Chapter 2: Treating health problems
Celeste’s steps for finding causes
1. Start with a doubt.
A young pregnant woman named Elena came to her midwife, Celeste,
for care. During the checkup, Elena said that she felt tired all the time.
First, Celeste acknowledged that she did not know what was making
Elena tired.
2. Think of all the possible causes.
Celeste knew that being tired can be caused by many
things. Sickness, hard work, not enough sleep, stress,
and anemia are some of the most common causes.
3. Look for signs to find the likely cause.
Celeste asked Elena questions to find out more about the tired feeling.
Are you
working more
than usual?
I work hard,
but no harder
than usual.
Are you
sleeping less?
Do you feel ill?
I’m sleeping
enough, and do
not feel ill.
Celeste also asked Elena what she usually ate. Elena said that she
mostly ate maize and beans every day. Actually, mostly just maize.
Elena complained of the high cost of buying meat.
Celeste checked Elena’s physical signs. Elena had pale eyelids and
gums and a fast, weak pulse — all signs of anemia.
14 A Book for Midwives (2010)