This article will give attention to smoking and diet in relation to health advertising within the midwifery job. Smoking and diet are two main regions of health promotion, that are addressed within the role of the midwife. Smoking and types of diet are both options which women choose to make, both of which can affect their own health insurance and the fitness of the youngster. Smoking is known to have unwanted effects on pregnancy. There have been many recent general population health promotions which encourage smoking cessation; the reason why for this will be reviewed in relation to maternal and fetal heatlh. Diet is an extensive topic and an poor diet can affect pregnancy in a variety of ways. The subtopics of vitamin deficiencies and weight problems will be reviewed as they are both highly relevant to today's populace of women within the UK.
It is a midwives role to promote a healthy diet and lifestyle; as set out from the Royal University of Midwives, and the Medical and Midwifery council, whom provide guidelines, regulations and standards which midwives must adhere to when practicing. Proof based suggestions are also set out by the National Institute for Clinical Brilliance, Centre for Maternal and Child Enquiries and the Royal College or university of Obstetricians and Gynaecologists to increase the manner in which midwives practice. Both guidelines and guidelines try to provide training which enable midwives to market a healthy diet and lifestyle to optimise the fitness of the girl and her growing fetus prior to and during pregnancy.
Being healthy means different things to different people. There are various explanations of health. The medical model, now common in the 20th century, defines health as being the absence of disease and presence of an good physical function. However, this description does not consider public or mental factors and targets treatment somewhat than prevention which may be considered as reductionist and negative (Scriven 2010). Whereas a all natural definition, from the World Health Organisation (1948), states that health is 'a state of complete physical, mental and interpersonal well-being rather than merely the absence of disease or infirmity'. Even though the alternative model may be praised for acknowledging that mental and sociable factors effect health, WHO's description has been greatly criticised for being too idealistic and would consider many people detrimental (Scriven 2010). In relation to midwifery it's important to market health, as a 'healthy' lifestyle prior to and during being pregnant improves the chances of a successful motherhood.
It is a midwives' role to market health and wellness of women and their infants (NMC, 2008). Health campaign, as described by Scriven (2010), is said to be 'improving, advancing, supporting, encouraging and inserting health higher on personal and open public agenda's'. Midwives use health promotion models and methods to enable the value to be produced clear; allowing all associates to work at the same goal. As a result, effective communication between midwives is more likely, and therefore the quality of health campaign given to women is improved (Bowden 2006). Commonly, Tannahill's style of health promotion, produced by Downie et al (1996), lends itself well to midwifery practice. The model mainly targets health education, health coverage and stopping ill-health. These three main issues overlap; where health promoting activities may fall season. Child vaccination programs applied by the NHS can be an example of health protection overlapping with ill-health avoidance that occurs in practice (Bowden 2006). This example emphasises the positive feature of the model; having the ability to carry out both aims of improving health insurance and avoiding disease (Sykes 2007). The educational approach is often used within this model whereby the midwife gives facts and information to the women who will then choose to act on the information given, or not (Bowden 2006). Similarly, the behavior change approach is commonly found in midwifery when motivating women to change her behaviour or beliefs to look at a wholesome lifestyle (Bowden 2006). There are lots of health promotions methods and models. However, no specific model is pertinent to every female. Each female will have individual needs and for that reason requires an individual assessment in relation to health campaign.
Recently smoking has been the centre of health campaign. It is generally accepted that smoking in motherhood has detrimental results on fetal expansion. Conter et al (1995) discovered that women who smoked smoking cigarettes during motherhood were more likely to truly have a baby with a lesser birth weight than babies born to women who didn't smoke during being pregnant. Carbon monoxide, inhaled in tobacco smoke, combines more quickly with haemoglobin than oxygen (Sherwood, 2006). Because of this, the maternal blood supplies less air to the fetus for expansion and development; often resulting in low-birth-weight infants. Lumley et al (2009) undertook a organized review and figured methods which encourage women to give up smoking while pregnant reduce the amount of women who continue steadily to smoke in late motherhood, as well as reducing low delivery weights and pre-term labor and birth. However, some women may claim that it is desirable to truly have a smaller baby as they assume labour will be shorter and less painful, and therefore will not give up smoking. The midwife must describe that is untrue and there are serious health implications to herself and her child. It is well-known that newborns given birth to with a low-birth weight are more likely to die in their first yr of life, or require special educational needs during years as a child (RCM 2003).
