Prenatal Care as it Relates to the Amish Community
Prenatal Care as it Relates to the Amish Community
Prenatal care is essential as it aids in the early detection of potential concerns and mitigating pregnancy and birth complications. The frequency of prenatal care depends on a woman’s pregnancy period and the risks of pregnancy complications. Scheduling of care services depends on the facility and the personal care provider. The paper will detail risk assessment, health promotion, and therapeutic intervention components of prenatal care, its relation to the Amish values, and values and beliefs to consider when handing Amish patients.
Risk assessment in pregnancy is paramount as it helps predict if a woman is at risk of experiencing adverse health events. In risk assessment, providers can determine the women at risk and administer risk-appropriate prenatal care. From several studies, women’s birth experiences are marked by various feelings, sometimes contradictory (Chin et al., 2021). Women emphasize being safe in the journey of their pregnancy. Multiple tools are used when assessing risk in prenatal care, including Pregnancy Risk Assessment Monitoring System (PRAMS). PRAMS is a surveillance project developed by the CDC. This tool gathers information from the general population about women’s experiences before, during, and after pregnancy. It aids in planning and reviewing programs to mitigate complications among expectant women (Chin et al., 2021).
Health promotion and education
Health promotion and education are essential parts of the pregnancy period. Health promotion is the process of empowering individuals to acquire control and enhance their health. Health education includes a wide range of learning experiences to assist patients in improving their health through expanded knowledge and attitude influence. Health promotion and education prepare women for reducing risks related to pregnancy and during childbirth, appropriate health-seeking behavior, newborn care, and parenting (Adams et al., 2017). Health education aids in warning about danger signs of pregnancy, their causes, and actions to take when these symptoms are noticed. Therapeutic interventions for pregnant women depend on the types of concerns they are experiencing. Some concerns include the stress of motherhood and the associated responsibilities (Stoll et al., 2018). The support of a therapist or a counselor during the pregnancy period helps such women relax and feel at ease. Women who experience psychosis require individual therapeutic intervention, while group therapy can also be done for a group of women with similar challenges (Stoll et al., 2018).
Prenatal practices in Amish women are highly influenced by their culture. The Amish culture does not routinely practice clinic-based prenatal care in the first trimester. They, however, opt for community midwife services during their pregnancy. From a study, most Amish women begin their prenatal care late in the second trimester of pregnancy. The Amish community has different beliefs regarding health care, preventive care, and lifestyle than other communities. The Amish fail to seek essential prenatal care practices, including risk assessment, health promotion and education, and interventions, due to their perception that outsiders will attempt to replace their beliefs and practices with others. The Amish people do not oppose modern medicine but believe they are entitled to take care of their community and do what best fits their needs. Although their willingness to seek health services varies from family to family, they do not accept outside help and prefer to pay cash for any health services they receive (Anderson & Potts, 2020).
Health care practices for the Amish community are significantly varied from the rest of the communities, led by their traditions, values, and religious and cultural beliefs. Amish people believe in the health care system, inclusive of traditional remedies passed from generation to generation. The Amish people distrust the modern pharmaceutical industry and opt for natural treatment methods such as CAM. Complementary and alternative healthcare and medical practices (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered part of conventional medicine. Today, CAM practices may be grouped within five major domains: alternative medical systems, mind-body interventions, biologically-based treatments, manipulative and body-based methods, and energy therapies. The Amish believe drug prescriptions are powerful, expensive, and have undesirable side effects. In cases of an adverse event and an urgent need for modern intervention, such as during surgery, is needed, the Amish people still recommend they be used together with CAM (Anderson & Potts, 2020).
In the Amish community, children are viewed as gifts from God, and they view fertility as a gift given to a family and the community. They care for and religiously raise their children, preparing them for eternal life. Lastly, the Amish community does not believe in using birth control methods, and they believe that birth controls contradict the work of God. They strongly oppose therapeutic abortions and invasive prenatal diagnostic testing and highly value Amish folk wisdom. A care provider must observe these believes and practices when offering prenatal education not to conflict with Amish beliefs and enhance trust and respect amongst them in care (Anderson & Potts, 2020).
