Psychological Needs for Women - Essay Example

Psychological Needs for Women This needs assessment report regards a Somali refugee, who was booked in 28+5/40 gravida Para 0. She hasno family in this country except a one male cousin. She has the fourth type female circumcision also referred to as female genital mutilation. She’s got a pregnancy which was conceived through rape. The woman does not have a permanent house so she lives in temporary accommodation. Findings Psychological needs The woman’s mind was extremely disturbed as a consequence of the disruptions. She was in great distress and anxiety as the episodes of her country’s conflicts were fresh in her mind. The reports she gave is that she had witnessed the brutal killing of her own husband before she was herself raped. The property in the house was turned upside down before it was set on fire. She managed to escape to this country where she is accommodated as a refugee. She often experiences sleepless nights with bad dreams and traumas. The inward fears have braided mistrust and inward feelings of insecurity whenever she is in a crowd or gathering. She is afraid of approaching people or even authority for help since she perceives that everybody is aware of her humiliation. She has therefore never shared the rape incident before and she has always concealed her dreaded pregnancy. Physical needs The woman suffers in severe poverty since she ran from her home empty handed. To begin, she does not have a permanent house so she lives in temporary accommodation. The region is unsafe and has occasionally experienced vandalism and robberies which often add to her traumas. Since she is a refugee, she has got no a legitimate job to earn her a living. In terms of food, she survives by the mercies of her kind neighbors and for the small portions provided for refugees by the government. She has no family in the country except for a one male cousin who barely supports her. Her health is not well catered for, with due consideration to her pregnancy which has she of late discovered. She cannot afford healthy foods since she barely anticipates for a meal everyday with no concern of its nutrients. She has never visited a hospital or clinic for the pregnancy check ups and consultation except for now. She has little knowledge about pregnancies and their complications since this was her initial conception. As a result, she was not aware of the routine practices in conception for healthy delivery and protection of the baby. Cultural needs The woman feels totally new in the country which has different people and environment. The culture she found here is contrast to what she is assimilated to in her native country. Differences in her way of dressing, language, skin color and more to the fact that she is circumcised makes her feel a mismatch. She has encountered discrimination and oppression at one point or the other. Many are the times she has been denied opportunities or people less interacted with her due to communication barriers since she speaks scanty English. Most of what she received in return was anxious looks and pity gestures on the public places. She feels culturally unaccepted which has created resistance of her interaction too due to shame. She often tries to hide or make herself invisible in order to avoid the humiliations. The basic reason she had not attended clinic was due to language barrier, she would have a hard time understanding the medical correspondence. She never also expected that the health care providers would understand her odds of rape and circumcision. The hospitals she could afford going are the cheap ones or those with free services where there are no interpreters. Social needs The woman has no family so she lives alone. She has no close affiliations except for the cousin who is a male, and therefore would not always intervene to her social needs of friendship and acceptance. She often stays in house and is not motivated to socialize with other people. Due to her poverty status, she is not able to afford networking gadgets like a phone. She does not have a radio or television in the house. There is therefore no means of getting information even from newspapers or journals she is barely educated and does not know how to read. The fact that she is in new society where almost everybody is educated except her has tremendously pulled down her esteem which has negatively affected her social well being. Impact and influence of the needs on each other The various challenges experienced by the woman are interrelated and impact on each other in one way or another. The trauma and the frightening experiences that she went through are too much to bear as a human being. They are enough to render her psychologically disturbed to extend of hating nature and human beings. This can easily make her decide not to keep the pregnancy and get rid of the infant. Since she is poor, she cannot afford the safe medical services for the abortion. She would therefore end up using queer methods which can easily kill her. She had initially gone through female circumcision which probably disoriented her not only socially but also in health issues especially more to the fact she was expecting. The practice is very dangerous to women since it may bring severe complications during delivery. The woman is poor in a new country where she barely has relatives or friends to take care of her. There is a deficiency of how to cater for both her material and social needs. She can hardly take care of herself not to mention the baby in her womb. She has no means of acquiring information about her condition due to her language barriers, and much less cannot read. The feeling of alienation makes her coil from seeking guidance and is not sure of who can listen and understand her present situation. The woman’s needs revolve each other in a way each of them is as a result of the other or a stumbling block to solving the other. Priorities and care A basic plan for catering for the woman’s care with consideration to providing a good living and ensuring healthy delivery would be as follows Psychological well being The psychological well being of the woman is as important as her health. This