Sindhu Sebastian

Lecturer
FMCON
Midwifery is as old as the history of human species.
Mid With
Wife - Woman

The art of assisting woman
in child birth
The definition term midwife was developed by
international confederation of midwives in
1972.
Midwife: A midwife is a person who, having been
regularly admitted to a midwifery educational
programme, duly recognized in the country in which it
is located, has successfully completed the prescribed
courses or studies in midwifery and has acquired the
requisite qualifications to be registered and or legally
licensed to practice midwifery.(WHO 1992)

Midwifery: is the knowledge necessary to perform the
duties of a midwife.

Obstetrics is a branch of medicine
concerned with the treatment of women
during pregnancy, childbirth birth.






Nursing encompasses autonomous and
collaborative care of individuals of all ages,
families, groups and communities, sick or well
and in all settings. Nursing includes the
promotion of health, prevention of illness, and
the care of ill, disabled and dying people.
Advocacy, promotion of a safe environment,
research, participation in shaping health policy
and in patient and health systems management,
and education are also key nursing roles. (ICN
2002)


Obstetrical nursing : Nursing care given to the
pregnant patient before, during, or after
childbirth.

Midwifery today:
Midwifery education & practice go beyond scope
of practice Outlined in the definition.
Nurse- midwifery
Education- midwifery + nursing+
medicine
Practice- all midwifery + components of nursing+
medicine


QUALITIES OF MIDWIVES
Skill full
Able to assess the women
Health educator
Managing care ability
Professionally competent
good communicator
Team spirit
Counselor

Midwifery is as old as the history of human
species
Archeological evidence of a women in squatting
in childbirth supported by another women from
behind existence of midwifery in 5000 BC
References in old testament
- Hebrew midwives

Hippocrates (460 BC) trained &
Supervised midwives
Aristotle(384-322BC) discussed the
essential qualities of midwife


Soranus -2
nd
centuaryspecialized in OBG
5
th
-15
th
century untrained midwives controlled
practice of midwifery.
In 1513 first book on midwifery was printed in
Germany based on teaching of Soranus (2
nd

century first to specialize OBG-1,500 years).
1540 translated in English (used for 150 years)
doctors excluded from labor room &
midwives assisted in childbirth)
Ambroise Pare founded a school for
midwives in Paris

Louise Bourgeos a midwife recommended
induction of labor for pelvic contraction.

Julius Caeser Aranzi wrote first book for
Italian midwives-17

editions. Advised cesarean
section for contracted pelvis. But term had
come from Latin word caedere means to cut.

William Harvey (1578-1657), father of British
midwifery,wrote 1
st
English textbook on
midwifery. He described fetal circulation and
placenta. First to deliver placenta by massaging
the uterus

French king Louis XIV (1663)
employed a Paris surgeon to attend
his mistresses in labour- honoured with
name accouchear -a person who assists
women in childbirth.

Mauriceau (physician) in
published a Treatise on
midwifery. He
described attitude
of fetus in uterus

Hugh Chamberlen -1965
designed obstetrical forceps.


William smellie explained
labour process .



Pelvimetry, Cephalometry
Forceps delivery

The midwifery chair was
founded in 1726 in university
Edinburgh.
John Leake replaced it with
delivery beds
Charles White stated
that puerperal fever was infectious
and Gordon explained puerperal sepsis
Fielding Ould described normal labour and
performed episiotomy.
Francois recognized fetal heart sound.
James Young used Chloroform first in
obstetrics for anesthesia.
Florence Nightingale conducted training for
midwives in 1862.
Semmelweiss demonstrated causes &
preventive measures for puerperal sepsis.
Louis Pasteur wrote a thesis on it demonstrating
presence of Streptococci in Lochia.
Spencer & Ballyantyne promoted concept of
antenatal care for pregnant women.
Munro Kerr 1926 introduced technique LSCS.
DEVELOPMENT OF MATERNITY SERVICES IN
INDIA
Earlier midwifery was practised by Dais.
In early part of 20
th
century changes in
practices began to occur.
Health Organization
Director General of IM
services+ Surgeon General of
Civil hospitals in States

Administration & maintenance
of associated institutions
Public heath commissioner +
Sanitation Commissioner in
States


Preventive health services
The All India Institute of Hygiene &
Public Health established in 1930 under
Rockefeller foundation which provided
programms for MCH.

1943- Govt. appointed Bhore committee which
recommended PHC for every 40,000 population with
having staff of each unit: 1 institutional nurse, 4
midwivwes & 4 trained dais. Programs for TD & ANMs
were started based on its report.


Training programs for nurses were
Mainly in mission hospitals.



Christian medical College Hospital
Vellore in
Tamil Nadu had nurses training program.
NSs of Mission Hospitals felt need for an organization
of their own by 1911.
1931- a formal institution of nurses was started- Nurses
Auxiliary of Christian medical Association of
India(CMAI)
1964- renamed as Nurses League. They had 2 boards of
nsg.education.
Mid India B.N.E+ B.N.E, south India branch.They had
GNM +ANM courses
1949- Indian Nursing Council
(INC) was Constituted.
It formulated standards for
Nsg.Educ.in the country.
During last five decades N.Edu has advanced.
Midwifery training is included into 3 yr basic
general nsg.program i.e diploma in nsg &
midwifery.
ANM program 2 yrs & MHW-multipurpose
health worker program- 18 months
B.SC+ M.SC courses are also available now.
Edu & practice in institutions approved by SNC
+ INC are mandatory for practicing nsg
+midwifery.