A case study as a method of enhancing psychosocial care in Midwifery Education

1. A case study as a method of enhancing psychosocial care in Midwifery Education Author: TaahirahMondell Co-author: Dr Johanna Mthibe-Neke

2. ACKNOWLEDGEMENTS DR JOHANNA MTHIBE-NEKE: Lecturer, Confidant, Mentor and Friend

3. INTRODUCTION • Midwives are recognised worldwide as Independent experts and Leaders in providing care in childbirth • Every woman expects to be treated as though she is special and important and therefore it becomes essential that midwives have an understanding of the SOCIAL, CULTURAL and CONTEXTUAL differences of each individual client (Fraser, D.M & Cooper, M.A., 2003:4-7) • HENCE, the practise of student midwives conducting a follow up case study of an individual client enhances this opportunity for learning

4. PURPOSE AND OBJECTIVES • Formed part of the undergraduate set work which accounted for 20% of the overall clinical year mark • To gain a broader understanding of the Roles and Functions of a Midwife • To develop a greater sensitivity and awareness in Midwifery practice as a student • Offered an opportunity for self-evaluation and self-directed learning

5. FOCUS OF THE STUDY “To aspire in discovering the very emotional and spiritual embarking’s of a new mother’s journey through her pregnancy and delivery, the life-changing passage into motherhood, the trials that were endured and the pure joy of carrying a life within her body”

6. TARGET POPULATION This assignment is dedicated to two of the strongest woman I have had the honour of knowing. Mary (pseudo-name); my follow up woman; and my mother.

7. DESIGN • This assignment was conducted as a case study assignment • According to Ramlaul, A (2010:228), a Case Study can be defined as single instance that is studied in depth and considered an approach, rather than a method • A case study is used to explore and reflect on what is occurring in a unique situation and allow for an in depth exploration of the context

8. DESIGN CONT… • This assignment was conducted over a period of five months (February – June 2011) • Follow the woman during Antenatal visits, delivery of the child and 6 weeks post-partum • Provide relevant health education on medical needs, as well as psychosocial health on a social and cultural context • Submit a written report of the study, integrating the biological, psychosocial sciences as well as relevant pharmacology applicable

9. FINDINGS FEAR AND ANXIETY “This is my first pregnancy, I’m 37 years old and scared to go through this experience alone”

10. FINDINGS cont… • Fraser & Cooper (2003:654) explain that the transition to motherhood compound many woman's lives • The competing images of fulfilling your biological destiny, bringing a new born into the world and losing your previous identity can be a challenging hurdle in this transition • Careful assessment by the midwife is of utmost relevance and importance especially during the antenatal period as a woman’s perception of events are extremely important to her emotional wellbeing and stability

11. FINDINGS cont… UNCERTAINTY OF THE FUTURE “I left my job as I always wanted to be a stay at home mother, now I’m not sure if I made the right decisions”

12. FINDINGS cont… • For many woman, varied emotional responses are expected during ANC, labour and post-partum • Uncertainty is a constant battle that challenges each individual differently • It is not the Midwives responsibility to always give solutions but rather, to help assist in the change (Fraser & Cooper, 2003:657-659)

13. FINDINGS cont… STIGMA “you never get use to the stares from other people…”

14. FINDINGS cont… • Mary is a product of a mixed marriage • Mary herself is married to an African man • Grew up with insults thrown at her on a daily basis and so she was faced with added emotional turmoil “I know how much I love my husband and that is all that matters. I grew up with an Indian father and I look Indian with my long black hair so I know from young what it feels like. I have to live my own life at the end of the day”

15. FINDINGS cont… SUPPORT BY THE FAMILY • Supportive husband • Husband has another family and so impacts on their relationship • Her own family stays in Durban: less support from them

16. IMPLICATIONS SO WHAT HAVE I LEARNED???

17. RECOMMENDATIONS • Strategy for learning as a holistic tool • Focus groups with students: reflection on personal experience • Follow up evaluation on families who experienced this method of teaching

18. CONCLUSION Woman are born resilient creatures They nurture, care and love and will take down mountains to care for their off-spring Midwives have an advantage of detecting psychosocial risk factors antenatally and thus, are the forerunners in prevention of emotional trauma and psychological damage and promotion of emotional wellbeing.

19. “A mother is the truest friend we have, when trials heavy and sudden, fall upon us; when adversity takes the place of prosperity; when friends who rejoice with us in our sunshine desert us; when trouble thickens around us, still will she cling to us, and endeavour by her kind precepts and counsels to dissipate the clouds of darkness, and cause peace to return to our hearts” -Washington Irving