2.1 Explain the role of the midwife in relation to other health professionals.

There are many health professionals that work alongside Midwives. Each professional has their own unique skills that make them needed in this specific area.
Doctors work closely with midwifes to a certain extent. Doctors are normally the first point of contact as they will confirm the pregnancy and will refer their patient to their local hospital where they will meet their midwife. As doctors are medical professional, if a midwife had a patient with a high risk pregnancy, the midwife would need to contact their doctor to have regular check-ups.
A paediatrician are also another type of doctor, they are specialised in caring for babies and children. A midwife may ask for paediatrician assistance if they are concerned about any health issues related to the baby’s growth, development or any diseases that the baby may have.
Midwifes may ask a social worker to help support pregnant women who have issues that are a cause of concern, for example: women suffering from domestic violence, drug abuse, live in poor conditions and young teenage mothers who may need help with housing and benefits. Social workers help give advice and guidance in areas where a midwife is not specialised in.
A midwife may need an obstetrician assistance if her patient is needed to have an emergency caesarean section, has suffered with pre eclampsia and has placenta previa. Obstetrician are also another type of doctor that is speacilised in surgery.They work alongside Gynecologist. If a midwife feels or finds any potential problems with a woman’s pregnancy and delivery, an obstetrician will be on standby if any emergencies arise.
A midwife may call or arrange with an Anaesthetist if an epidural or a caesarean is required. An anaesthetist normally works on the wards. They specialise in given local anaesthesia which is a drug that temporarily blocks pain.
A health visitor maybe required to help mothers with crucial concerns where a midwife cannot assist in. If a midwife feels that her patient is at high risk then the midwife would need to advise a health visitor of the issue that are a concern. These issues could be in regards to the family’s setup, the mother of a new born not having the skills or behaviour to look after their baby. A health visitor will offer help and advice.
Haematologist are specialised in treating conditions which involve the blood. A midwife will have to work very closely with a haematologist if their patient has any blood disorders, for example thalassemia or sickle cell. A haematologist would need to be there to address any blood conditions that are a cause of concern before any complications occur.
If a pregnant woman is under or overweight a midwife may ask for either a nutritionist or dietician to help monitor and support the expected mother with any diet requirements. A nutritionist and dietician may also help the woman if they have special dietary needs or allergies. Both midwife and nutritionist will keep each other updated to make sure the pregnant woman has a healthy diet throughout the pre-pregnancy, pregnancy and the post-childbirth period.
Both pregnant woman and midwife may require having a translator. This could be of a number of reason, for example; if the woman has poor English or does not speak any English at all, a translator would need to be present at all appointments to help translate information or advice. This is so the woman and her family understand everything that the midwife informs her. The translator will also translate to the midwife of any questions, answers or concern that the expected mother and family may have.
In some cases a physio maybe required by the midwife. They will help the pregnant woman with any discomforts that she may have had previously from injuries or even from previous pregnancies. This could be from caesareans, bad posture, and displacement of the hip and also during the woman’s pregnancy. The midwife may ask a physician for the woman to have some physical therapy to help relieve the discomfort, to help the woman have an easier delivery.
If the midwife has any concerns about the baby’s development, they would refer the pregnant woman to go and see a sonographer. A sonographer specialises in checking the baby’s development through a scan. They can detect the baby’s heartbeat; confirm number of foetus in the womb and position of the baby and placenta. They can also detect any abnormalities such as an ectopic pregnancy, spina bifida and the risk of Down’s syndrome.
A counsellor may be needed as not all pregnant woman personal situations are the same. A midwife may ask for the woman’s consent for a counsellor’s support if they feel the patient has any personal issues that need assistance with. This can be through the post-natal period and after delivery which is known as postnatal depression. A counsellor can provide support for pregnant women in many areas e.g. if the woman has had an unplanned or an unwanted pregnancy, suffering from domestic violence, death of a baby from stillbirth, miscarriage and a termination for medical reasons. There are so many reasons why a counsellor might be needed. It’s the midwife's duty to make sure they observe, check and record everything. The pregnant woman’s GP would also be notified and given a copy of the woman’s report.

