g.c. rijninks van driel msc rm
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European Midwives Association . Postnatal care . G.C. Rijninks van Driel MSc RM. 2005/36/EC directive. European Midwives Association. Provision of sound family planning information and advice - PowerPoint PPT PresentationTRANSCRIPT
G.C. Rijninks van Driel MSc RM
Postnatal care European Midwives Association
2005/36/EC DIRECTIVE European Midwives Association
Provision of sound family planning information and advice
Diagnosis of pregnancies and monitoring normal pregnancies; carrying out the examinations necessary for the monitoring of the development of normal pregnancies
Prescribing or advising on the examinations necessary for the earliest possible diagnosis of pregnancies at risk
Provision of programmes of parenthood preparation and complete preparation for childbirth including advice on hygiene and nutrition
2005/36/EC DIRECTIVE European Midwives Association
Caring for and assisting the mother during labour and monitoring the condition of the foetus in utero by the appropriate clinical and technical means
Conducting spontaneous deliveries including where required episiotomies and in urgent cases breech deliveries
Recognising the warning signs of abnormality in the mother or infant which necessitate referal to a doctor and assisting the latter where appropriate; taking the necessary emergency measures in the doctor’s absence, in particular the manual removal of the placenta, possibly followed by manual examination of the uterus
2005/36/EC DIRECTIVE European Midwives Association
Examining and caring for the newborn infant; taking all initiatives which are necessary in case of need and carrying out when necessary immediate resuscitation
Caring for and monitoring the progress of the mother in the postnatal period and giving all necessary advice on infant care to enable her to ensure the optimum progress of the newborn infant
Carrying out treatment prescribed by doctors Drawing up the necessary written reports
POSTNATAL CARE SURVEY Survey conducted after the EMA AGM in Slovenia
in 2009. Developed by Marianne Mead, in collaboration
with Susanne Simon and Kerstin Belfrage Bristol on Line december 2009- january 2010 Corrections by March 2010 25 countries participated:
… Austria, Belgium, Croatia, Cyprus, Denmark, Estonia, Finland, France, FYR Macedonia, Germany, Greece, Ireland, Italy, Latvia, Luxembourg, Malta, Norway, Portugal, Slovakia, Slovenia, Spain, Sweden, The Netherlands, Turkey and the United Kingdom
European Midwives Association
NUMBER OF PROFESSIONALS
Estonia The Netherlands
Midwives 540 2444Midwives in association
220 2170
General Practitioners
853 8760
Obstetricians 272 739Paediatricians 241 1090
European Midwives Association
BIRTH STATISTICS
Estonia The Netherlands
Births 16.109 170.494Spontaneous vaginal births
74.8% 75%
CS rate 20.2% 15.1%
European Midwives Association
PROFESSIONALS PER 1000 BIRTHS
European Midwives Association
Estonia Netherlands0
5
10
15
20
25
30
35 34
1417
4
midwivesobstetricians
LENGTH OF TIME OF CARE Most EU countries the “ legal definition” of
the postnatal period is 42 days (6 weeks) However length of time postnatal care by
midwife
European Midwives Association
Estonia The Netherlands
Day 1 > 90% > 90%Day 2 > 90% > 90%Day 3 75-90% > 90%Day 4 and 5 10-25% > 90%Day 7 < 5 % > 90%> Day 9 < 5 % < 5%
PROVISION OF CARE Estonia:
… At home… Public hospital … Private hospital … Health centre
The Netherlands:… At home… Public hospital… Birth centre… Health centre
European Midwives Association
REQUIRED EXAMINATION Estonia:
… Mother gynecologist (midwife)… Baby GP or paediatrician
The Netherlands:… Mother none… Baby none
European Midwives Association
MATERNAL CHOICE Estonia:
… Midwife, but not as the only professional… GP… Obstetrician
The Netherlands:… Midwife, can be the only professional… GP… Obstetrician, in case of pathology
European Midwives Association
MATERNAL CAREObservations Estonia NetherlandsHistory taking Midwife MidwifeTemperature Midwife HCAPulse Midwife HCABlood pressure Midwife MidwifeFundal height Midwife HCALochia Midwife HCAPerineum Midwife HCA / midwifeBreasts Midwife HCABreast feeding Midwife HCAArtificial feeding Midwife HCAMental health Midwife MidwifePostnatal depression screening
- -
Maternal nutrition Midwife HCA
European Midwives Association
NEONATAL CAREObservations Estonia NetherlandsGeneral examination Paediatrician MidwifeTemperature Midwife HCAHeart rate Paediatrician MidwifeRespiration Paediatrician MidwifeFeeding assesment Midwife MidwifeBreast feeding advice Midwife HCAArtificial feeding advice
Midwife HCA
Weight Midwife HCAHeel prick Midwife Public Health
NurseBaby bath demonstration
Midwife HCA
European Midwives Association
FAMILY PLANNING
By midwife or by other health professionals? Estonia:
… By midwife 10-25%… Most likely other: obstetrician in hospital
The Netherlands:… By midwife 75-90%… Most likely other: obstetrician in hospital
European Midwives Association
POSTNATAL CARE IN THE NETHERLANDS
96.4 % of all women have a part of their postpartum period at home with help of health care assistant
After a normal delivery in hospital they go home within 6 to 12 hours
After a CS they go home after 4 to 5 days
After homebirth 80% breastfeeding
After hospital birth 63% breastfeeding
DUTCH TRADITIONS
“ Beschuit met muisjes”
DUTCH TRADITIONS
We believe baby's are brought by storks…….
And decorate our houses to announce a baby arrived….
DUTCH TRADITIONS
Family visiting
Announcement of birth
Postnatal care visits
THE DUTCH MIDWIFE IN PRIMARY CARE
QUESTIONS? European Midwives Association