Caring For Women With Complex Social Factors Flashcards
Applying Crenshaw 1989 theory of intersectionality
Framework to analyse how interlocking systems of power affect those who are most marginalised in society
Aspects of a persons social and political identities combine to create different modes of discrimination and privilege
Poverty in the uk stats
More than one in six people in the uk are in relative low come before housing costs, rising to more than one in five onc accounting for housing costs
Proportion of children living in poverty is slowly increasing
Homelessness in the UK
Affecting more than 309000 across England including 140000 children - rise of 14% from the previous year
Rate of homelessness is 1:182 people
Approx 3000 people are sleeping rough on an given right
47% of families who are homeless in temporary accommodation have been here for more than tw years
Sex work in the UK
105000 people in uk - significant rise from 70000 in 2016
Around 11% of British men aged 16-74 have paid for sex on at least one occasion which equates to 2.3 million individuals
Sale and purchase of sexual services between consenting adults is legal
However activiities related o prostitition such as soliciting, kerb crawlin, brothel keeping and various forms of exploitation are illegal
People who engage in sex work are subject to high levels of social exclusion
Nice guideline
Woman centred care - treat with kindness, respect a dignity. Value and beliefs respected
Confidentiality and record keeping - respect confidentiality. Ensure handheld maternity notes contain a full record of care recieved and the results of all antenatl tests
Booking appt
Discuss he need for antenatl care
Offer booking appt. In the first trimester ideally before 10 weeks if she wishes to continue the pregnancy, or offer referral to sex health services if she is considering termination of the pregnancy
Give women a phone number to enable her to contact healthcare professional outside of normal working hours
Take early opportunity to form a MDT to support the woman
Communication in AN period
Ask woman to tell her if address changes and has phone number for this purpose
Give phone number for out of hours contact
Provided each woman with a one to one consultation without her partner a family member or guardian presenta t leats one occasion
General AN consideration
Accessibility - provide flexibility with location, considering travel costs. May provide a one stop shop
Continuity of care- building consistent relationships improves outcome
Sex health screening - facilitate regular screening for women involved in direct sex work or otherwise at risk
Routine enquiry - be mindful of changing personal situation including vulnerability to trafficking modern da slavery and domestic abuse
Trauma informed care - considering re traumatisation through triggering conversations such as booking question, recognising potential triggers and coping strategies
Assessment — holistic consideration of situation, including housing, finances, social, support, stability, safety
Role of a doula
Improve maternal mental wellbeing
Increase maternal self esteem, and self efficacy
Suppor women to make effective use of maternity services
Intrapartum consideration
Trauma informed care - considering potential exposure t sexual violence and retraumatisation. Discussion process of decision making and consent
Presence of birth partners - doula as an additional birth partner. Financial situation an chaotic lifestyle may impact on birth partner support during labour
Accessibility - consideration of transport costs in latent/established labour may be relieved by offering by offering admission in latent phase (reducing ambulance calls )
Postnatal and neonatal considerations
Safeguarding - awareness of child protection plans, assesment of parenting capacity
Relationship building - support the establishment of family unit, integrating important members to the mother and baby. Promote positive parenting behaviours such as skin to skin contact, love and touch, responding to babys needs
Infant feeding - breastfeeding offers buffering against the effects of poverty for babies born into poverty
Roles in MDT
Writes a letter to the housing association about overcrowding - midwife / GP / family support worker
Provides ongoing emotional support - charities/ midwife/ social worker/doula
Refers to local authority social services - midwife/ health visitor/ anyone with a concern
Disbrutes food parcels from the local food bank - volunteers/charities
Helps with application for universal credit - job centre/ charities
Assesss whether the needs of the unborn child can be met - social worker
Signpost to community groups - midwives
Acts as a gateway into support services - midwives/ health visitor/ GP / charities
Makes decision about how people should live their lives - themselves or less court order
How do we improve their services
Commissioners should ensure that women with complex social factors presenting for antenatl care are asked about their satisfication with the services provided and the womans response are
- recorded and monitored
- used to guide services development
Commissioners should involve women and their families in determine local needs and how these might be met
