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- 2nd Trimester
Whanaungatanga
Building connection and trust is the foundation for succesful care.
Young Māori tell us that whanaungatanga and building trust needs to be prioritised over health assessment/questions at first contact. Convey warmth and respect without judgement to pave the way for return visits.
Whanaungatanga is the process after mihi (greeting and engagement) of establishing connection and trust. For whānau Māori this may be understanding the persons whenua (land) connections, whānau involvements and use of Te Reo language. It also requires some sharing of information about yourself.
Ask: “Is there anyone that you would like to bring in or call to be a part of your visit?”
Build connection: If you do not know each other “My name is (), and I am (role) ... (share some things about yourself e.g., family, where you are from) …
Ask: "I'm interested to get to know about you. Would you like to share a bit about yourself/s first before we talk more about your pregnancy?"
This may be a good opportunity to ask Māori about their whānau, hapū and iwi. It's also an opportunity to ask about cultural or religious beliefs or practices in relation to pregnancy.
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Whānau (family):
Can you share with me your previous experiences of being hapū (pregnant) because it will help me to understand what your needs are now.
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How many times have you been hapū (pregnant), including this pregnancy? |
How many times have you given birth at 20 weeks hapū (pregnant) or more? |
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Option A: Quick summary of previous pregnancies, births and babies (> 20 weeks gestation)
Option B. Detailed information about each pregnancy, birth, and pēpi/baby
Taha tinana – physical wellbeing
Taha hinengaro - Mental and emotional wellbeing
Over the last two weeks, have you been bothered by:
Being hapū (pregnant) is a special time for well-being as you grow pēpi. We ask the next questions for every hapū māmā to ensure they have the opportunity and choice to get extra support if they need it.
Essential exam/screening
| BP from PMS for last 12 months displayed here |
Targeted examination
Consider if indicated:
Screening tests to check for Down syndrome and other genetic conditions. The blood test is free for NZ residents, and there is usually a co-payment for nuchal translucency scan.
Find Your Midwife:
Healthy Hapūtanga (Pregnancy)
Sleep Safety
Kōrero guide for talking about sudden unexpected death in infancy (SUDI)
Ask: “Many people worry about their pēpi/baby dying suddenly in their sleep. You might know this as SUDI, SIDS or cot death. Have you heard of this, and how did you find out about it?”
Reflect what you have heard e.g. “So, that’s good. You know …”
Build knowledge: “The reason we are talking about this is that most deaths can be prevented when whānau know how to keep their pēpi safe”
Ask: “What do you already know about preventing SUDI?”
Reflect: Either “Great I’m hearing that you know quite a lot already” or “Ok so I’m hearing that you've not been given you much information about this."
Build knowledge: "Can I share what I know? It’s important that you protect your baby’s breathing for every sleep because this will prevent SUDI. You can do this by:
- Placing them to sleep in their own sleep space, like a wahakura, Pēpi-pod®, or cot, where they won’t get rolled on, squashed, or wedged.
- Couches, sofas or armchairs are not safe places for a pēpi/baby to sleep.
- On their back and flat without pillows or propping up, with their face clear so their airways are open and it’s easy to breathe.
- Smokefree air to breathe.
- Sleeping pēpi in the same room as the person caring for them.
- Pēpi being breastfed and immunised so they stay well.
- Making sure their caregiver is not using alcohol and drugs so they can keep pēpi safe.
- Having a plan for when pēpi is unwell, unsettled, or you are exhausted so that they are always safe sleeping.”
Check: “Can I check that I have explained it well? What did you hear babies need to be safe when sleeping?” “Maybe there are good reasons why you plan to do things differently– I’d be interested to hear your thoughts?”
Build knowledge: Affirm whānau intent to do the best for pēpi. Engage in joint problem-solving, acknowledging complex life situations.
Support: Request additional support if needed in the context of the māmā, pēpi and whānau (e.g. maternal exhaustion, smoking, baby bed/pēpi-pod, mental health or alcohol and drug use)
Confirm plan: A suitable plan for SUDI protection “You’ve told me you know about …. but what you need is some help with …. and ……”
