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Needs of women with multiple pregnancy
BLAŽKOVÁ, Barbora
In the last 15 years, the number of multiple pregnancies has climbed way up, in the Czech Republic. Natural factor for their emergence is gradually increasing maternal age. The occurence of multiple pregnancy is largely influenced by the wide choices of IVF programs in curable infertility. This bachelor thesis introduces readers with the multiple pregnancy topic not only theoretically but as well practically. We used experiences of mothers expecting twins. Theoretical part is devided into three phases in which are systematically listed stages of pregnancy, labour and the time after birth. To better orientation in this issue, each period is described in terms of medical and nursing care. The first part of the thesis defines issues of multiple pregnancies classification of multiple pregnancy, its diagnosis, nursing care in the prenatal period, during labour and after birth, furthermore it discussed associated complications and presented theory of needs. The needs of women with multiple pregnancy are specified in the last chapter. The practical part focuses on the biopsychosocial needs of women in all three periods - during pregnancy, during childbirth and after birth period. The research was conducted at the Institute for Mother and Child in Prague - Podolí. The aim of this thesis was to analyze these needs and to identify differences in the experience of pregnancy, childbirth and the after birth period. The method of qualitative research through case studies was chosen. Stated objective was realized on the basis of three research questions - what are the psychosocial needs of women with multiple pregnancies during pregnancy, during delivery and in the postpartum period. Two women were approached for the purpose of this research - primipara (first delivery) and woman who is pregnant for the second time (sekundipara). In the practical part of bachelor thesis was found that multiple pregnancy woman experiences very much like woman with singleton pregnancies. Based on the analysis of interviews with women show that the gestation period of a multiple pregnancy does not have to be more challenging than in women with singleton pregnancy. The needs of women with multiple pregnancies are in many respects identical, pregnant women most commonly reported problems with fatigue, back pain, and increased urge to urinate. More difficult for women is breathing, increased joint pain, limited adopting of a suitable position and the associated discomfort while sleeping. This is due to greater spatial complexity and weight of the fetus. In the question of the need, case reports have shown that respondents have concerns about the course of multiple pregnancy, caesarean section and managing the care for the twins. During all three stages of pregnancy, they felt the greatest need for sufficient information and for communication with the medical staff. The actual delivery of twins women perceive as well as a birth of one child and the needs of women in this stage are similar. Case reports describe two cases of women after caesarean section. Postpartum period is the same as for singleton pregnancies. The fundamental difference is in the care of a newborn and breastfeeding. The answers of the respondents show that education is very important in this area. The research shows how important is quality nursing care, empathy, listening and communication between the medical staff and the client. It is important to work on a positive relationship between the two parties. It's not just about performing routine nursing care of clients, but also about a human approach, warmth and empathy. The conclusion contains highlighted differences between singleton and multiple pregnancies. The results of this work could be useful for the medical staff (midwives and neonatal nurses) for the basic orientation and for the better perspective on the issue. This is mainly because the multiple pregnancy is not so common.
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