Maternal smoking is considered to increase the risk of miscarriage. Unusual placentation is a reason behind spontaneous abortion of which is associated with increased blood circulation pressure; an adverse effect of smoking (Stables and Rankin, 2010). However, research studies are inconclusive. Similarly, maternal smoking may increase the probability of sudden infant loss of life syndrome (SIDS). Blair et al (1996) discovered that the chance of sudden baby death rose with maternal smoking. Postnatal infant exposure to cigarette smoke cigarettes was also seen to raise the probability of SIDS. It can therefore be concluded that antenatal care that motivates smoking cessation during being pregnant and reduces exposure to tobacco smoking in the postnatal environment may help to lessen stillbirths and child deaths. However, the hyperlink between smoking and SIDS is not directional as the causes of SIDS are not yet known.
Considering the possible outcomes of smoking in motherhood, it is important that midwives offer support and help to women and their families to encourage smoking cessation. NICE (2010) has advised that midwives should breath test women that are pregnant for carbon monoxide levels at booking and antenatal appointments. However, this method may be unreliable as carbon monoxide levels fall season quickly in expired breath, and therefore is likely to fail to observe carbon monoxide levels associated with low-levels of smoking. Furthermore, such a test may be considered intrusive as some women might not want to reveal their smoking status or. Many women may also feel discouraged to attend antenatal consultations in concern with being judged by the midwife if they never have, or do not need to quit smoking. This may prevent midwives from promoting health if indeed they do not get to speak to, support and inform the women throughout their antenatal sessions.
Alternatively, all smoking pregnant women should get guidance and described NHS GIVE UP SMOKING Services (NICE 2010). Such services are made to provide evidence-based non-judgemental support to the people who want to stop smoking. It's the responsibility of the midwife to refer women to another specialist if their health or wellbeing would reap the benefits of doing so (NMC 2008). This might include referral to a particularly trained midwife to aid women that are pregnant in preventing smoking. This might permit women to start to see the same midwife regularly, allowing a midwife-woman romance to be developed. Therefore women may feel a greater degree of support provided by the midwife; increasing the likelihood of smoking cessation. Yet a lack of midwives may prevent this and instead become a barrier to the further improvement of effective health campaign and smoking cessation services.
Successful smoking cessation not only will involve educating pregnant women, but their families too. Ashford et al (2009) suggested that it's significantly important that a woman's partner and family are well educated by medical researchers about the effects of carbon monoxide smoke to maintain a smoke-free home to avoid postpartum relapse rates. It's the responsibility of the midwife to ensure that the pregnant female and her family are aware of the psychological and physical effects of unaggressive smoking. In response to the, a midwife may offer information to women and her family regarding nicotine replacing remedy to encourage cessation. Smoking cessation advice given with the provision of nicotine replacing therapy is an average intervention with regards to the prevention health education area of the Tannahill model (Sykes 2007).
For most smokers determination to avoid smoking is key. Yet for most women and their associates the occurrence or planning of any pregnancy is sufficient determination (Heggie 2006). However, used, the midwife may not only provide information about medical benefits of smoking cessation, but the public and financial too. Cost savings can be large and seen quickly, a possible interesting factor to stopping smoking. Socially, women may have the ability re-build relationships with non-smoking friends; a good way to obtain support to avoid smoking relapse (Heggie 2006). Considering time constraints which often cause a barrier to effective health advertising by the midwife, conversations related to smoking may be quick or an information overload. The midwife may use visual helps such as leaflets, pictures and dining tables may improve the likelihood that the info is understood, preferably improving the likelihood that the woman would choose to quit smoking. When pushing women to give up smoking, the midwife commonly uses educational and behaviour-change models, to inform and encourage women to boost their lifestyle for the good thing about her own and the fitness of her baby.
It is similarly important that midwives provide women that are pregnant with information on diet and nourishment as well as smoking with regards to promoting health. It is essential a pregnant female has a good healthy intake, prior to conception and during motherhood as the developing fetus requires basic nutritional substances for the introduction of vital structures and systems (Stables and Rankin, 2010).
It is normally advised that pregnant women should consume a balanced diet, rich in fruit, vegetables, dairy products and starchy glucose. A poor healthy intake can lead to deficiencies which can cause fetal deformities. A good example of this is folic acid; a vitamin essential for the introduction of DNA and the stressed system. A scarcity of folic acid in early on pregnancy can result in neural tube flaws such as spina bifida. During the first 4 weeks of pregnancy, the neural pipe is expanding, which is often before a female realises she is pregnant. It could then be recommended to take folic acid as soon as possible, up until 12 weeks of being pregnant, as well as eating a variety of foods rich in folic acid such as leafy vegetables, citrus fruits and fortified cereals (Hunter et al, 2003).
Similarly, vitamin supplements D is also important during pregnancy. Women who are not regularly exposed to sun light or do not eat seafood nor dairy products, may have a insufficiency in vitamin supplements D. Vitamin supplements D helps with the absorption of calcium mineral, essential for the forming of the developing bones and tooth of the fetus (Hunter et al, 2003). However, a randomised control trial conducted by Abdel-Aleem et al (2009) figured there are no notable results on fetal or child growth blessed to women who received calcium supplementation during pregnancy. Yet, it is difficult to generalise these findings to western civilizations as members were from eastern civilizations such as India, South Africa and Vietnam.
