A case study as a method of enhancing
psychosocial care in Midwifery Education
Author: Taahirah Mondell
Co-author: Dr Johanna Mthibe-Neke
ACKNOWLEDGEMENTS
DR JOHANNA MTHIBE-NEKE: Lecturer, Confidant, Mentor and
Friend
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
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 selfdirected learning
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”
TARGET POPULATION
This assignment is dedicated to two of
the strongest woman I have had the
honour of knowing. Mary (pseudoname); my follow up woman; and my
mother.
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
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
FINDINGS
FEAR AND ANXIETY
“This is my first pregnancy, I’m 37 years old and scared
to go through this experience alone”
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
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”
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)
FINDINGS cont…
STIGMA
“you never get use to the stares from other people…”
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”
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
IMPLICATIONS
SO WHAT HAVE I
LEARNED???
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
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.
“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