Pregnancy and Health

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Seely Niazy is a 27-year old woman who is 6-months pregnant. She resides in Manchester, London, in the United Kingdom. The purpose of this interview is to assess the pregnancy of Seely Niazy per Gordon’s eleven functional health patterns for a pregnant woman. As such, this interview was conducted in the best interests, respect, and knowledge of Seely Niazy. Additionally, the purpose of this interview was to understand the situation surrounding her pregnancy such as her economic status, her health state, her personal attitude towards her pregnancy, and to make propositions on the measures that should be taken to ensure she has a smooth pregnancy period (Guest, Bunce and Johnson 2006). Nutrition-Metabolic is one of Gordon’s eleven functional health patterns for a pregnant woman that will be discussed in the paper. The domain assists in evaluating the type of food a pregnant woman should eat, the conducive environment for her and the fetus, the supplements to be taken in case of a deficiency, and the measures to be taken to ensure she takes care of herself physically during pregnancy.

Sexuality-Reproduction

This domain is quite vital because it provides a clear insight of how a woman should handle her pregnancy. It provides information on how a woman can control her sexuality during pregnancy and the changes in her behavior during this period. In the case of Seely Niazy, she accepted her pregnancy rather positively. This is because she had been trying to conceive a baby with her husband for a while until she had to undergo an IVF (In Vitro Fertilization). IVF involves the use of a sperm cell to fertilize a female egg manually. The embryo is then attached to the woman’s uterus (Downs and Ulbrecht, 2006). Therefore, Seely Niazy has been able to maintain a positive attitude towards her pregnancy because she planned for it and was expecting it. As such, it is important to understand that changes in behavior during pregnancy are usually common and that a pregnant woman should be handled with a lot of mental and physical attention.

Health perception/Health Management

Pregnant women can make use of various midwifery practical models. Some of them include Vaginal Examination model, Obstetric Assistance Model, and a newly developed one called the Perineal Suture Model. Such models are more applicable during labor and assist in ensuring there is a smooth birth delivery under any circumstances. However, in the case of Seely Niazy, she was only offered three options, a midwifery group, a local midwife or a hospital. Her options were limited to the ones mentioned above. At the time of the interview, she was an outpatient at a children and women’s hospital.

How one understands the healthcare measures to be taken during pregnancy is crucial to delivering a healthy baby ((Lawrence, Contreras, Chen and Sacks, 2008). Furthermore, one should be taught on how to get better physical care during pregnancy. For Seely Niazy, she could only access and utilize the midwifery models available in her hospital. Factors such as her income contribute to her incapacity to utilize better midwifery practical models. However, it is evident that Seely Niazy has managed her health status pretty well, before and during her pregnancy. She portrays this by not having a habit of utilizing any drugs and not taking any alcohol.

Nutrition-Metabolic

The nutrition observed by a pregnant woman is paramount to the well-being of both the mother and the fetus. As such, a pregnant woman should always be careful with the type of food she eats. Seely Niazy was watching her diet before she got pregnant but she does admit there is a change of pattern in her appetite and she now craves for different foodstuff. She also lost some weight for failing to eat well, though the doctors put her on medications that helped her regain her appetite and weight. She now eats more than she used to at the beginning of her pregnancy. Moreover, she currently supplements her deficiency of vitamin D and iron under the supervision of her doctor. In addition, she drinks cold water because warm water makes her vomit. Cold water is not bad for pregnancy as popularly assumed. Cold drinks such as water and milk that are not at very low temperatures are advisable for expectant women (Kazemi, et al 2009).

Elimination

Elimination in this context refers to excretion among pregnant women. Some changes should be expected in the color of urine of an expectant woman. This is quite vital in evaluating their health situation. As such, the color of urine and the number of times an expectant woman goes to the toilet is important in helping a physician determine whether the woman and the fetus are in great shape. Seely Niazy admits to visiting the toilet for a long-call only once a day. This is somewhat abnormal because a normal pregnant woman excretes more frequently. The interview also reveals that she suffered from constipation before and during her pregnancy. This shows that she had not been cautious with her health before the pregnancy. However, as she said in the interview, it is possible that the medication she has been on could be the cause of her constipation during her pregnancy (Zlotnick, Miller, Pearlstein, Howard and Sweeney 2006). Nonetheless, her level of ignorance is evident in the fact that she had been constipating yet she did not bother to find out the exact reason as to why. Additionally, she does not take any laxatives to assist in her constipation.

