geography Online Available at http// Accessed 3 January 2011Bond J Bond S (1994) Soc iology and Health Care (2nd ed), Ch 4, p 70, Churchill Livingstone, EdinburghCronk M Flint C (1989) Community Midwifery A Practical Guide, Ch2, p 9, Heinemann Nursing, OxfordEwles L Simnett I (1992) Promoting Health A Practical Guide, (2nd ed), Scutari Press, MiddlesexFuller G, Award Finalist NHS Greater Glasgow (2005) Complementary medicament Online Available at http// Accessed 2 January 2011BBC News Scotland (2009) Glasgow has the worst UK unemployment Online Available at http// Accessed 3 January 2011Lowry S (1991) Housing and Health, British Medical Journal, LondonBlackburn C (1991) Poverty and Health, Ch 2, pp32-36, Open University Press, BuckinghamDorling D, BMJ (2009) Unemployment and Health Online Available at http// Accessed 3 January 2011Houston S M (1999) Multi-professional education programmes in midwifery Britis h Journal of Midwifery, Vol 7 No 1, p 32NHS Scotland, Midwifery 2020 (2010) Core role of the Midwife Workstream Online Available at http// Accessed 4 January 2011Homer, C et al. (2000) What do women feel about community based antenatalcare? Australian and New Zealand Journal of Public Health, 24, pp. 590-595.Buckley E R (2000) Helping pregnant women stop smoking British Journal of Midwifery, Vol 8 No 10, pp. 101-103Mcgowan A, Hamilton S, Barnett D, Nsofor M, Proudfoot J Tappin J M (2008) Breathe The stop smoking service for pregnant women in Glasgow Midwifery 26, e1-e31, Elsevier, GlasgowASH Scotland, Duffy S (2010) Deaths from smoking in deprived areas double that of affluent Online Available at http// Accessed 4 January 2011BBC News Health (2010) Newborn deaths higher in deprived areas Online Available at http// 11899900 Accessed 4 January 2011Jarvis M J (2004) Why people smoke British Medical Journal, Vol 328 No 7434Lewis, G (ed) (2001) Why Mothers overtake 1997- 1999 the fifth report of the confidential enquiries into maternal deaths in the United Kingdom. London RCOD PressFullerton D (1997) Preventing and reducing the adverse effects of teenage pregnancy. Health Visit 70(5) 197-9Allen E J (2002) Aims and associations of reducing teenage pregnancy British Journal of Midwfery, Vol 11 No 6, pp.366-367Salmon D Powell J (1998) care for women in poverty a critical review British Journal of Midwifery, Vol 6 No 2, pp. 108-111Alderdice F Lynn F (2009) Stress in pregnancy identifying and supporting women British Joural of Midwifery, Vol 17 No9, p 553Proctor S (1998) Womens reactions to their experience of maternity care British Journal of Midwifery, Vol 7 No 8, p 492Henderson C (2002) The public health role of a midwife British Journal of Midwifery, Vol 10 No 5, p 268

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