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All midwives should be nurses first

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A midwife is a trained proficient which has unique expertise of offering support to pregnant women to maintain a health measures, counselling, prenatal education, offering personal care expertise and …

A midwife is a trained proficient which has unique expertise of offering support to pregnant women to maintain a health measures, counselling, prenatal education, offering personal care expertise and generally assisting the mother throughout her pregnancy and after with the childbearing cycle as echoed by Abernathy and Donna (1989). The midwife assists the mother and her newborn to identify the uniqueness of their physical, emotional and social requirements. However, in cases where the case becomes out of bound of the midwife expertise capability, then the mother is referred to a specialized health care provider for further diagnosis and care (Courter, 1992; Edwards & Waldorf, 1984). This assignment shall outline the fact outlaid by the debate should midwives be nurses first or should they just be midwives without first being nurses (Hart Et al, 2001; Gordon, 2001).


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  • 1. Midwives Vis-à-Vis Nurses MIDWIVES VIS-À-VIS NURSES Name: Grade Course: Tutor’s Name: (10, August, 2010)
  • 2. Midwives Vis-à-Vis Nurses Midwives Vis-à-Vis Nurses Introduction A midwife is a trained proficient which has unique expertise of offering support to pregnant women to maintain a health measures, counselling, prenatal education, offering personal care expertise and generally assisting the mother throughout her pregnancy and after with the childbearing cycle as echoed by Abernathy and Donna (1989). The midwife assists the mother and her newborn to identify the uniqueness of their physical, emotional and social requirements. However, in cases where the case becomes out of bound of the midwife expertise capability, then the mother is referred to a specialized health care provider for further diagnosis and care (Courter, 1992; Edwards & Waldorf, 1984). This assignment shall outline the fact outlaid by the debate should midwives be nurses first or should they just be midwives without first being nurses (Hart Et al, 2001; Gordon, 2001). History of midwifery Traditionally these were the only qualified personnel who would oversee child delivery and offer prenatal care and counselling, they only comprised of elderly ladies who had expertise in handling this procedures (Albers & Vern, 1993; Gillow, 2001). According to Bergen and Garvey (1994) this tradition was passed on from generation to generation, and only certain family who had perfected this profession was allowed to practice within the society. The history of midwifery in Australia dates back to 1801, but the recorded literary articulate that this practice was recognized and accepted after Callaghan, Emma Jane (1884-1979), who was an aboriginal nurse and midwife was imprisoned and later released from allegation of witchcraft. She was the first ever recorded midwife in Australia. This practice was then formalized in education in the year 1866 after doctor Thomas discovered there were midwifery examiners in Royal college of 2
  • 3. Midwives Vis-à-Vis Nurses Surgeon in England and carried this work to Australia. He offered his services of midwifery and also taught other this art. Presently majority of the university offers three year bachelor of midwifery and this was initiated in the year 2002 by five universities in two states. This was the auspice of Australian College of midwives (ACMI) and from this juncture was renamed National education Standard Taskforce (ANEST) (Edwards & Waldorf, 1984; Varney, 1987). Types of midwives Generally there are two types of midwives, nurse-midwives this are the ones who have special training on health care provision in both sector of nursing and midwifery, and direct entry midwives, this are also trained to be midwives but are not as qualified nurses (Durand, 1992). Lefeber-Mans and Yvonne (1994) articulates that the most credited midwife is a Certified Professional Midwife (CPM) this are trained professional who offer midwifery services and they undergo training of nursing of three years. Direct-Entry Midwives (including Licensed Midwives) Direct Entry Midwives: this are midwifes that have initiated in the midwifery profession as an apprentice in the field of midwife without attending any formal learning concerning this profession (Youngkin & Davis, 1995). Direct entry midwifery education has been notched up in Australia and is escalating to the tertiary (university) level in majority of the states. Usually this course is offered for one year in the hospital; however the new initiative requires at least a university outreach program which offers some courses in direct entry midwifery. Most of the university which offers these programs offers a package of graduate diploma which duration is one to two years (Kitzinger, 1991; WHO, 1990). 3