Excretion is paramount to a pregnant woman because of the circulation of nutrients in the body. The unwanted material must be removed from the body to ensure the mother and the embryo/fetus receives the necessary nutrients at all times. Seely Niazy frequent the toilet for a short call between 4 to 5 times in 24 hours. This is not okay because a pregnant woman should excrete more times than that (Brantsaeter, Haugen, Julshamm, Alexander and Meltzer 2009). As such, it is important for Seely Niazy to consult her doctor concerning this matter. Nevertheless, her revelation in the interview that her urine is yellowish and it is abnormally smelly is a sign of a healthy pregnancy. Additionally, her UTI test (Urinary Tract Infections) revealed that she did not have any infections whatsoever.

Activity-Exercise

It is imperative for a pregnant woman to be observant of the activities she partakes in during this period. During the early stages, a pregnant woman is recommended to do physical exercises such as jogging in the morning, and taking evening walks. Hobbies such as traveling may be limited in the pregnancy period for the safety of both the mother and the fetus. As such, the doctor should monitor the normal activities of a pregnant woman. However, that is not to say that women should put a halt to their normal routines once they discover they are pregnant. On the contrary, a pregnant woman should ensure she does physically active to not only strengthen her health but that of the child too (Guest, Bunce and Johnson, 2006).

In the interview, Seely Niazy reveals that her usual hobbies were going out with her husband and watching TV but she finds relaxing to be quite comforting in this period of pregnancy. However, she admits to not having sufficient energy to do much. She gets tired quickly, and she has been quite impatient off late (Downs and Ulbrecht, 2006). This may be attributed to hormonal changes in her body that lead to mood swings but such changes are relatively normal. Research shows that during the early stages of pregnancy, a woman may still have the energy to do much but as time progresses, she loses the energy to conduct her regular routines. A change in attitude is quite prevalent and this is why Seely Niazy no longer finds make up to be appealing.

Cognitive-Perceptual

Cognition deterioration is quite common among pregnant women. Research shows that it is normal for a pregnant woman to have a little memory loss as the pregnancy progresses and an unusual sense of taste and smell. However, it is not to say that a pregnant woman must be completely stressed out and have an enhanced sense of smell at all times (Henry and Sherwin, 2012, 73). Therefore, Seely Niazy is completely normal when she says that she is more sensitive to garlic and onions smell, and she finds tap water taste as metallic. Nevertheless, there are perceived impairments during pregnancy such as memory loss, but Niazy has not experienced that. The abdominal pains her doctor ignored require urgent attention to ensure the well-being of both Niazy and her baby.

Sleep-Rest

This domain revealed that Seely Niazy is not getting enough sleep at night and during the day. A pregnant woman is expected to sleep for more than 8 hours in the night. However, Seely Niazy is always up by four or five in the morning, and headaches sometimes make her wake up. The economic status of Niazy is crucial to how she takes care of herself during her pregnancy. Due to her job, she does not get enough sleep at night because she has to get up for her morning shift. Alternatively, she does not get enough naps during the day because she may be required to attend the evening shift at her work. Therefore, she should get the right schedule for working to ensure the well-being of both herself and her baby.

Self-perception/ Self-concept

Most of the physical and mental changes are attributed to hormonal changes that occur during pregnancy. The body produces a lot of different hormones in response to adjusting to pregnancy. For instance, one of the body changes is getting fat, which leads to a woman losing her normal body shape. There are also a lot of attitude changes which shows that it is quite normal for Niazy to be experiencing some body changes and a difference in approach. However, she revealed that she is excited in how her all-day sickness makes her feel nothing. Additionally, she is quite comfortable with her body changes during her pregnancy, and she has no history body image issues. Another change is in her assertiveness when she says that she now gets angry and anxious, which is normal during pregnancy (Kazi et al, 2006).

