1. Read the following description: Charlotte and Chandler are expecting their fi
ID: 3509882 • Letter: 1
Question
1. Read the following description:
Charlotte and Chandler are expecting their first child in two months. They have been told they are having a boy. They live in a rural part of Mississippi. They have been together as a couple for a little over a year. They are not married and both are not sure whether or not they would like to be in the future. The couple lives together in a small, one bedroom house. Charlotte is 21 years-old and is a student at the local community college. She had a full-time job at a retail store that she recently quit. She is considered a good student, as usually makes As and Bs. She plans to continue to pursue her degree after the baby is born. Chandler is 22 years-old, and never finished high school. He has no plans to earn his GED and he works odd-jobs within the construction field. Although neither of them had health insurance, Charlotte signed up for Medicaid benefits when she found out she was pregnant. Now on Medicaid, she routinely sees her OB/GYN.
Both Charlotte and Chandler are emotionally close to their own parents. They both come from middle class families. All of their parents work and are not able to financially contribute to the couple’s income on a regular basis. Although their parents are emotionally supportive to them, they don’t give them a lot of guidance about how to handle things in life or how to deal with their situation as a couple.
Charlotte and Chandler have been arguing a lot over money and role expectations. Chandler takes on extra jobs to earn more money. Charlotte doesn’t like him taking extra jobs because it takes away from the time they can spend together. Charlotte wants Chandler to stay home with her more as she feels lonely and sad due to the changes that are occurring to her body and her life. Chandler spends more time away from the house to get away from the negativity he feels when he is around Charlotte. This leads Charlotte feeling even lonelier. She reacts by fighting with Chandler when he is home, which drives him further away. Both feel they are under tremendous stress that the other one doesn’t understand.
Although Charlotte wants to stop, she has continued to smoke cigarettes throughout the pregnancy. She also worries about gaining too much weight. She often skips meals and eats snacks throughout the day including chips, crackers, and cheese. She also drinks large amounts of Mountain Dew. She has stopped taking her prenatal vitamins since they make her feel more nauseated.
Her doctor has informed her that she needs to take care of herself better by getting rest, eating well, and watching her blood pressure. The doctor is unaware of her unhealthy habits. He has been concerned that Charlotte has not gained weight throughout the pregnancy like expected. She in turn is hoping that the baby will be born early so that she won’t have to gain as much weight or go through the pain of labor that she is anticipating.
Neither, Charlotte or Chandler, are prepared for when the baby comes home. Both are the youngest in their own families and have very limited experience with newborns and children in general. Neither has taken a child preparation class or read any books about parenting. They both think they will “wing” it, but are really depending on their own mothers to guide them. When asked about caregiving, neither of them has made any realistic plans for the near future.
From what you have learned this semester (coming from e-text and Power Points), compose a 2-3 page typed report (single-spaced, no larger than a 12 point font) that addresses the following:
Discuss infant mortality rates and main causes of death during infancy.
Identify the protective factors (things are favorable for healthy development) for this child based on the hypothetical couple description above.
Identify the risk factors (things that are unfavorable for healthy development) for this child based on this hypothetical couple description above.
Discuss how the factors you identified are related to infant mortality rates.
Identify what other things must be considered that the hypothetical description did not address.
State your opinion on whether or not you think this child would live to see his first birthday. Explain/support your position.
Explanation / Answer
Premature birth is the biggest contributor to the Infant Mortality. Other leading causes of infant mortality are birth asphyxia, pneumonia, term birth complications such as abnormal presentation of the foetus umbilical cord prolapse, or prolonged labor, neonatal infection, diarrhea, malaria, measles and malnutrition. One of the most common preventable causes of infant mortality is smoking during pregnancy.Many factors contribute to infant mortality, such as the mother's level of education, environmental conditions, and political and medical infrastructure. Improving sanitation, access to clean drinking water, immunization against infectious diseases, and other public health measures can help reduce high rates of infant mortality.
Low birth weight makes up 60–80% of the infant mortality rate in developing countries. The New England Journal of Medicine stated that "The lowest mortality rates occur among infants weighing 3,000 to 3,500 g (6.6 to 7.7 lb). For infants born weighing 2,500 g (5.5 lb) or less, the mortality rate rapidly increases with decreasing weight, and most of the infants weighing 1,000 g (2.2 lb) or less die. As compared with normal-birth-weight infants, those with low weight at birth are almost 40 times more likely to die in the neonatal period; for infants with very low weight at birth the relative risk of neonatal death is almost 200 times greater." Infant mortality due to low birth weight is usually a direct cause stemming from other medical complications such as preterm birth, poor maternal nutritional status, lack of prenatal care, maternal sickness during pregnancy, and an unhygienic home environments.[10] Along with birth weight, period of gestation makes up the two most important predictors of an infant's chances of survival and their overall health.
