Also, no trial included out of hospital birth. 8 History edit Ancient history edit a woman giving birth on a birth chair, from a work by german physician Eucharius rößlin Icon Birth of Mary (detail). Russia, 17th century In ancient Egypt, midwifery was a recognized female occupation, as attested by the Ebers Papyrus which dates from 1900 to 1550 bce. Five columns of this papyrus deal with obstetrics and gynecology, especially concerning the acceleration of parturition (the action or process of giving birth to offspring) and the birth prognosis of the newborn. The westcar papyrus, dated to 1700 bce, includes instructions for calculating the expected date of confinement and describes different styles of birth chairs. Bas reliefs in the royal birth rooms at Luxor and other temples also attest to the heavy presence of midwifery in this culture.
The case for midwifery
In some countries, such as Chile, the midwife is the professional who can direct neonatal intensive care units. This is an advantage for these professionals, because this professionals can use the knowledge in perinatology to bring a high quality care of the newborn, with medical or surgical conditions. Midwifery-led continuity of care edit Clinical midwifery facilitator training midwives "Babies" for student practice midwifery-led continuity of care is where one or more midwives have the primary responsibility for the continuity of care for childbearing women, with a multidisciplinary network of consultation and referral with. This is different from "medical-led care" where an obstetrician or family physician is primarily responsible. In "shared-care" models, responsibility may be shared between a midwife, an obstetrician and/or a family physician. 8 The midwife plays a very unique role is part of very intimate situations with the mother. For this reason, many say that the most important thing to look for in a midwife is comfortability with them, as one will go to them with every question or problem. 21 According to a cochrane review of public health systems in Australia, canada, ireland, new zealand and the United Kingdom, "most women should be offered midwifery-led continuity models of care and women should be encouraged to ask for this option although malayalam caution should be exercised. A longer mean length of labour as measured in hours increased chances of being cared for in labour by a midwife known by the childbearing woman increased chances of having a spontaneous vaginal birth decreased risk of preterm birth decreased risk of losing the baby. All trials in the cochrane review included licensed midwives, and none included lay or traditional midwives.
This is a score out of 10 that assesses the baby on five different areas—each worth between 0 and 2 biography points. These areas are: colour, respiratory effort, tone, heart rate, and response to stimuli. The midwife checks the baby for any obvious problems, weighs the baby, and measure head circumference. The midwife ensures the cord has been clamped securely and the baby has the appropriate name tags on (if in hospital). Babies lengths are not routinely measured. The midwife performs these checks as close to the mother as possible and returns the baby to the mother quickly. Skin-to-skin is encouraged, as this regulates the baby's heart rate, breathing, oxygen saturation, and temperature—and promotes bonding and breastfeeding.
A postnatal assessment includes the woman's observations, general well being, breasts (either a discussion and assistance with breastfeeding or a discussion about lactation suppression abdominal palpation (if she has not had a caesarean section) to check for involution of the uterus, or a check. The baby is also checked for jaundice, signs of adequate feeding, or other concerns. The baby has a nursery exam between six and seventy two hours of birth to check for conditions such as heart defects, hip problems, or eye problems. In the community, the community midwife sees the woman at least until day ten. This does not mean she sees the woman and baby daily, but she cannot discharge them from her care until day ten at the earliest. Postnatal checks include neonatal screening test (nst, or heel prick test) around day five. The baby is weighed and the midwife plans visits according to the health and needs of mother and baby. They are discharged to the care of the health visitor. Care of the newborn edit further information: Newborn At birth, the baby receives an Apgar score at, at the least, one minute and five minutes of age.
midwives in Toronto, midwifery care north Don river Valley
The midwife does regular assessments for uterine contraction, fundal height, 17 and vaginal bleeding. 18 Throughout labor and delivery the mother's vital signs (temperature, blood pressure, and pulse) are closely monitored and her fluid intake and output are measured. The midwife also monitors the baby's pulse rate, palpates the mother's abdomen to monitor the baby's position, and does vaginal checks as needed. If the birth deviates from the norm at any stage, the midwife requests assist from a more highly trained favourite health care provider. Birthing writers positions edit main article: Childbirth positions Until the last century most women have used both the upright position and alternative positions to give birth. The lithotomy position was not used until the advent of forceps in the seventeenth century and since then childbirth has progressively moved from a woman supported experience in the home to a medical intervention within the hospital. There are significant advantages to assuming an upright position in labor and birth, such as stronger and more efficient uterine contractions aiding cervical dilatation, increased pelvic inlet and outlet diameters and improved uterine contractility.
19 Upright positions in the second stage include sitting, squatting, kneeling, and being on hands and knees. 20 Postpartum period edit main article: Postpartum period For women who have a hospital birth, the minimum hospital stay is six hours. Women who leave before this do so against medical advice. Women may choose when to leave the hospital. Full postnatal assessments are conducted daily whilst inpatient, or more frequently if needed.