In compare, women who over-eat are also vulnerable during pregnancy. Weight problems is becoming a growing problem for women within the united kingdom. The NHS UK excess weight statistics (2010) declare that in 2008 25% of women aged 16 and aver were classed as obese. Women that are pregnant with a Body Mass Index of 30 kg/m2 at the first antenatal discussion are believed obese (CMACE & RCOG, 2010). In obesity, fatty deposits to develop within the arteries, creating blockages. This may cause hypertension, which can raise the chances of preeclampsia; a hypertensive disorder of motherhood. O'Brien et al (2003) found that the risk of preeclampsia doubled in women with a greater pre-pregnancy body mass index. In response to many findings suggesting that obesity has adverse effects on pregnancy, it might be concluded that pre-pregnancy healthy eating advice and weight damage programmes may be beneficial.
Due to the considerable results that diet can have on being pregnant, it is important that the midwife addresses the importance of a healthy diet plan to women in her care. It is vital that midwives look at a woman's lifestyle with regards to her diet. Many women may have a active lifestyle where they are unable to regularly exercise and prepare meals with fresh materials; possibly a contributing factor of excess weight. The Centre for Maternal and Child Enquiries plus the Royal College or university of Obstetricians and Gynaecologists (2010) released guidelines in relation to the management of women with weight problems in pregnancy. This enables specific suggestions for midwives to check out to provide extra support for girls with obesity. Despite the fact that the guidelines focus on women that are pregnant with a body mass index greater than 30 kg/m2, the tips can be designed for women whose body mass index is just below this fatness threshold if considered beneficial.
The midwife should spend some time during the booking interview to explaining the importance of specific nutrients in relation to her own and her baby's health. NICE (2008) shows that all women that are pregnant should be recommended of the value of folic acid supplementation prior to and through the first 12 weeks of motherhood. All women should also be up to date about where you might get folic acid, which foods contain folic acid, and the suggested daily dosage of 400 micrograms each day to prevent less-educated women from not accessing the dietary supplement. Supplementation of pre-pregnancy folic acid can be an example of preventing ill-health and disease domain of the Tannahil's model that occurs used (Bowden 2006). Also, it is important a midwife explains which foods should be averted and just why.
However, women may choose never to eat nutrient-rich foods because they don't like them. In response, a midwife should provide information on practice alternatives and changes to encourage a wholesome diet. Again, this is an example of the behaviour-change and educational models in practice. However, some recommendations may be expensive, for example, increasing fruits and vegetable intake or extra nutritional supplements. Hence the midwife must have an up-to-date knowledge of financial benefits that pregnant women can claim, to prevent less economically advantaged women in from being disadvantaged.
Again, time restraints may be considered a barrier to providing health related information to permit women to make enlightened options about their diet. Therefore the midwives communication must succeed to ensure that ladies understand the information. It really is part of an midwives role to speak effectively (NMC 2008). 'More than one form of communication is more effective in increasing understanding, than only using one' (Kerr et al, 2005). Used, the midwife may therefore discuss a dietary need then provide leaflets and websites with referrals so women can gain access to further information to allow their knowledgeable choice. In addition, during reservation, the midwife provides a free copy of 'the pregnancy reserve' to every girl. The book is designed to provide extra information and support for expectant mums and companions, Different aspects of motherhood are told optimise medical and wellbeing of the mom and baby.
NICE (2008) says that all women that are pregnant should get information about the importance of their own and their baby's health during the arranging interview and antenatal visits. Often this consists of discussing the girl smoking position, diet and the environment which effects this. This consists of assessing a women and her baby, providing current and correct information in relation to their health, and when necessary referral to other medical services. The midwife is accountable for upgrading her own knowledge and skills to ensure that ladies receive the most up to date health care and information. When providing effective good care, the midwife must ensure that she treats each woman as an individual, with value, dignity, and kindness to permit women to trust her midwife with her health and wellness (NMC 2008).
In final result, the midwife has a vital role in promoting health with regards to smoking and diet. Smoking and a poor diet during being pregnant can have serious adverse effects on the mom and baby. Often the key point of contact during motherhood, the midwife provides essential information and support to women and her family with the health of the mom and baby in mind. By adhering to rules, expectations and suggestions the midwife can ensure that the care and attention provided is of the highest standard. Midwives recognize that each woman can be an specific and her needs are evaluated on a person basis, with a non-judgemental, caring nature. It is vital that a midwife fulfils her role to advertise a balanced, nutritious diet and lifestyle prior to and during pregnancy to improve the chances of an effective pregnancy results.
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