Role-Relationship

The people that surround a pregnant woman especially her friends and colleagues contribute enormously to the well-being of the mother and the fetus. How they relate to her in this period of pregnancy is quite crucial (Godwin, Keyes and Simuro, 2007). Family and friends should give their financial, spiritual and social contribution to the pregnant woman to ensure that things around her run smoothly. The fact that Seely Niazy lives with her husband who is the breadwinner is a bonus to the well-being of herself and their baby. She goes to work if she feels physically fit but when she is tired, she has the choice to just relax at home. As such, she is not stressed about much thereby ensuring a sustained growth and development of the fetus. Additionally, she now has a stronger social relationship with her friends and family that guarantees more support during her pregnancy period.

Coping/ Stress Tolerance

It is quite crucial for pregnant women to learn how to cope with stress and to have tolerance in problematic situations. Seely Niazy explains that she is always calm and patient. She analyses every situation and comes up with solutions. This is quite important not only during her pregnancy but also in the postnatal period. It helps in ensuring that the child is under great care under any circumstances (Saldana, Siega-Riz, Adair and Suchindran, 2006). Such qualities will help Seely Niazy make great strides in raising her child when he/she is born. She has already taken significant steps in her life by getting married, leaving her parental home and living with her husband, and now she is about to have another major change in her life by having a child. She has proven that she can quickly adapt to change.

Value-Belief

Seely Niazy is greatly inspired by family, health, and work, and they keep her striving for more. Additionally, she is a Muslim who frequently visits the mosque to pray. Since she conceived through the IVF process, she aspires to give birth in the hospital so she could get all the medical support required. She was not made aware of any other birth plan which limits her chances of considering better birth plans that exist. Furthermore, it is also important to note that her financial status may not allow her to consider other birth plans, which could be more complicated and expensive. Nonetheless, she should be educated on all the available options by the hospital and to allow her to make the right choice, as per her capabilities.

Nutrition-Metabolic

Pregnancy comes with a lot of body changes such as reduced appetite, morning sicknesses, change in weight, and also dehydration. As such, it is important for a pregnant woman in conjunction with her healthcare practitioner to ensure she eats the right food, she stays in a conducive environment, and she takes care of herself physically. Seely Niazy experienced the usual morning sickness, which later transitioned to her being all-day sick and she had to be admitted to the hospital due to dehydration. They put her under antiemetic drugs which helped improve her appetite, and she could now eat well albeit she reveals her diet has changed since getting pregnant. She experienced weight loss at first, but after receiving medication and improving her diet, she has gained the three kilograms she initially lost and continues to add more (Maura, Gomes, Thais, Rodrigues and Oliveira, 2011). For instance, in the last 24 hours before the interview, she had eaten honey and butter, muesli bar, potatoes for lunch with some bread and yogurt. Additionally, she takes supplements of vitamin D and iron because her blood test revealed that she had a deficiency of both.

However, she admits to not craving for anything that much though her appetite has improved after being put under medication. She takes cold water and milk, which are recommended, for pregnant women but in moderate temperatures. Seely Niazy still requires her tablets to maintain her health and appetite during her pregnancy period and she still experiences morning and all-day sickness if she does not take them. As such, pregnant women such as Seely Niazy have been advised to take small meals often, not to drink anything with meals, to eat soda crackers after waking up in the morning, to avoid warm places and to open windows to let in fresh air, and also to take naps and get plenty of sleep during the night (WHO, 2010).

Conclusion

Seely Niazy shows great concern for her pregnancy. She was interested in getting pregnant, and therefore, she went through the IVF process to conceive. She is experiencing the normal challenges of a pregnant woman such as abdominal pains, attitude changes which lead to mood swings, changing her work schedule and taking care of her pregnancy, and also physical body changes. Other weaknesses include her physician ignoring her abdominal pains and herself ignoring and tolerating her headaches. Additionally, I would recommend Seely Niazy to leave her job and resume after giving birth (Woodruff, Zota and Schwartz, 2011). She should seek a better doctor who pays attention to every detail concerning herself and her pregnancy. Nonetheless, she has a great personality with so much positivity. Also, she should consider other alternative midwifery models which she is capable of acquiring for they are quite relevant during labor times. Lastly, this discussion has proved that all pregnant women should adhere to Gordon’s eleven-health pattern during pregnancy for they can be quite helpful in ensuring a smooth pregnancy.

