Waris Mohamud is a 19-year-old African woman who presents in the Antenatal Assessment Clinic. Her partner who speaks some English accompanies her. He tells you that she has been seen by a GP, who confirmed her pregnancy 6 weeks ago. This is her first baby.
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- How will you assess this woman's antenatal care needs?
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- What resources might you need to give this woman optimal care?
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- Are you aware of any particular obstetric needs she may have?
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- Are you aware of any information needs she may have?
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- Do you know of any existing programs at the Royal Women's Hospital, which might be suitable for this woman?
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In going through her history, Waris appears very shy, and lets her partner do the talking. Her partner tells you that Waris has only been in Australia for 6 months, having arrived via a refugee program from Kenya, where she has been living for the past 3 years. He tells you that she is originally from Somalia, like himself.
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- How might you assess her social supports and language needs?
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- Are you aware of any appropriate programs or agencies to refer her to?
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- How might her refugee experience impact on her health and pregnancy?
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As you go through the medical history, it appears uneventful - no surgical or medical procedures. Waris appears to be a healthy young woman, with a straightforward pregnancy. Her partner seems attentive, and only asks that, if possible, Waris be seen by women doctors and carers.
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- What birthing care options might be available to Waris?
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- How might you present these options to her?
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Waris leaves the clinic after you have outlined the routine of future clinic visits. A few weeks later you attend an inservice given by two of the FARREP workers at the Women's, who explain that their role is to support women from the Horn of Africa, particularly those affected by FGM. They give you some information about FGM, and about some of the cultural issues for women in their communities.
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You next encounter Waris in the clinic, at 36 weeks. She is on her own, as her partner is working, but you are able to contact the Somali FARREP worker to assist with the consultation. It emerges that Waris is well, but concerned about the delivery, as she is infibulated, and has not had the opportunity to discuss what this means, beyond listening to some of the older women in her community.
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- What strategies might you use to assist her?
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- Are you aware of particular health needs at this stage?
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- What steps might you put in place to support Waris at this stage?
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