Rural Midwives Placement Program

CLINICAL CASE STUDY

I.

BACKGROUND OF THE STUDY

The aim of the study was to show how midwives cared for women
midwives negotiated care that was culturally comfortable for
women and their families.
Furthermore, the partnership between the midwife and the
diverse client are needed as well as the development of aspect of
the health service that is more culturally sensitive, studies have
explored the experiences of childbearing women. Responsive
approach incorporates the client values, belief life ways, and
practices into mutually acceptable.

II.

OBJECTIVES
A. General Objectives
To lunch your professional individuality, to highlight
your key qualifications by starting what you, as a
midwife professional, have to offer your services
beyond their expectations, to inform your employer of
the midwife position you are seeking and your career
goals.

B. Specified Objections:
The trainee will be able to:
1. Analyze the issue and trends in midwifery.
2. Analyze the issue and concept of care and mother and
newborn.
3. Integrate the selected nursing theories and researches to
promote mother and newborn health in premarital, prenatal,
labor and postpartum period.
4. Identify roles of nurse midwife in mother and newborn care
in premarital, prenatal, labor and postpartum period such as
premarital counseling, family planning, preparation of
childbirth, attending the normal labor and conducting of
selected method of delivery, promoting in breastfeeding,
bonding and parent roles etc.

III.

PERSONAL
Patient
: T.M
Age
: 27 yrs. old
Sex
: Female
Date
: 4-27-16 2016 5:47 pm
Religion
: Roman Catholic
Birthplace
: So. Pandan, Brgy. Caradio-an, Himamaylan
City
Present Address
: So. Pandan, Brgy. Caradio-an, Himamaylan
City
Attending Physician:
Chief Complaint
: Admitted of patient with c/c of labor pain
few mins.
Diagnosis
: G4P3 Cephalic presentation, I.E done and 9cm
Cervical dilatation FHB of 14lb/min.
BP 120/80 mmHg FH 27 cm and mild vaginal Discharges
and labor pain.

IV.

ASSESSMENT
A. History of present illness
At around 4:00 AM in the evening patient suffered from lumbar
pain and probable sign of true labor pain, checked and
monitored client her true sign labor.
B. Physical Examination
Latest physical examine shows the following data: assessment
weight 66 kgs, BP100/70 mmHg. L1-Breech L4-cephalic
presentation NO ultrasound conducted but laboratory test done
CBC Hemoglobin 123 g/L (N-110-150g/LF) Hematocrit (N.0 37
0.7) 0.33 RBC 4.10 CN. 4.10 CN 4.0-5.5x 1012/L WBC 9.15x109
(N 5-10) NO significant finding noted on the previous prenatal,
negative HBs. Ag. Platelet Count-Adequate, Blood Group B RH
group -+.
C. Medical History
Dizziness and sprain occur along pregnancy discomfort such as
back pain.

V.

MIDWIFE CARE PLAN

A. Planning
Explain patient on how to do during pregnancy explain patient
to go to the health center to monitoring during pregnancy and
able to adjust effectively prepare her role as a mother.
B. Intervention/ Implementation
B1. Specified midwife Care Plan APIE format for encountered
health problem.
You should ensure that your collaborative arrangement
or care plan are in place from the commencement of
care in order ensure you are covered throughout the
course of care establishment trust through effective and
therapeutic communications daily monitor of her
pregnancy. Prenatal including vital sign given laboratory
request, instruct mother on how to care the body.
Provide quality time and the patient collaborate the rural
health unit and regards to the program of maternal and
childcare.
B2
4:00 pm monitor progress of labor, Intact how, FBH
142b/mins
BP 110/70mmHg FH 30cm HR 89/mins. Tem 36 5oC
4:35 Am, monitor progress of labor, I.E done 9 cm, Intact
bow
5:47 Am, I.E done, BOW ruptured
5:49 Am delivered spontaneously to an alive Bb. Girl
with Cephalic presentation in good conditions, cut cord
aseptically
Uterus checked well contract
Applied pads, keep clean & dry & comfortable
Mefenamic Acid 500mg 1 cap every 6 hours for pain
Vit A 1 cap 200,000 IV given of ferrous sulphate 1 tab
once a day for 3 months supplies.
Advised mother exclusive B.F up to 6 months
Weight 2.8 kgs. Ophthalmic ointment apply both eyes
Hepa B. 0.5 ml inj. @ birth @ deltoid muscles vit. K 0.1
ml.inj. @L deltoid muscles
Baby measurement: Head 32 cm, chest 33cm, length
52cm
Date & time of discharge: Both mother & baby discharge
in good physical condition.

C. Lesson Learned/ Insight

This care process is dynamic, continuous, and circular
when need, following an orderly succession of steps and
requiring critical thinking and various types and levels of
decision making throughout. Or at times date collected
or decisions made unanticipated outcomes will require
re-visiting an earlier step and re planning with the
woman.
Patient was in a good because she has complete Prenatal record with 3 or more visited complete tetanus
toxoid complete ferrous sulphate of 180 tab for 6 months
and complete Laboratory feto gram, ultrasound, and
given Vit A to mother after birth.

RHMP
P

LILIAN S. CASTILLO
Himamaylan City Negros Occidental