The document provides an overview of the evolution and significance of midwifery in maternity care, highlighting its transition from a domestic practice to a professional medical field. It emphasizes the vital role of midwives in supporting women during pregnancy and childbirth and discusses the challenges and obstacles faced in providing respectful and effective care. The importance of promoting independent decision-making and addressing issues of power dynamics and discrimination in maternity care is also underscored.

1. MIDWIVES
FOR
MOTHERS
Dr. Sujnanendra Mishra

2. Safe motherhood is
a central component
of reproductive
health.
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3. MOTHERS, MIDWIVES AND
MEDICAL MAN
A history of maternity care
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4. The early tradition of
midwifery:
Issues of social class and gender
• Before the twentieth century, pregnancy and birth were primarily domestic
rather than medical issues.
• Women gave birth at home with other women for company, one of whom
might be a midwife ( in higher class).
• Many midwives learned their craft through informal apprenticeship to a more
experienced practitioner.
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5. The middle tradition
of midwifery: Issues
• Technological developments, and
• Dominance of male physicians in the practice of obstetrics
• Men made an appearance in the lying-in room because the lives of mother.
• It was fashionable for wealthy women to have a doctor in attendance at birth
even if the situation was uncomplicated
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6. The present tradition
of midwifery: Issues
• In the twentieth century, birth moved from home to hospital, and was
increasingly seen as a medical event
• Childbirth is the most fundamental of human events now considered as human
right .,Mother and baby both were considered to be worth saving.
• Development of Professional practice.
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7. CHILDBIRTH
• CHILDBIRTH IS MORE THAN THE ACT OF GIVING BIRTH.
• FOR A WOMAN IT IS A CONTINUOUS PROCESS ,FROM CONCEPTION
THROUGH REGNANCY,LABOUR,BIRTH AND BEYOND.
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8. WITHOUT MIDWIFERY
THE HEALTH SYSTEM STRUGGLES. MIDWIFERY IS PIVOTAL TO
ANY MCH APPROACH’.
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9. • International Definition of the Midwife
• A midwife is a person who, having been regularly admitted to a midwifery educational
programme, duly recognised in the country in which it is located, has successfully
completed the prescribed course of studies in midwifery and has acquired the requisite
qualifications to be registered and/or legally licensed to practice midwifery.
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10. • The midwife is recognized as a responsible and accountable professional who
works in partnership with women to give the necessary support, care and
advice during pregnancy, Labour and the postpartum period, to conduct births
on the midwife’s own responsibility and to provide care for the newborn and
the infant.
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11.  This care includes preventative measures, the promotion of normal birth,
the detection of complications in mother and child, the accessing of medical
care or other appropriate assistance and the carrying out of emergency
measures.
 The midwife has an important task in health counselling and education, not
only for the woman, but also within the family and the community. This work
should involve antenatal education and preparation for parenthood and may
extend to women’s health, sexual or reproductive health and child care.
 A midwife may practice in any setting including the home, community,
hospitals, clinics or health units.
 Source: ICM, 2005
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12. The Shift
 Numbers of births have risen since 2002 and are projected to increase;
 There are more older mothers, with higher rates of complication;
 There is more fertility treatment, leading to a higher rate of multiple births;
 There are more obese women, who are less fit for pregnancy;
 There are more women who survive serious childhood illness and go on to have children,
and who need extra care in pregnancy and childbirth;
 There are rising rates of intervention in labour, in particular in rates of caesarean section;
 There is increasing social and ethnic diversity, sometimes leading to communication
difficulties and other social and clinical challenges in maternity care.
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13. POWER works……. Use It with CAUTION
•Power in relationships with Clients
•Power 'for' - nutritive
•Power 'with' – integrative
•Power 'over' - exploitative, manipulative*
* SPOILS EVERYTHING
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14. Facing obstacles along the way - mothers' and
midwives'
• Institutional dominance
• Paternalism
• Lack of self-determination
• Fear, Safety, Mortality-Morbidity (negativity of attitude)
• Unsupportive of the woman
• Procedure-oriented approach; 'system workers'
• Values conflict
• Workplace/service provider versus personal/professional midwifery ethics
• Not valuing individuals
• Emotions/feelings
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15. Going to a comfortable place
• 'Being with' woman
• Values-Virtues
• Supporting the woman
• Knowing the woman
• Woman's comfort: security, 'safe' for the woman
• Ways of seeing
• Metaphors used by mothers and midwives
• Personal transformation
EVERYTHING IS ABOUT
RESPECTFUL CARE
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16. What is RESPECT
“To take notice of,
to regard as worthy,
to honor,
to esteem for a personal quality or ability”
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17. We have all the same
• Human Beings
• Feelings/emotions
• We all feel pain, we all bleed in we are cut
• Work to provide for ourselves and our families
• We expect to be treated with respect
• At work,
• In public places,
• In Family,
• In the community too.
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18. Start with “I”
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19. Honor
Reverence
Courtesy
RecognitionDignity
Esteem
Regard ConsiderationRespect
Elements Of Respectful Approach
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20. 4/16/2019

21. Types of Disrespect
• Discrimination
• Stereotyping
• Harassment
• Bullying
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22. Discrimination
• Discrimination – with our words or actions we treat certain individuals or
groups differently
• Routine Care.
• Emergency Care.
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23. Stereotypes
• We give everyone in a certain
group the same attributes.
• The attributes do not have to be
negative.
• We are all different, even within
groups
• We put others in boxes
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24. Harassment
• Harassment – with our words or actions we make the workplace
uncomfortable and hostile for individuals or groups
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25. LETS HAVE A CLEAR VISION FILLED
WITH VALUES……..
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26. Respectful Maternity Care ( RMC)
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27. RMC– why does it matter? why does it matter?
• Reputation, Professionalism and Quality of Care,
• Patient Safety, Service Use and Health Outcomes,
• Provider's Safety, Satisfaction. and
• Client Retention,
• Enrichment of work culture.
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28. Final words….
• Inherent imbalance in power and knowledge between Providers and Clients
results in.
• Increase in patients’ vulnerability.
• Also a concomitant dependency.
• It Obligatory on the part of Care providers to promote
• independent and
• informed decision-making by patients .
• Violation of human rights destroys the trust essential to the health care and
healing process.
• Adhere to Respectful Care.
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29. 4/16/2019
MIDWIFERY….
 An opportunity – to care for and care about our
commitments.
A challenge - to meet and exceed Client
expectations.
A chance – for everyone to create the right
impression for both clients and Providers.