References

de Moura, L.N.B., Gomes, K.R.O., Thais, M., Rodrigues, P. and de Oliveira, D.C., 2011. Information about contraception and sexuality among adolescents who experienced a pregnancy. Acta Paul Enferm, 24(3), pp.320-26.

Adibi, J.J., Whyatt, R.M., Williams, P.L., Calafat, A.M., Camann, D., Herrick, R., Nelson, H., Bhat, H.K., Perera, F.P., Silva, M.J. and Hauser, R., 2008. Characterization of phthalate exposure among pregnant women assessed by repeat air and urine samples. Environmental health perspectives, 116(4), p.467.

Saldana, T.M., Siega-Riz, A.M., Adair, L.S. and Suchindran, C., 2006. The relationship between pregnancy weight gain and glucose tolerance status among black and white women in central North Carolina. American journal of obstetrics and gynecology, 195(6), pp.1629-1635.

Goodwin, R.D., Keyes, K. and Simuro, N., 2007. Mental disorders and nicotine dependence among pregnant women in the United States. Obstetrics & Gynecology, 109(4), pp.875-883.

Kazi, A., Fatmi, Z., Hatcher, J., Kadir, M.M., Niaz, U. and Wasserman, G.A., 2006. Social environment and depression among pregnant women in urban areas of Pakistan: importance of social relations. Social Science & Medicine, 63(6), pp.1466-1476.

Anand Dhruva, D., Lee, K., Paul, S.M., West, M.C., Dunn, L., Dodd, M., Aouizerat, B.E., Cooper, B., Swift, P. and Miaskowski, C., 2012. Sleep-wake circadian activity rhythms and fatigue in family caregivers of oncology patients. Cancer nursing, 35(1), p.70.

Henry, J.F. and Sherwin, B.B., 2012. Hormones and cognitive functioning during late pregnancy and postpartum: a longitudinal study. Behavioral neuroscience, 126(1), p.73.

Downs, D.S. and Ulbrecht, J.S., 2006. Understanding exercise beliefs and behaviors in women with gestational diabetes mellitus. Diabetes care, 29(2), pp.236-240.

Brantsaeter, A.L., Haugen, M., Julshamn, K., Alexander, J. and Meltzer, H.M., 2009. Evaluation of urinary iodine excretion as a biomarker for intake of milk and dairy products in pregnant women in the Norwegian Mother and Child Cohort Study (MoBa). European journal of clinical nutrition, 63(3), pp.347-354.

Kazemi, A., Sharifi, F., Jafari, N. and Mousavinasab, N., 2009. High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population. Journal of women's health, 18(6), pp.835-839.

Villar, J., Purwar, M., Merialdi, M., Zavaleta, N., Anthony, J., De Greeff, A., Poston, L. and Shennan, A., 2009. World Health Organisation multicentre randomised trial of supplementation with vitamins C and E among pregnant women at high risk for pre‐eclampsia in populations of low nutritional status from developing countries. BJOG: an International Journal of Obstetrics & Gynaecology, 116(6), pp.780-788.

Lawrence, J.M., Contreras, R., Chen, W. and Sacks, D.A., 2008. Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999–2005. Diabetes care, 31(5), pp.899-904.

Zlotnick, C., Miller, I.W., Pearlstein, T., Howard, M. and Sweeney, P., 2006. A preventive intervention for pregnant women on public assistance at risk for postpartum depression. American Journal of Psychiatry, 163(8), pp.1443-1445.

Guest, G., Bunce, A. and Johnson, L., 2006. How many interviews are enough? An experiment with data saturation and variability. Field methods, 18(1), pp.59-82. World Health Organization, 2010. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: recommendations for a public health approach-2010 version. World Health Organization.

Woodruff, T.J., Zota, A.R. and Schwartz, J.M., 2011. Environmental chemicals in pregnant women in the United States: NHANES 2003-2004. Environmental health perspectives, 119(6), p.878.

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