During a prenatal intake interview, the client informs the nurse ...

[Garrulous]

During a prenatal intake interview, the client informs the nurse that she would prefer a midwife to provide her care during pregnancy and deliver her infant. What information would be most appropriate for the nurse to share with this patient?
 
  a. Midwifery care is available only to clients who are uninsured because their services are less expensive than an obstetrician. Costs are often lower than an obstetric provider.
  b. The client will receive fewer interventions during the birth process.
  c. The client should be aware that midwives are not certified.
  d. Delivery can take place only at the client's home or in a birth center.

Question 2

While obtaining a detailed history from a woman who has recently emigrated from Somalia, the nurse realizes that the client has undergone female genital mutilation (FGM). The nurse's best response to this patient is:
 
  a. This is a very abnormal practice and rarely seen in the United States.
  b. Do you know who performed this so that it can be reported to the authorities?
  c. We will be able to restore your circumcision fully after delivery.
  d. The extent of your circumcision will affect the potential for complications.

[janieazgirl]

Answer to Question 1

ANS: B
This patient will be able to participate actively in all decisions related to the birth process and is likely to receive fewer interventions during the birth process. Midwifery services are available to all low-risk pregnant women, regardless of the type of insurance they have. Midwifery care in all developed countries is strictly regulated by a governing body, which ensures that core competencies are met. In the United States, this body is the American College of Nurse-Midwives. Midwives can provide care and delivery at home, in freestanding birth centers, and in community and teaching hospitals.

Answer to Question 2

ANS: D
The extent of your circumcision will affect the potential for complications is the most appropriate response. The patient may experience pain, bleeding, scarring, or infection and may require surgery before childbirth. With the growing number of immigrants from countries where FGM is practiced, nurses will increasingly encounter women who have undergone the procedure. Although this practice is not prevalent in the United States, it is very common in many African and Middle Eastern countries for religious reasons. Responding with, This is a very abnormal practice and rarely seen in the United States is culturally insensitive. The infibulation may have occurred during infancy or childhood. The client will have little to no recollection of the event. She would have considered this to be a normal milestone during her growth and development. The International Council of Nurses has spoken out against this procedure as harmful to a woman's health.