1. ROLE AND SCOPE OF MIDWIFERY
PRACTICE:
PRESENTED BY:
Ms. Sweta K. Gaude
M.Sc.(N) 1st year
SDM INS
2. In general the role of nurse can be expressed as:
Provides necessary supervision, care & advices to women
in pregnancy, labor & postnatal period.
Promotes women’s sexual or reproductive health & child
health.
Facilitates & carries out the audits of maternal & neonatal
care.
Carries out evidence based research & further implement it
to clinical practice.
Disseminates information to women & families about safe
abortion, contractive & spacing etc.
Role Of Midwifery
3. Extended Role:
A perinatal nurse today may function as: a nurturer, educator,
Physical care provider
Critical thinker
Support person
Counselor
Case manager
Research
Expanded Role:
Nurse, Nurse practitioner, Nurse midwives
Certified nurse-midwives
Certified midwives
4. The basic role of midwife originally was that assisting
in delivery process but now scope has wider
applications and there are many role of midwife.
SCOPE OF MIDWIFERY
6. Midwife has to work as a team members in an obstetric
department & has to cooperate with a team members i.e
obstetrician, Gynecologist & Neonatalogist etc.
2) Participating In Special Investigation:
Midwife has an opportunity or right to participate in
special investigation like ultrasonography, Amneocentesis,
Corionus villi samping (CVS), Non-stress Test (NST),
Contraction Stress Test (CST).
1) Member Of Obstetric Team
7. 3) Midwife As a Counsellor:
Midwife has scope to utilize her knowledge & opportunity
to coucil the mother & her family members in clariyfing
dought & solving problems or giving suggestion.
4) Midwife As a Teacher:
Midwife has an opportunity at education sector & can guide
students by implementing her knowledge at both site i.e.
classroom teaching as well as clinical teaching E.g:
Demonstration of assessment of antenatal mother.
8. 5) Specialized Duties Of Midwife:
She carries some of specialized duties like providing
assistance in treatment and diagnosis e.g. ART.
6) Scope Of Supportive Role:
Midwife provide support to family members during
pregnancy, Labor and peuperium. She makes professional
relationship with team members as well as with her sub-
ordinates & make sure that she is best caretaker & beast
guide.
9. 7) Multisectorial Approach:
She maintains good relationship with other approaches to
the people at the time of any National Health Programmes
like RCH programmes, Anemia prophylaxis programme &
also motivate people to participate, voluntarily in these
programme to achieve the Goal.
8) Midwife As Researcher:
Midwife has opportunity/scope in carrying out many scope
related to her department so that her findings can be
utilized for further information. E.g.
Sitz bath for episiotomy patient.
Application of cabbage leaves inhibits the milk production.
10. 9) Midwife As Administrator:
If a midwife gets chance to bean administrator. She can
putforth & accept the duties of administration.
Administration at institution & at clinical sector could be
done.
10) Independent Midwife Practitioner:
Midwife has scope to become an independent midwife
practitioner to make diagnoses as well as decisions that are
based on knowledge, skills and experience. She also
recognises deviations from normal and provide treatment
for those deviations.
11. As professionals, nurses are both ethically and legally
accountable for their nursing care.
Care of the pregnant women and their newborn
requires specialized knowledge, communication and
team work among other health care workers.
Ethical issues and concerns have multiplied with the
increased use of technology and scientific
advancement.
LEGAL AND ETHICAL ISSUES
12. Standard 1-Quality of Care: The nurse systematically
evaluates the quality and effectiveness of nursing practice.
Standard 2- Performance Appraisal: The nurse evaluates his
or her own nursing practice in relation to professional
practice standards and relevant statutes and regulations.
Standard 3- Education: The nurse acquires and maintains
current knowledge in nursing practice.
Standard 4- Collegiality: The nurse contributes to the
professional development of peers, colleagues and others.
