Midwifery

src: www.uos.ac.uk

Midwifery is a health sciences and health profession related to pregnancy, childbirth, and childbirth (including newborn care), in addition to their sexual and reproductive health throughout their lives. In many countries, midwifery is a medical profession (especially for independent, independent direct education, do not be confused with medical specialties, which depends on previous general training). A professional in midwifery is known as a midwife.

The 2013 Cochrane Review concludes that "the majority of women should be offered an ongoing midwifery care model and women should be encouraged to request this option although caution should be exercised in applying this advice to women with substantial medical or obstetric complications." The study found that midwifery-led care was associated with reduced epidural use, with fewer episiotomies or instrumental births, and a reduced risk of losing the baby before 24 weeks of gestation. However, care-led midwifery is also associated with the average length of working length measured in hours.

Video Midwifery

Primary obstetric field

Pregnancy

First trimester

Trimester means "3 months." Normal pregnancy lasts about 9 months and has 3 trimesters.

First trimester filtration varies by country. Women are usually offered Pap smears and urine analysis (UA), and blood tests include full blood count (CBC), blood type tests (including Rh screen), syphilis, hepatitis, HIV, and rubella. In addition, women may have chlamydia testing through a urine sample, and women considered to be at high risk for screening for Sickle Cell and Thalassemia. Women must approve all tests before they are done. Blood pressure, height and weight of women are measured. Past pregnancy and family, social, and medical history have been discussed. Women may have ultrasound scans during the first trimester that can be used to help find an approximate due date. Some women may have genetic testing, such as screening for Down's Syndrome. Diet, exercise, and discomfort such as morning sickness are discussed.

Second trimester

The mother visits midwives every month or more often during the second trimester. A partner's mother and/or coach can accompany her. Midwives will discuss the problem of pregnancy such as fatigue, heartburn, varicose veins, and other common problems such as back pain. Blood pressure and weight were monitored and the midwife measured the mother's abdomen to see if the baby grew as expected. Laboratory tests such as UA, CBC, and glucose tolerance tests are performed if midwives feel the need.

Third trimester

In the third trimester, the midwife will see the mother every two weeks until week 36 and every week thereafter. Weight, blood pressure, and stomach measurements will continue. Laboratory tests such as CDC and UA can be performed with additional testing performed for risky pregnancies. Midwife passes woman's abdomen to build lies, presentation and fetal position and then, engagement. A pelvic exam can be performed to see if the mother's cervix is â€‹â€‹enlarged. Midwives and mothers discuss birth options and write birth care plans.

Childbirth

Labor and delivery

Midwives are eligible to assist with normal vaginal delivery while more complicated deliveries are handled by health care providers who have undergone further training. Childbirth is divided into four stages.

First stage of labor The first stage of labor involves the opening of the cervix. At the beginning of this stage the cervix will become soft and thin so as to prepare for the birth of the baby. The first stage of labor is completed when the cervix has dilated as high as 10 cm. During the first stage of labor, the mother begins to feel strong and regular contractions that come every 5 to 20 minutes and last 30 to 60 seconds. Contractions gradually become stronger, more frequent, and more durable.

Second stage of labor During the second stage, the baby begins to move down the birth canal. As the baby moves into the opening of the vagina, "crown", which means the top of the head can be seen at the entrance of the vagina. At one time the "episiotomy", (an incision in the tissue at the opening of the vagina) is done routinely because it is believed that it prevents excessive tears and is more easily curable than natural tears. However, more recent research suggests that surgical incisions may be wider than natural tears, and are more likely to contribute to later incontinence and pain during sex than those that occur in natural tears.

The midwife helps the baby as needed and when it appears fully, cuts the umbilical cord. If desired, the baby's father can cut the cord. In the past the umbilical cord was cut shortly after birth, but there is growing evidence that delayed cord cuts may benefit the baby.

The third stage of labor The third stage of labor is where the mother should deliver the placenta. In order for mothers to do this, they may need to encourage. Just like the contractions in the first stage of labor, they may experience one or two of them. The midwife can assist the mother in giving the placenta by pulling the umbilical cord slowly.

The fourth stage of labor The fourth stage of labor is the period that begins immediately after birth and extends for about six weeks. The World Health Organization describes this period as the most critical and most neglected phase of maternal and infant life. Until now babies are routinely expelled from their mothers after birth, but beginning around 2000, some authorities began to suggest that skin-to-skin contact (putting naked babies in the mother's chest) is beneficial for both mother and baby. In 2014, early skin-to-skin contact is supported by all major organizations responsible for infant health. Thus, to help build the bonding and success of breastfeeding, midwives perform a mother and baby's immediate examination as the infant lies on the mother's breast and moves the baby for further observation only after they get their first milk.