In the past the cord was cut shortly after birth, but there is growing evidence that delayed cord-cutting may benefit the infant. 14 Third stage of labor The third stage of labour is where the mother must deliver the placenta. 12 In order for the mother to do this they may need to push. Just like the contractions in the first stage of labour they may experience one or two of these. 12 The midwife may assist the mother in delivering the placenta by gently pulling on the umbilical cord.
12 fourth stage of labor The fourth stage of labor is the period beginning immediately after the birth and extending for about six weeks. The world health Organization describes this period as the most critical and yet the most neglected phase in the lives of mothers and babies. 15 Until recently babies were routinely removed from their mothers following birth, however beginning around 2000, some authorities began to suggest that early skin-to-skin contact (placing the naked baby on the mother's chest) is of benefit to both mother and infant. As of 2014, early skin-to-skin contact is endorsed by all major organizations that are responsible for the well-being of infants. 16 Thus, to help establish bonding and successful breastfeeding, the midwife carries out immediate mother and infant assessments as the infant lies on the mother's chest and removes the infant for further observations only after they have had their first breastfeed. Following the birth, if the mother had an episiotomy or a tearing of the perineum, it is stitched.
Certified nurse midwife, wikipedia
12 The first stage of labour is complete when the cervix has dilated the full 10cm. 12 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 longer lasting. Second stage of labor During the second stage the baby begins to move down the birth canal. As the baby moves to the opening of the vagina it "crowns meaning the top of the head resume can be seen at the vaginal entrance. At one time an "episiotomy (an incision in the tissue at the opening of the vagina) was done routinely because it was believed that it prevented excessive tearing and healed more readily than a natural tear. 13 However, more recent research shows that a surgical incision may be more extensive than a natural tear, and is more likely to contribute to later incontinence and pain during sex than a natural tear would have. 13 The midwife assists the baby as needed and when fully emerged, cuts the umbilical cord. If desired, the baby's father may cut the cord.
The midwife palpates the woman's abdomen to establish the lie, presentation and position of the fetus and later, the engagement. A pelvic exam may be done to see if the mother's cervix is dilating. 11 The midwife and the mother discuss birthing options and write a birth care plan. Childbirth edit labor and delivery edit An illustration of normal head-first presentation. The membranes have ruptured and the cervix is fully dilated. Newborn rests as caregiver checks languages breath sounds main article: Childbirth Midwives are qualified to assist with a normal vaginal delivery while more complicated deliveries are handled by a health care provider who has had further training. Childbirth is divided into four stages. First stage of labor The first stage of labour involves the opening of the cervix. 12 In the early parts of this stage the cervix will become soft and thin thus preparing for the delivery of the baby.
partner and/or the labor coach may accompany her. The midwife will discuss pregnancy issues such as fatigue, heartburn, varicose veins, and other common problems such as back pain. Blood pressure and weight are monitored and the midwife measures the mother's abdomen to see if the baby is growing as expected. Lab tests such as a ua, cbc, and glucose tolerance test are done if the midwife feels they are necessary. 10 Third trimester edit In the third trimester the midwife will see the mother every two weeks until week 36 and every week after that. Weight, blood pressure, and abdominal measurements will continue to be done. Lab tests such as a cdc and ua may be done with additional testing done for at-risk pregnancies.
9 First trimester screening varies by country. Women are typically offered a pap friendship smear and urine analysis (ua and blood tests including a complete blood count (cbc blood typing (including Rh screen syphilis, hepatitis, hiv, and rubella testing. 9 Additionally, women may have chlamydia testing via a urine sample, and women considered at high risk are screened for Sickle cell disease and Thalassemia. 9 Women must consent to all tests before they are carried out. The woman's blood pressure, height and weight are measured. Her past pregnancies and family, social, and medical history are discussed. Women may have an ultrasound scan during the first trimester which may be used to help find the estimated due date. Some women may have genetic testing, such as screening for Down's Syndrome.
Acnm - american College of Nurse-midwives)
This article is about the health science and the health profession. For the medical specialty, essay see obstetrics. Midwifery is the health science and health profession that deals with pregnancy, childbirth, and the postpartum period (including care of the newborn 1 in addition to the sexual and reproductive health of women throughout their lives. 2, in many countries, midwifery is a medical profession (special for its independent and direct specialized education; should not be confused with the medical specialty, which depends on a previous general training). A professional in midwifery is known as a midwife. A 2013, cochrane review concluded that "most women should be offered midwifery-led continuity models of care and women should be encouraged to ask for this option although caution should be exercised in applying this advice to women with substantial medical or obstetric complications." 8, the. However, midwifery-led care was also associated with a longer mean length of labor as measured in hours. 8, contents, main areas of midwifery edit. Pregnancy edit, main articles: Pregnancy and, prenatal care, first trimester edit Trimester means "3 months." A normal pregnancy lasts about 9 months and has 3 trimesters.