  • 4. Midwives Vis-à-Vis Nurses Advantages of direct entry midwives • Offer solace to the mother • Allows the mother to make most of the decisive decision through counselling • Usually lessen the chances of infection in cases of home birth • Allows mother to be with her family even the delivery period • Minimizes the cases of infant mortality • Minimizes the cases of premature birth • Offer services at low prices • Lessens chances of caesarean section delivery (Dean & Mountford, 1990; Ulrich, 1993) Disadvantages of direct entry midwives • Lack of expertise in time of complication • Usually increase infection to the baby after birth • Not equipped to handle an emergency be it high risk or low risk deliveries • Direct entry midwives cannot administer prescriptions in the cases of infections or labor pains (Renfrew and Neilson, 1995). Certified Nurse Midwives (CNMs) /(CPM) Nurse Midwife this are midwives who have undergone the formal training of nursing and midwifery in Australia they are certified by the Australian College of Midwives (ACMI) located in Melbourne Victoria, they also license on behalf of the Nurses Registration Boards. Bachelors Degree is mandatory at the end of the training period (Edwards & Waldorf, 1984; Gillow, 2001). Nurse midwives education is required to have three years of nursing course in university education; this is usually a degree course which encompasses all aspects of nursing and health. 4
  • 5. Midwives Vis-à-Vis Nurses After graduation the nurse midwives can practice in different division concerned with prenatal care delivery like the postnatal areas, midwifery units and NICU (Bergen & Garvey, 1994; Varney, 1987). Advantages of Nurse Midwives • Nurse midwives have competencies in lessening infant and maternal mortality • Nurse midwives usually lessens the chances low birth weight rates • Nurse midwives prenatal care is of higher quality equivalent to that of care provided by doctors • Nurse midwives are more adept than direct entry midwives when providing prenatal care as they converse with the mother for latest development and preventive actions (Dean & Mountford, 1990). • The quality of care offered by nurse midwives is equivalent to doctor’s care within their line of competence (Holloway & Wheeler, 2002). • They don not have to answer to anyone directly Disadvantages of Nurses Midwives • Their prices are relatively higher than those of direct entry midwives • Not fully equipped to do operations or caesarean section delivery • Midwives usually have little time for themselves as they always engrossed in prenatal caring and supporting the expectant mother (Bergen & Garvey, 1994) Conclusion 5
  • 6. Midwives Vis-à-Vis Nurses Midwives and nurse midwives are two very distinct overlapping medical field of practice which centralizes on provision of postpartum and prenatal care to an expectant mother and delivery. Because of numerous complication that usually arises in the course child bearing cycle there is need to have some formal nursing training to the midwives (Castro, 2000). Nurse midwives have the capacity to facilitate any form of normalities that may arise during pregnancy. Midwives without nursing education will have problem mitigating some complication that may arise during pregnancies. However, it may also be necessary that if it not formal education then they have close association with doctors (Conrad & Kern, 1996). References Abernathy, T., & Donna, M. (1989). Planned and Unplanned Home Births and Hospital Births. Public Health Reports. 104, 4. 373-377. Albers, L., & Vern, L. (1993). Birth Setting for Low-Risk Pregnancies, an Analysis of the Current Literature. Journal of Nurse-Midwifery 36, 4. 215-220. Bergen, D. & Garvey, J. (1994). Obstetric Myths Versus Research Realities. London: The Feminist Press. Burst, H. (1987). Women's Health: Pregnancy and Childbirth. Issues and Concerns of Healthy Pregnant Women. Public Health Reports Supplement. 19. 57-61. Castro, M. (2000). Homeopathy for Pregnancy, Birth, and Your Baby's First Year. New York: St. Martin's Press. Cochran, S. (2008). Home Birthing Discussion. Retrieved on August 10 2010 from http://www.youtube.com/watch?v=Lv-7B43iPWg&feature=player_embedded Conrad, P. & Kern, R. (1996). The Sociology of Health and Illness: Critical Perspectives. New York: St. Martin's Press. 6
  • 7. Midwives Vis-à-Vis Nurses Courter, G. (1992). The Midwife's Advice. New York: Penguin. Dean, J. & Mountford, B. (1990). Innovation in the assessment of nursing theory and its evaluation: a team approach. Journal of Advanced Nursing. 28, 2. 409-418. Durand, M. (1992). The Safety of Home Birth: The Farm Study. Journal of the American Public Health Association. 82. 450-452. Edwards, M., & Waldorf, M. (1984). Reclaiming Birth: History and Heroines of American Childbirth Reform. New Jersey: The Crossing Press. Gillow, K. (2001). Organizing the nursing workforce: a review of the literature. Toronto: University of Toronto. Gordon, L. (2001). Woman's Body, Woman's Right: A Social History of Birth Control in America. New York: Grossman. Hart, A., Lockey, R., Henwood, F. & Sommerville, F. (2001). Evaluation of the effectiveness of midwifery education in preparing midwives to meet the needs of women from disadvantaged groups. London: Palgrave. Holloway, I. & Wheeler, S. (2002). Qualitative research in nursing. Oxford: Blackwell publishing. Kitzinger, S. (1991). The Midwife Challenge Pandora. Journal of Social Research. 39. 652-78. Lefeber-Mans, B. & Yvonne H. (1994). Midwives without Training: Practices, and beliefs of traditional birth attendants in Africa, Asia and Latin America. Netherland: Van Gorcum & Comp. Renfrew, M. & Neilson, J. (1995). A Guide to Effective Care in Pregnancy and Childbirth. Oxford: Oxford University Press. Ulrich, L. (1993). A Midwife's Tales. New York: Vintage Books. 7
  • 8. Midwives Vis-à-Vis Nurses Varney, H. (1987). Nurse Midwifery. Oxford: Blackwell Scientific Publications. World Health Organization. (1999). Standards for midwifery practice for safe motherhood. Delhi: Regional Publication. Youngkin, M. & Davis, T. (1995). Woman's Health, a Primary Care Guide. Connecticut: Appleton and Lange Press. 8