is ensured by providing special remedial assistance for full recovery from the traumas and bad experiences. This is because; the suffering or witnessing of the torture of rape and murder severely affected her brain. This translates to her living in grief and anxiety or too traumatized to take care of herself .It leads to malnutrition and illnesses which are dangerous to the pregnancy. I would offer to give direct services through guidance and counseling or refer her to a psychiatrist, and fund for the services with an assurance of trust and confidentiality of her information. This would cater for the bad rape experiences and the assist her accept and take care of her pregnancy. I would find a way of connecting her with various acquaintances like referring her to a refugee camp where she could find people whose needs and predicaments identify. She would be easily assimilated in such an environment. Interactions and socialization would hasten her mental and psychological healing. Providing information The mother is not educated and she therefore has very little knowledge about her pregnancy. I would therefore provide her with information about antenatal care services and guide her in making the informed decisions about delivery. I would begin by explaining basically how the baby develops in the womb with emphasis on the sensitivity of each phase. This would further bring in the issue of how carelessness and intake of alcoholic drugs is dangerous to the pregnancy. I would educate her on nutrition and the proper way of having well balanced meals. This would also include advises on practices of daily routines for the well being of the child and for easy delivery. I would also lay emphasis on the importance of hygiene as part ensuring health of the mother and the child. I would explain the importance of having a scan for the pregnancy in order to reveal any abnormalities especially after going through tough experiences. She would probably have doubts and fears about the screening process but I would clear them out by explaining the security and accuracy of the test, with great emphasis on how it would help her discover the health of the child. I would not ignore explaining a variety of possible outcomes of the test, which would psychologically prepare her for the unexpected. I would also inform her of the alternative ways she can let her child live incase she was not ready for parental responsibilities. This includes the adoption option which is legalized and has freedom to engage. This takes away the worries of child bearing expenses since she is poor. Facilitate the decision making Prior to educating her about pregnancy and the antenatal services, I would counsel in order to assist her make her right decision. This would include a decision of where she would like to deliver from, that is home or hospital. Since of course she is not educated she would have fears of delivering in a hospital which I would advocate for, by explaining the dangers of home delivery. I would carefully listen to her needs and priorities as I offer further information on the decision she makes. I would give directives for the pregnancy scan which, other than determining the health of the fetus, it would facilitate bonding of the child to the woman. This would improve her psychological health. I would train her about the screening tests and probably show her some videos as I explain the occurrences. I would also give my own beliefs and experiences concerning the issue, in order to assist her come up with the right decision. Another important decision I would guide make is on the various forms of diagnosis she is expected to receive in terms of oral drugs or tablets, which would depend on her preference. Providing support After the woman has given in to the decision of keeping the pregnancy and attending to the antennal care services, I would try to provide both psychological and material support in one way and the other. This would be in consideration of her poverty status which might bring fears of not affording the services. I would look for well wishers or concerned organizational bodies to cheap in the expenses. Concerning her language barrier and low education status, I would offer to be her core care giver throughout the diagnosis since I would at least have had a way of communicating with her. This would involve lengthy interpretations of the diagnosis and make her understand the its directives and following instructions. It would involve regular follow ups in which I would occasionally visit her home. It would in the process create a friendship bond where she would also feel loved and appreciated. I would also organize for and encourage her to attend parental classes where basic training for parenthood is provided. This would be after she had accepted to raise the child herself. The services would be individualized with provision of an interpreter, due to the language and cultural differences. In conclusion, I would employ my professional skills as a midwife by providing preventive measures and work possibly to promote a healthy normal delivery for the woman. I would integrate all the tasks of counseling and educating, with accommodation also for her psychological, social and physical needs. Bibliography Clement, S. (1998) Psychological perspectives on pregnancy and childbirth. New York: Churchill Livingstone. Print Squires, C. (2003). The Social Context of Birth. New York: Radcliffe Publishing. Print Dunkley, J. (2000). Health Promotion in Midwifery Practice Tindall: Kaleidoscope Books. Print Stables, D. (2005). Physiology in Childbearing. North Carolina: McFarland & Company. Print Jordan, S. (2002) Pharmacology for midwives: the evidence base for safe practice. Washington: Palgrove. Print Kargar, I. & Hunt, S. (1999) Challenges in midwifery care. New York: Macmillan. Print Nelson-Piercy, C. (2001) Handbook of obstetric medicine .Donitz O Luanaigh, P & Carlson, C. (Eds) (2005) Midwifery and Public Health: future directions and new opportunities Elsevier. New York: Churchill Livingstone. Print Robson, S. E, Waugh J (Eds) (2008) Medical Disorders in Pregnancy: A manual for midwives. New York: Wiley Blackwell. Print Read More