3.1 Explain factors that the midwife should consider in the care of the pregnant woman through:

* The process of the fetal development and growth Ultrasound scans are used to monitor the foetus growth, development and also to see if there are any abnormalities. The first scan will confirm pregnancy, fetus number, gestational age and to see if there are any abnormalities. At the second ultrasound scan will the fetal’s limbs will be measured, the purpose of this scan is “to reassure the mother that the fetus has no obvious structural abnormalities” (D.M. Fraser second edition 2012 pg. 89)
The third pregnancy scan is to mainly check for abnormalities and to monitor the fetal’s wellbeing, growth and development. * The different stages of ante-natal care
There are several stages of antenatal care that have to be followed up by the midwife. Antenatal care entail 2-4 weekly visits until 28 weeks and then 1-2 weekly until due date. The first antenatal appointment is to allow the midwife and pregnant woman to get to know one another. This appointment is to find out what stage the woman is at in her pregnancy, to find out about family health history to get a general insight of the woman wellbeing. The midwife will also check the woman’s blood pressure and urine. They will also discuss birth plans options. This appointment will also allow the woman to ask question about anything that she is unsure about.
The second stage is for the woman to have an ultrasound scan to check for any fetal abnormalities.
The third stage will be another routine check of the woman’s blood pressure, protein level in the urine. This can also give the chance to make any adjustments to the woman care plans.
The fourth stage of antenatal care will consist of another ultrasound to check the foetus growth and development. The woman’s blood pressure will be taken along with her urine.
The fifth and sixth antenatal appointment will be to have another routine check-up and to discuss screening tests that were taken at the 28wks scan.
The remaining antenatal appointments will be to check the foetus’s position and to continue checking the woman’s wellbeing. The midwife and woman will discuss related issues to make sure the woman’s care plan is updated at each appointment. * The function of the main forms of antenatal testing
Antenatal testing is vital during pregnancy as the midwife will check the woman’s health by examining her to ensure that she is well and healthy. During the antenatal check-ups the midwife will carry out routine checks of the woman’s blood pressure and urinalysis, these will be taken at every visit to compare results throughout the pregnancy. Blood tests will be taken at the initial assessment to see if the woman may have any blood disorders such as sickle cell or thalassemia. The blood test will also show if the woman has hepatitis B, rubella, HIV antibodies, and to confirm blood group. Antenatal testing covers a wide range of health issues that a pregnant woman may have from before and during her pregnancy, examples of these health problems vary from diabetes, haemoglobin, genetic history of spinal bifida and downs syndrome. The woman can also have allergies to certain medication, so it’s important that it is stated in the woman’s notes. * The main ailments and infections in pregnancy and the consequences
There are many illnesses and infections during pregnancy, some of them have more consequences than others. Below is a list of some of the infections that can occur: * UTI (urinary tract infection) * Pre-eclampsia * Diabetes * High/low blood pressure * STI’S * Low iron * Hyperemesis * Obesity * Allergies * Mental health issues(stress, depression)
Some of the above have more consequences. Urinary tract infection is caused by bacteria it can cause bladder infections, infect the kidneys but in the worst scenario the infection can spread to the blood stream which can become life threatening. If the woman’s kidneys become infected mortality is a very high risk for the fetal or newborn.
High blood pressure also known as hypertension can become very severe which can be harmful to both mother and baby. This can lead to pre- eclampsia. Pre- eclampsia can affect the kidneys, liver, brain and blood clotting system, this can become very dangerous and it can affect the oxygen and nutrients that are transferred from mother to baby.
There are so many STI’s diseases that a woman can have from before and during her pregnancy. These can cause major complications such as early labour, uterine infection, premature rupture. Some sexually transmitted diseases can be life threatening to the baby, causing devastating consequences such as still births, eye infections, blood infections known as sepsis, brain damage, low birth weight, blindness and deafness.

4.1 Impact of lifestyle choice on pregnancy
It is very important for the pregnant woman to make sure that she takes care of her health, as everything she does impacts on her baby. Maintaining a healthy diet will help the baby to grow and develop. Certain foods should be avoided such as shellfish, peanuts, under cooked meats, soiled foods, pates, and raw fish, all of these foods can make the pregnant woman become ill and they can also harm the baby. One to two units of alcohol once or twice a week is enough, drinking can cause learning, behavioural disorders and growth restrictions. As when a woman drinks alcohol it passes from mother’s blood through the placenta this can seriously affect the baby’s development. Smoking and taking illegal drugs such as cannabis, cocaine, ecstasy and heroin can put the baby at extreme danger. Everything a mother intakes travel through the placenta to give to the baby, these drugs can reduce the amount of oxygen that needs to reach the baby causing the baby’s growth and development to be at risk. Cocaine and the highly addictive drugs can cause life threatening consequences. It’s very important that any woman who feels that their lifestyle is a cause of concern should go and see their doctor to get some support and advise, as not living a healthy lifestyle can cause major damage to both mother and baby.