introduction to obg

7/21/2019 Introduction to OBG

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Sindhu Sebastian

Lecturer

FMCON

WELCOME


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MIDWIFERY

Midwifery is as old as the history of human species.


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MEANING

Mid With Wife - Woman

The art of assisting woman

in child birth


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The definition term midwife was developed byinternational confederation of midwives in1972.


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DEFINITION Midwife: A midwife is a person who, having been

regularly admitted to a midwifery educationalprogramme, duly recognized in the country in which itis located, has successfully completed the prescribed

courses or studies in midwifery and has acquired therequisite qualifications to be registered and or legallylicensed to practice midwifery .(WHO 1992 )

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


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CONTINUED .....

Obstetrics is a branch of medicineconcerned with the treatment of womenduring pregnancy, childbirth birth.


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Nursing encompasses autonomous andcollaborative care of individuals of all ages,families, groups and communities, sick or welland in all settings. Nursing includes thepromotion of health, prevention of illness, andthe care of ill, disabled and dying people.

Advocacy, promotion of a safe environment,research, participation in shaping health policyand in patient and health systems management,

and education are also key nursing roles. (ICN


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CONTINUED .....

Obstetrical nursing : Nursing care given to thepregnant patient before, during, or afterchildbirth.


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SCOPE

Midwifery today:

Midwifery education practice go beyond scopeof practice Outlined in the definition.

Nurse- midwifery

Education- midwifery + nursing+

medicinePractice- all midwifery + components of nursing+

medicine


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QUALITIES OF MIDWIVES

Skill full Able to assess the women

Health educator Managing care ability Professionally competent good communicator Team spirit Counselor


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HISTORICAL REVIEW

Midwifery is as old as the history of humanspecies

Archeological evidence of a women in squattingin childbirth supported by another women frombehind existence of midwifery in 5000 BC

References in old testament

- Hebrew midwives


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Hippocrates (460 BC) trained

Supervised midwives

Aristotle(384-322BC) discussed theessential qualities of midwife


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CONTINUED ..... Soranus -2 nd centuary specialized in OBG 5 th-15th 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 roommidwives assisted in childbirth)

Ambroise Pare founded a school formidwives in Paris


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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 c edere means to cut.

William Harvey (1578-1657) , father of Britishmidwifery,wrote 1 st English textbook on

midwifery. He described fetal circulation and

placenta. First to deliver placenta by massaging

the uterus


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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


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Hugh Chamberlen -1965

designed obstetrical forceps.

William smellie explained

labour process .

Pelvimetry, Cephalometry Forceps delivery


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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.


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James Young used Chloroform first inobstetrics for anesthesia.

Florence Nightingale conducted training formidwives in 1862.

Semmelweiss demonstrated causespreventive measures for puerperal sepsis.

Louis Pasteur wrote a thesis on it demonstratingpresence of Streptococci in Lochia.

Spencer Ballyantyne promoted concept ofantenatal care for pregnant women.

Munro Kerr 1926 introduced technique LSCS.


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DEVELOPMENT OF MATERNITY SERVICES ININDIA

Earlier midwifery was practised by Dais. In early part of 20 th century changes in

practices began to occur.

Health Organization

Director General of IMservices+ Surgeon General ofCivil hospitals in States

Administration maintenanceof associated institutions

Public heath commissioner +Sanitation Commissioner inStates

Preventive health services


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The All India Institute of Hygiene

Public Health established in 1930 under

Rockefeller foundation which providedprogramms for MCH.

1943- Govt. appointed Bhore committee whichrecommended PHC for every 40,000 population withhaving staff of each unit: 1 institutional nurse, 4midwivwes 4 trained dais. Programs for TD ANMswere started based on its report.


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Training programs for nurses wereMainly in mission hospitals.

Christian medical College HospitalVellore in

Tamil Nadu had nurses training program NSs of Mission Hospitals felt need for an organizationof their own by 1911.

1931- a formal institution of nurses was started- NursesAuxiliary of Christian medical Association ofIndia(CMAI)

1964- renamed as Nurses League. They had 2 boards ofnsg.education.

Mid India B.N.E+ B.N.E, south India branch.They hadGNM +ANM courses


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1949- Indian Nursing Council(INC) was Constituted. It formulated standards forNsg.Educ.in the country. During last five decades N.Edu has advanced.

Midwifery training is included into 3 yr basicgeneral nsg.program i.e diploma in nsgmidwifery.

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.


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introduction to obg

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