Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
AND SCOPE OF
MIDWIFERY
PRACTICES
SUBMITTED TO
SUBMITTED BY
MRS.JESMI JOHN
MRS.LEKSHMI P
SENIOR LECTURER
YEAR MSC NURSING
JOSCO COLLEGE OF NURSING
COLLEGE OF NURSING
1 ST
JOSCO
SUBMITTED ON 06 /11/2013
INTRODUCTION
The role of a midwife whether she practices in hospitals, health centers, or
domiciliary conditions has been recognized as one of the most rewarded job.
Her function carries great responsibilities and demands, specific knowledge
and skills. They play a central role in health care delivery- promotion,
prevention, treatment and rehabilitation, in areas of great health needs,
especially in remote areas. The midwife may practice in any setting
including the home, the community, hospitals, or in any other maternity
services. In all settings the midwife remains responsible and accountable for
the care she provides.
DEFINITIONS
According to ICM membership (International confederation of midwives) and
joint study group of maternity care and WHO, the term midwife id defined as
Primary level
Care would be provided in the community, birth center public
maternal unit and private hospitals or in combination.
E.g. Women would receive all her antenatal care in the community, labour
and child birth would be in hospitals.
Secondary level
Provide additional care during the antenatal, labour and birth and
postnatal period for women and babies who experience complications and
who have clinical needs for referral or transfer
Tertiary level
These services provide multidisciplinary specialist team for women and
babies with complex and or rare feto-maternal needs who require access to
specialist services.
These services provide multidisciplinary specialist team for women and
babies with complex and or rare feto-maternal needs
The care provided at health center, large or small, include capabilities for
Obstetric first aid
Administration of antibiotics, oxytocin and anticonvulsant.
Basic emergency obstetrical care
Along with obstetrical first aid
P h a s e IIIIII
The nurse midwife plays an important part in all areas of womens health
care. The scope of midwife can be explained through their role in the
following field namely;
1.
2.
3.
4.
PRECONSUPTION CARE
Preconception care is the care that the women receive before she gets
pregnant. It involves finding and taking care of any problem that may affect
the women and her baby later. By taking action on health issue before
pregnancy, any future problem to the mother can be prevented. When a
couple is seen and counseled about pregnancy, its course and outcome well
before the time of actual conception is called preconception counseling.
Objective is to ensure that women enter pregnancy with an optimal state of
health which would be safe both to herself and the fetus. The three aspects
included in the preconception care are educational, informational and
eugenics.
Educational
Education should be provided on ideal age of pregnancy. Patient with
medical condition should be educated about the effect of disease on
pregnancy. The couple should be educated about avoiding the hazardous
working environment. Women should be urged to stop smoking, taking
alcohol and abusing drug. Couple should be also educated to do life style
modifications.
Informational
Preconception care include helping to assess and identify
Nutritional status: supplement of folic acid or supplementation of
micronutrients such as iron, iodine and folic acid
Pre existing medical condition: treatment of conditions such as obesity,
diabetes, epilepsy, hypothyroidism and hypertension.
Infectious diseases: vaccination against rubella, varicella, hepatitis B;
screening for HIV/AIDS and other sexually transmitted infections
Family planning for appropriate timed pregnancy
Drugs used are verified and changed if required
Maternal health is optimized.
Eugenics
It is the science of improving a population by controlled breeding to increase
the occurrence of desirable heritable characteristics. Its a belief to improve
the qualities of human species or a human population, especially by means
of discouraging reproduction by persons having genetic defect or presumed
to have inheritable undesired traits(negative eugenics) or encouraging
II.
III.
IV.
V.
VI.
VII.
6. Chest X-ray
7. Pap test
8. Gonorrhea test if needed
On subsequent visit
Physical examination (weight gain, blood pressure)
Laboratory test should include urine examination, hemoglobin
estimate
Iron and folic acid supplement and medication as needed
Immunization against tetanus
Group or individual instruction on nutrition, family planning, self care,
delivery and parenthood.
Referral services, where necessary.
Antenatal advices on Diet
Rest and sleep
Clothing
Dental care
Care of breast
Travel
Smoking and alcohol
General advice
NEWBORN CARE
Immediate care
Neonatal assessment
General appearance
RESEARCH ABSTRACT
A study was conducted to assess the scope and practice among staff nurse
in Gujarat and the study revealed that the scope is limited as compared to
international standards of midwives. Their right to practice was not legally
defined, but they were not specially prohibited from practice. As a
consequence the staff nurse faced loss of skills as their practice was
restricted. The clinical midwifery education of nursing and midwifery
student was marginalized because the education of medical students was
given priority, and the students got only exposed to restricted practice of
staff nurse.
CONCLUSION
The midwife is a person who has undergone a prescribed training and has
been certified by a statutory body appointed by a national government to
undertake the responsibility of giving the necessary care and advice to
women during pregnancy, labour and postnatal period. In this topic the
various position handled by the midwife and their role in providing care to
the mother and child is discussed.
BIBLIOGRAPHY
Textbook
www.midwiferycouncil.health
www.nursingtimes.net
Nursingcareers.nhsemployer.org
www.nfpa.org
www.midwiferyjournal.com