Prenatal care is essential for the well-being of a mother and infant. It serves to mitigate pregnancy complications by early detection of potential health concerns and administering appropriate risk-preventive measures. Prenatal practices include risk assessment, which entails addressing any possible pregnancy complication. Health promotion and education include promoting health-seeking behaviors among pregnant women and the importance of prenatal care. Therapeutic interventions assist women suffering from mental conditions related to pregnancy. The Amish community has a different perspective regarding prenatal care and only seeks it in their late periods of pregnancy. Community beliefs, values, and practices such as family planning should be observed when offering prenatal education to Amish patients.
Adams, S. H., Gregorich, S. E., Rising, S. S., Hutchison, M., & Chung, L. H. (2017). Integrating a nurse‐midwife‐led oral health intervention into Centering Pregnancy prenatal care: results of a pilot study. Journal of midwifery & women’s health, 62(4), 463-469.
Anderson, C., & Potts, L. (2020). The Amish health culture and culturally sensitive health services: An exhaustive narrative review. Social Science & Medicine, 265, 113466.
Chin, H. L., O’Neill, K., Louie, K., Brown, L., Schlade‐Bartusiak, K., Eydoux, P.,& Jones, S. J. (2021). An approach to rapid characterization of DMD copy number variants for prenatal risk assessment. American Journal of Medical Genetics Part A, 185(8), 2541-2545.
Stoll, K., Swift, E. M., Fairbrother, N., Nethery, E., & Janssen, P. (2018). A systematic review of nonpharmacological prenatal interventions for pregnancy‐specific anxiety and fear of childbirth. Birth, 45(1), 7-18.
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The subgroup of Amish people is the largest growing group in America. There is an alarming need to understand the Amish heritage and culture so we can provide the best medical practice to them (Harder, 2021). We need to understand their beliefs in the medical field. Previous studies indicate that Amish women would like more information on prenatal care and pregnancy emergencies (Rohr, et al, 2019). Amish people believe is that the biblical mandate is to have a life separate from the world free of sin. Their house does not have electricity no are they able to have electronic devices, but some are open to using new technology if promoting health or necessity for their income. Most children do not get any education past middle school. Most medical cases for Amish are usually injuries from equipment or from transportation accidents (Purnell, et al, 2013). There is a great respect for obedience and disciple in the community (Rohr, et al, 20190).
The Amish feel that a gift of a child is a gift from God, most families have an average of seven children. Birth control is look down at, as it interferes with God’s plan for the family (Purnell, 2013). With our family in our case study the need to understand the living situation and environment the family is living in is a main concern. We need to understand any factors in the premature birth of the baby, was any of the other children born premature and did they have similar illnesses at the same age. We will also want to understand how long the infant has been sick. We need to know if the mother was exposed to tobacco or any other toxin that cause birth defects. Amish prefer to have home births which could lead to more complications. The Amish communities due have midwifes to help with the home births. If women can feel comfortable with their providers to share their prenatal care, we can offer support. It comes down to communicating and finding the patient-doctor comfort zone. Some women will not be seen unless the male is with them (Purnell, 2013). In forming a bond with patients, it is important to stop and let them communicate, so they do not feel rushed or disrespected during the visit (Rohr, et al, 20190).
Safety would be the upmost important are to discuss with not just prenatal care but with their lifestyle in whole. They use wood burning fireplaces and oil lamps, we would want to discuss fire safety and how to treat injuries from farming or house chorus and burns. We want to have the Amish patients to feel comfortable with discussing any issues they may come into in their lives, there are some studies that discuss abuse. There personal and sexual life is not something they can usually discuss or will feel comfortable with, so gaining their trust and looking for signs of abuse will be key and need to be approached delicately (Harder, 2021).
Harder, J. (2021). Understanding and Partnering with Amish Communities to Keep Children Safe. Child Welfare, 99(1), 69.
Purnell, L.D., & Paulanka, B. J (2013). Transcultural health care: A culturally competent approach. (4th ed.). Philadelphia: F.A. Davis Co. ISBN: 9780803637054
Rohr, J. M., Spears, K. L., Geske, J., Khandalavala, B., & Lacey, M. J. (2019). Utilization of Health Care Resources by the Amish of a Rural County in Nebraska. Journal of Community Health, 44(6), 1090–1097. https://doi.org/10.1007/s10900-019-00696-9
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