After birth, if the mother has an episiotomy or perineal rupture, she is stitched. Midwives perform routine assessments for uterine contractions, fundal height, and vaginal bleeding. Throughout the delivery and delivery of mother's vital signs (temperature, blood pressure, and pulse rate) are closely monitored and fluid intake and output are measured. Midwives also monitor the baby's pulse, massage the mother's stomach to monitor the baby's position, and perform a vaginal examination as needed. If births deviate from norms at any stage, midwives seek help from more trained healthcare providers.

Birth position

Until the last century most women have used upright positions and alternative positions for childbirth. The position of lithotomy was not used until the advent of forceps in the seventeenth century and since then labor has progressively moved from a woman backed by home experience to medical intervention within the hospital. There are significant advantages to assuming upright positions in labor and delivery, such as stronger and more efficient uterine contractions that help the cervical dilatation, increase inlet pelvis and outlet diameter and increase uterine contractility. Upright positions in the second stage include sitting, squatting, kneeling, and being in the hands and knees.

Postpartum period

For women who give birth at the hospital, the minimum hospital stay is six hours. Women who went before this did so on medical advice. Women can choose when to leave the hospital. Full postnatal assessments are performed on a daily basis during hospitalization, or more frequently if necessary. Postnatal assessment includes female observation, general well-being, breast (both discussion and assistance with breastfeeding or discussion of lactation suppression), abdominal palpation (if she does not have a caesarean section) to check uterine involution, or caesarean section examination (dressing does not need to be removed for this ), her perineum examination, especially if she tears or has stitches, reviews her locally, makes sure she has urinated and defecates open and checks for signs and symptoms of DVT. Babies are also examined for jaundice, signs of adequate feeding, or other concerns. The baby has a nursery test between six and seventy-two hours of birth to check for conditions such as heart defects, hip problems, or eye problems.

In society, community midwives see women for at least ten days. This does not mean that he sees his woman and baby every day, but he can not release them from his care until the tenth day at the earliest. Postnatal examinations include a neonatal screening test (NST, or heel prick test) around the fifth day. Babies are weighed and midwives plan visits according to the health and needs of mothers and infants. They are thrown into the care of health visitors.

Newborn care

At birth, babies receive an Apgar score of at least one minute and five minutes. This is a score of 10 that rates babies in five different areas - each worth between 0 and 2 points. These areas are: color, breathing effort, tone, heartbeat, and response to stimuli. The midwife checks the baby for any obvious problems, weighs the baby, and measures the circumference of the head. The midwife ensures the cable has been securely locked and the baby has the appropriate name tag (if it is in the hospital). Baby length is not measured regularly. The midwife conducts this examination as close as possible to the mother and returns the baby to the mother quickly. Skin-to-skin is recommended, because it regulates baby's heartbeat, breathing, oxygen saturation, and temperature - and improves bonding and breastfeeding.

In some countries, such as Chile, midwives are professionals who can direct a neonatal intensive care unit. This is an advantage for these professionals, as these professionals can use knowledge in perinatology to bring high-quality care to newborns, with medical or surgical conditions.

Maps Midwifery

Midwifery guided midwifery

Midwifery guided midwifery is where one or more midwives have primary responsibility for the continuity of care for women who give birth, with a multidisciplinary consultation and referral network with other health care providers. This is different from "medical-led treatment" in which a gynecologist or family doctor is primarily responsible. In the "collective care" model, responsibilities can be shared between midwives, obstetricians, and/or family doctors. Midwives play a very unique role is part of a very intimate situation with the mother. For this reason, many say that the most important thing to look for in a midwife is their comfort, because someone will go to them with every question or problem.

According to Cochrane's review of public health systems in Australia, Canada, Ireland, New Zealand and the UK, "most women should be offered an obstetric care-led care model and women should be encouraged to request this option despite caution. for women with substantial medical or midwifery complications. "Care-led midwives have the following effects:

reduction in epidural use, with fewer episiotomies or instrumental births.
Longer work duration measured in hours
increases the likelihood of being cared for by a midwife known to women who gave birth to a child
increased chance of spontaneous vaginal delivery
lowers the risk of premature birth
lowered the risk of losing the baby before 24 weeks' gestation, although there seems to be no difference in risk of losing the baby after 24 weeks or overall

There is no difference in the number of cesarean section. All of the trials in Cochrane's review include a licensed midwife, and none of which include a traditional or a traditional midwife. Also, no trial included out of the birth of the hospital.

src: mightyoakmidwifery.ca

History

Ancient history

In ancient Egypt, obstetrics were recognized women's occupations, as evidenced by the Ebers Papyrus dating from 1900 to 1550 BC. These five columns of papyrus are related to obstetrics and gynecology, particularly regarding the acceleration of birth process and the prognosis of newborns. Westcar papyrus, dated 1700 BC, includes instructions for calculating the expected date of the confinement and describing the various styles of birth seats. Bas reliefs in the royal court in Luxor and other temples also attest to the heavy presence of midwifery in this culture.