An example Of Nursing Practice
Standards Related To Maternal And
Newborn Care:
13. Standards 5- Ethics: The nurse’s decisions and actions on
behalf of patients are determined in an ethical manner.
Standard 6- Collaboration: The nurse collaborates with
patient, significant others, & health care providers in
providing patient care.
Standard 7- Research: The nurse uses research findings in
practice.
Standard 8- Resource Utilization: The nurse considers
factors related to safety, effectiveness, and cost in planning
and delivering patient care.
14. Standard 9- Practice Environment: The nurse contributes to
the environment of delivery care within the practice setting.
Standard 10- Accountability: The nurse is professionally and
legally accountable for her or his practice. The professional
registered nurse may delegate to and supervise qualified
personnel who provide patient care. (Adapted from
association of Women’s Health, Obstetric and Neonatal
Nurses (2003).
15. Standards of care are based on a legal model rather
than on ethics.
Law is based primarily on a rights model that
establishes rules of conduct to define relationships
among individuals.
ETHICAL COMPONENTS OF CARE
STANDARDS
16. 1) Ethics involve determining the best course of action,
what is morally right and reasonable, in a given situation.
2) Ethical issues have become more complex with
advanced technology, which allow the family more
options.
3) Complex ethical questions are related to maternal versus
fetal rights. Widely varying standards of viability,
abortion, mandated contraception, use of fetal tissue for
research, length of time resuscitation should be
continued, cord blood banking & the use & protection of
genetic information.
ETHICAL ISSUSE IN MATERNA-NEW
BORN NURSING
17. 1) Nurses are legally responsible and accountable for the
quality of nursing care they give. They may also be held
accountable for care given by other members of the
health care team.
a) Accurate assessment data & careful documentation are
essential in protecting the nurse & justfying a course of
action.
b) Crucial areas of concern are establishing who may give
consent for health care, providing care for the fetus, &
caring for clients not of legal age.
c) Nurses are legally responsible for reporting the following;
PROFESSIONAL LIABILITY ISSUES IN
MATERNAL-NEW BORN NURSING:
18. Suspected cases of child abuse.
Inappropriate or incomplete care provided by other health
care workers.
Professionals impaired by substance abuse.
2) Malpractice claims against both physicians and nurses
have escalated during the past few years.
a) Perinatal nursing is the area in which most lawsuits occur.
The most common problems occuring at birth or slowly
after are prematurity, low birth weight, congenital
anomalies, respiratory distress syndrome, etc. These are
the tragic movements for the parents, & they may look for
someone to blame.
19. b) To avoid malpractice claims, nurses are expected to
provide care within the context of nurse practice acts, &
policies developed by the agency which they practice.
3) Documentation is essential for protecting the nurse &
justifying her actions.
20. a) Nurse-midwifery exists for the good of women & their
families.
b) Nurse-midwives upload the belief that childbearing &
maturation are normal life processes.
c) Decisions regarding nurse-midwifery care require client
participation in an ongoing negotiation process in order to
develop a safe plan of care.
d) Nurse-midwives share professional information with their
clients that leads to informed participation & consent.
e) Nurse-midwives practice competently. They consult &
refer when indicated by their professional scope of
practice &/or personal limitations.
CODE OF ETHICS:
21. f) Nurse-midwives provide care without discrimination based
on race, religion, life-style, sexual orientation, socio-
economic status or nature of health problem.
g) Nurse-midwives maintain confidentiality except when
there is a clear, serious & immediate danger or when
mandated by law.
h) Nurse-midwives take appropriate action to protect clients
from harm when endangered by incompetent or unethical
practices.
i) Nurses midwives interact respectfully with the people
with whom they work & practice.
22. J) Nurse-midwives participate in developing & improving the
care of women & families through supporting the
profession of nurse-midwifery, research, & the education
of nurse-midwifery students & nurse-midwives.
K) Nurse-midwives promote community, state, & national
efforts such as public education & legislation, to ensure
access to quality care & to meet the health needs of
women & their families.