According to the New England Journal of Medicine, "in the past two decades, the infant mortality rate (deaths under one year of age per thousand live births) in the United States has declined sharply." Low birth weights from African American mothers remain twice as high as that of white women. LBW may be the leading cause of infant deaths, and it is greatly preventable. Although it is preventable, the solutions may not be the easiest but effective programs to help prevent LBW are a combination of health care, education, environment, mental modification and public policy, influencing a culture supporting lifestyle. Preterm birth is the leading cause of newborn deaths worldwide. Even though America excels past many other countries in the care and saving of premature infants, the percentage of American woman who deliver prematurely is comparable to those living in developing counties.
Malnutrition is a primary factor contributing to the complications of both diarrhea and pneumonia, although the causal links and mechanisms remain unclear. Factors other than nutrition also influence the incidence of diarrhea, including socioeconomic status, disruption of traditional lifestyles, access to clean water and sanitation facilities, age and breastfeeding status.
Protein energy malnutrition and micronutrient deficiency are two reasons for stunted growth in children under five years old in the least developed countries. Malnutrition leads to diarrhea and dehydration, and ultimately death. Millions of women in developing countries are stunted due to a history of childhood malnutrition. Protein-energy deficiency results in low-quality breastmilk that provides less energy and other nutrition.
Vitamin A deficiency can lead to stunted growth, blindness, and increased mortality due to the lack of nutrients in the body. Two hundred and fifty million infants are affected by Vitamin A deficiency. Among women in developing countries, 40% have iron deficiency anemia, which increases maternal and infant mortality rates, chances of stillbirth, cases of low birth weight babies, premature delivery, and probability of fetal brain damage. One way to prevent Vitamin A deficiency is to educate the mother on the many benefits of breastfeeding. Breastmilk is a natural source of Vitamin A, and supplies the suckling infant with enough Vitamin A.
Bacterial infections of the bloodstream, lungs, and the brain's covering (meningitis) are responsible for 25% of neonatal deaths. Newborns can acquire infections during birth from bacteria that are present in their mother's reproductive tract. The mother may not be aware of the infection, or she may have an untreated pelvic inflammatory disease or sexually transmitted disease. These bacteria can move up the vaginal canal into the amniotic sac surrounding the baby. Maternal blood-borne infection is another route of bacterial infection from mother to baby. Neonatal infection is also more likely with the premature rupture of the membranes (PROM) of the amniotic sac.
Seven out of ten childhood deaths are due to infectious diseases: acute respiratory infection, diarrhea, measles, and malaria. Acute respiratory infection such as pneumonia,bronchitis, and bronchiolitis account for 30% of childhood deaths; 95% of pneumonia cases occur in the developing world. Diarrhea is the second-largest cause of childhood mortality in the world, while malaria causes 11% of childhood deaths. Measles is the fifth-largest cause of childhood mortality. Folic acid for mothers is one way to combat iron deficiency. A few public health measures used to lower levels of iron deficiency anemia include iodize salt or drinking water, and include vitamin A and multivitamin supplements into a mother's diet. A deficiency of this vitamin causes certain types of anemia (low red blood cell count).
In this case, since the mother of the child is young and no uterine complications have been mentioned, it could be expected that there is no major cause of preterm labour. However, she has to rest properly and foliow all the instructions of Doctor. Proper nutrititous eating and taking the pre-natal medicines is important for ensuring correct birthweight of baby, but this Charlotte has not done. Still now two months are left for delivery, so still there is chance for increasing the birthweight of the baby. Charlotte has also been smoking in her pregnancy, which could lead to malformations in the baby. However, this could be revealed by the ultrasound reports.
It is also mentioned above that there is a reason of mental stress in the mother and other members of the family. But it could be managed easily through an unstressful workout by Charlotte, which would increase the income. But, in brief it could be mentioned some of the factors like Charlotte's smoking is a reason which has considerably increased the chances of infant mortality. However, there is chance to rectify the other factors. Breast feeding of the baby have also to be done regularly. Still there are equal chances, that the child could survive.
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