Midwifery in Greco-Roman times included a wide range of women, including elderly women who continued the medical tradition of the people in the villages of the Roman Empire, trained midwives who gathered their knowledge from various sources, and highly trained women who were considered female physicians. However, there are certain characteristics that are desired in the "good" midwife, as explained by the doctor Soranus of Ephesus in the 2nd century. He declares in his Gynecology that "a suitable man of learning, with his intelligence of him, has a good memory, a loving, noble work and is generally not particularly defective in senses [ie, seeing , olfactory, hearing, limbs, strong voice, and, according to some, has long slender fingers and short fingernails on the tip of his finger. "Soranus also suggests that midwives be sympathetic (though he does not have to bear children alone) and that he keeping her hands soft for the comfort of mother and child. Pliny, another physician of this time, respects the nobility and calm, unattractive nature of a midwife. There appeared to be three midwife "levels" present: The first was technically adept; the latter may have read some texts on obstetrics and gynecology; but the third is highly trained and considered worthy as a medical specialist with concentration in midwifery.

Agnodice or Agnodike (Gr. ????????) is an early history, and possibly apocryphal, a midwife mentioned among the ancient Greeks.

Midwives are known by many different titles in antiquity, ranging from iatrin? (Gr. Nurse), maia (Gr., Midwife), obstetrix (Lat., Obstetrician), and medica (Lat., Doctor). It seems that obstetrics are treated differently at the Eastern end of the Mediterranean basin as opposed to the West. In the East, some women advanced beyond the profession of midwives ( maia ) with a gynecologist (i irosros gynaikeios), translated as female physician ), where formal training is required. Also, there are some medical and educated gynecological channels in the East that are written by women by the Greek name, although these women are few in number. Based on these facts, it would seem that midwifery in the East is a respectable profession where respectable women can earn a livelihood and reward enough to publish works that are read and quoted by male doctors. In fact, a number of Roman legal provisions strongly suggest that midwives enjoy status and remuneration comparable to male doctors. One example of the midwife is Salpe Lemnos, who writes on women's diseases and is mentioned several times in Pliny's works.

However, in western Rome, our knowledge of practical midwives comes primarily from the burial epitaph. Two hypotheses are suggested by looking at a small sample of this tombstone. The first is obstetrics is not a profession of freeborn women from families who have enjoyed the free status of several interested generations; therefore it seems that most midwives are from slaves. Secondly, since most of these graves depict liberated women, it can be proposed that midwives are generally well regarded, and earn enough to earn their freedom. It is not known from these epitaphs how certain slave girls were chosen to be trained as midwives. Slave girls may have been apprentices, and most likely mothers are teaching their daughters.

The actual work of the midwives in primeval times consisted mainly of assisting in childbirth, although they may also have helped with other medical issues related to women when needed. Often, midwives will seek the help of a doctor when a more difficult birth is anticipated. In many cases the midwife carries two or three assistants. In ancient times, it was believed by midwives and doctors that normal births became easier when a woman sat up straight. Therefore, during the birth process, the midwife takes the bench to the house where the birth takes place. In the birth seat there is a crescent-shaped hole where the baby will be born. Birth seats or chairs often have armrests for mothers to grasp during shipping. Most chairs or birth chairs have a back that the patient can suppress, but Soranus points out that in some cases the chairs are unusable and an assistant will stand behind the mother to support him. Midwives sit facing mothers, encourage and support them through birth, may offer instructions for breathing and pushing, occasionally massaging the opening of the vagina, and supporting the perineum during childbirth. The assistants may help by pushing down at the top of the mother's abdomen.

Finally, the midwife receives the baby, puts it in pieces of cloth, cuts the umbilical cord, and cleans the baby. The child is sprinkled with "fine salt and powder, or natron or aphronitre" to absorb the remainder of the birth, rinsed, and then powdered and rinsed again. Furthermore, the midwife cleanses all and all mucus from the nose, mouth, ears, or anus. Midwives are encouraged by Soranus to put olive oil in the baby's eyes to clean up the remains of the birth, and place a piece of wool soaked with olive oil over the umbilical cord. After delivery, the midwife makes a preliminary call on whether the baby is healthy and loads back. He checks the newborn for congenital defects and tests his cries to hear if it's strong and healthy. Ultimately, the midwife makes a determination about the possibilities for the survival of the baby and is likely to recommend that newborns with any severe abnormalities are exposed.

A 2nd century terracotta aid from the tomb of Ostian from Scribonia Attice, wife of surgeon M. Ulpius Amerimnus, detailed the scene of childbirth. Scribonia is a midwife and help shows it in the middle of delivery. A patient sitting in the birth seat, holding the handle and assistant midwife standing behind her provide support. Scribonia sits on a low bench in front of the woman, turning her face while assisting the delivery by widening and massaging the vagina, as driven by Soranus.

Midwife services are not cheap; This fact shows that poor women who can not afford professional midwife services often have to be satisfied with sisters. Many rich families have their own midwives. However, most women in the Greco-Roman world are very likely to receive maternity care from employed midwives. They may be highly trained or have only a basic knowledge of midwifery. Also, many families have a choice of whether they want to employ midwives who practice traditional medicine or newer methods of professional birth. Like many other factors in ancient times, the quality of gynecological care often relies heavily on the socioeconomic status of the patient.

Post-classical history

Sejarah modern

From the 18th century, conflicts between surgeons and midwives emerged, as medical men began to assert that their modern scientific techniques were better for mothers and infants than traditional medicine practiced by midwives. Because doctors and medical associations encourage legal monopoly on obstetric care, obstetrics are strictly prohibited or regulated throughout the United States and Canada. In Northern Europe and Russia the situation is slightly easier - in the Russian Empire in Estonian Duchy, Professor Christian Friedrich Deutsch founded obstetrics school for women at the University of Dorpat in 1811, which existed until World War I. It was a precursor to Tartu Health Care College. The training lasts for 7 months and in the end the certificate for practice is given to female students. Despite allegations that midwives are "incompetent and indifferent", some argue that poorly trained surgeons are much more dangerous for pregnant women. The argument that the surgeon was more dangerous than the midwife lasted until the study of bacteriology became popular in the early 1900s. Women are beginning to feel safer in hospital settings with the amount of help and ease of birth they experience with their doctors. "Doctors trained in the new century find great contrast between hospitals and midwifery practices in women's homes where they can not maintain a sterile condition or get trained help." German social scientist Gunnar Heinsohn and Otto Steiger theorize that obstetrics are subjected to abuse and oppression by public authorities because midwives have very specialized knowledge and skills about not only helping with birth, but also contraception and abortion.

Contemporary

By the end of the 20th century, midwives were recognized as highly trained and specialized professionals in midwifery. However, at the beginning of the 21st century, the medical perception of pregnancy and birth as potentially pathological and dangerous still dominate Western culture. Midwives working in hospitals have also been influenced by this view, although in general they are trained to see birth as a normal and healthy process. While midwives play a much larger role in the care of pregnant women in Europe than in America, the persecuted birth model still has influence in these countries, even though the World Health Organization recommends natural, normal and humane births.

Pregnancy and delivery midwifery models as a normal and healthy process play a far greater role in Sweden and the Netherlands than in other Europe. Swedish midwives stand out because they manage 80 percent of prenatal care and more than 80 percent of family planning services in Sweden. Midwives in Sweden attend all normal births in public hospitals and Swedish women tend to have less intervention in hospitals than American women. The infant mortality rate in the Netherlands in 1992 was the world's tenth lowest level, with 6.3 deaths per thousand births, while the United States ranked twenty seconds. Midwives in the Netherlands and Sweden owe much of their success to supporting government policy.

Midwifery Studies MSc | Middlesex University London

src: www.mdx.ac.uk

References

Note

Bibliography

Craven, Christa. 2007 A "Consumer Right" to Choose a Midwife: A Shift in the Meaning of Reproduction Rights under Neoliberalism. American anthropologist, Vol. 109, Issue 4, pp.Ãƒ, 701-712. At I.L. Montreal and Kingston: McGill-Queens University Press.
Ford, Anne R., & amp; Wagner, Vicki. In Bourgeautt, Ivy L., Benoit, Cecilia, and Davis-Floyd, Robbie, ed. 2004 Reconceiving Midwifery. McGill-Quenn's University Press: Montreal & amp; Kingston
MacDonald, Margaret. 2007 Working in the Field of Birth: Midwifery Narratives on Nature, Tradition, and Home. Vanderbilt University Press: Nashville
Martin Emily (1991). "Eggs and Sperm: How Science Has Built Romantic Based on the Stereotypical Role of Girls". Women's Journal in Culture and Society . 16 (3): 485-501. doi: 10.1086/494680.
(in Dutch) Obstetricians in the city of Groningen.

midwives-1 | Maternity & Midwifery Forum

src: www.maternityandmidwifery.co.uk

External links

Media related to Midwifery in Wikimedia Commons
International Confederation of Midwives (ICM)
Newborn Baby Partnership and Child Health (PMNCH)

Source of the article : Wikipedia

Midwifery

Minggu, 10 Juni 2018

Midwifery

Video Midwifery