TRENDS OF MATERNITY SERVICES IN INDIA Prepared by: Mayuri Gamit M.Sc Nursing (OBG) Nursing tutor

1. P R E PA R E D B Y: M AY U R I G A M I T
M . S C N U R S I N G ( O B G )
N U R S I N G T U TO R
TRENDS OF MATERNITY
SERVICES IN INDIA

2. INTRODUCTION
 In our mothers and grandmothers days, an untrained woman, neighbors,
relative or friend delivered most babies at home. All the changes started in
29th century, when parturition moved into the hospital setting. At that
point, child bearing became far from a family affair.
 The mother and newborn remained isolated from the family for a week to
ten days.
 Nursing was separated into three specialties, with one nurse caring for the
mother during labour, and delivery, another handling postpartum mothers
and third caring for the baby.

3.  In the year 1940s, ‘rooming in’ concept was devised. The advantages of the
system included a reduction in neonatal infection from cross-contamination,
increased confidence and independence for the mother and greater breast-feeding
success.
 In 1960s, the focus changed from the person giving care to the recipient. With that
change, came a change in terminology and obstetrical care became Maternity care.
 WHO offers definition of maternity care - the object of maternity care is to ensure
that every expectant and nursing mother maintains good health, learns the art of
child care, has a normal delivery and bears healthy children.

4. 1. Changes in social structure, variations in family
lifestyle
 It has altered health care priorities for maternal and child
health nurses.
 Today, client advocacy, an increased focus on health
education and new nursing roles are ways in which nurses
have adapted to these changes.

5. 2. Cost containment
 Cost containment refers to systems of health care delivery
that focus on reducing the cost of health care by closely
monitoring the cost of personnel, use and brands of
supplies, length of hospital stays, numbers of procedures
carried out, and number of referrals requested.

6. 3. Expanded roles for nurses
 Increasing nursing responsibility for assessment and
professional judgment and providing expanded roles for
nurse practitioners, such as the nurse – midwife.


7. 4. Family centered care
 More natural childbirth environment where partners, family
members may remain in a homelike environment and
participate in the childbirth experience.
 By adopting a view of pregnancy, childbirth as a family event,
nurses can be instrumental in including family members in
care and consult family members about a plan of care and
provide clear health teaching so that family members can
monitor their own care.

8.  Maternally care today has enhanced to family centred
care. Definition of health include physical , social,
psychological and economic dimension.
 Family centered approach is basic unit of society. Thus
emphasis on this aspect is must that fosters family unity.
 Integration and bonding takes high priority and much
anticipatory counselling is offered.

9. 5. Access to health care
 Strong predictors of access to quality health care include having health
insurance, a higher income level and a regular primary care provider or other
source of ongoing health care.
 Use of clinical preventive services, such as early prenatal care, can serve as
indicators of access to quality health care services.
 The objectives selected to measure progress in this area are:
1. Increase the proportion of persons with health insurance.
2. Increase the proportion of persons who have a specific source of ongoing
care.
3. Increase the proportion of pregnant women who begin prenatal care in the
first trimester of pregnancy.

10. 6. Shortening hospital stays (Early discharge )
 Women who have preterm labor stay in the hospital while
labor is halted and then are allowed to return home on
medication with continued monitoring.
 Routine hospital stay for mothers and newborns after an
uncomplicated birth is now 2 days or less.
 Short term hospital stays require intensive health teaching by
the nursing staff and follow up by home care or community
health nurses.

11.  In earlier days, women were hospitalized for longer
duration and physical activity was increased very
gradually.
 Over the years now, however, health care personnel have
realised that early return to normal activities is the best
course for uncomplicated births.

12. 7. Increased use of alternative treatment modalities
 There is a growing tendency to consult alternative forms
of therapy, such as acupuncture or therapeutic touch, in
addition to, or instead of traditional health care providers.
 Nurses have an increasing obligation to be aware of
complementary or alternative therapies.

13.  Families have growing tendency to use alternative
therapies such as acupuncture or the therapeutic touch.
Health care providers should be aware of alternative
forms of therapy, like meditation, exercises, herbal
therapies.etc

14. 8. Increased use of technology
 The field of assisted reproduction (e.g. in vitro fertilization),
seeking information on the internet and monitoring fetal heart
rates by Doppler ultra sonography are another examples.
 In addition to learning these technologies, maternal and child
health nurses must be able to explain their use and their
advantages to clients. Otherwise, clients may find new
technologies more frightening than helpful them.

15. 9. Technological advances
 As the technology has revolutionized and increasingly sophisticated
computers in today’s world, it has become necessary for the nursing
personnel to have thorough knowledge of the new technology being
used.
 Due to this advancement, ‘the hands on care’ of the client is
reduced, so also is the, quality nursing care.
 Today foetal monitoring has progressed from the use of fetoscope to
electronic foetal monitors. It can be used both, directly and
indirectly.

16.  Experts believe that in coming years, births are going to
be high – tech innovations, resulting in low perinatal
mortality and morbidity.
 In future , there are challenges for nurses, as they will
provide care in the world of high technology.

17. 10. Increased cost of high- tech care
 As the high and sophisticated technology is being
introduced into todays world, the cost are also increasing.
For the procedures such as ultrasound, fetal monitoring
etc, the couple has to pay good amount of money .
Gradually , obstetrics care is becoming a business for the
care providers.

18. 11. Changing patterns of child birth
 There are increasing numbers of working women.
 As early marriage practise still continue , both ends, the
older and younger mothers face increased risks of
complications during pregnancy, such as preterm delivery,
LBW ect.

19. 12. Increase Perinatal risk factors
 The problems of society are reflected in risks; among
them are AIDS in mothers and newborns.
 LBW account for about 30-40% of live births in
developing countries.
 In addition to maternal age, risk factors of LBW include
mother’s medical history, past pregnancy, socio economic
status and prenatal care.

20. 14. Rising caesarean birth rates
 With the use of fetal monitoring and ultrasound for
prenatal monitoring and ultrasound for prenatal evaluation
of fetal condition , has come and increased rate of
caesarean birth rates.

21. 15. Increasing the number of intensive care units
 Over past 20 years, care of infants and children has
become extremely technical.
 Many infants nowadays are born with low birth weight
and who are ill. Such infants are transferred to NICU. For
this, the opportunities for advanced practice nurses also
has increased.

22. 18. Role of father
 With increased societal emphasis on shared parenting and the
recognition of parental bonding, many fathers are active in care
giving and enjoy the closeness it brings
 The involved father, as present, accessible, available, understanding,
willing to learn about the pregnancy process and to provide
emotional, physical and financial support to the woman carrying the
child. Women emphasized a sense of “togetherness” during the
pregnancy.

23. 19. Psychological Support during labour
 mother will experience physical sensations discomfort to severe pain.
 Helping the mother to be as relaxed as possible and aware of the situation can
help minimize the physical pain and emotional distress of labour and birth.
 Mother can be helped with this by receiving adequate care, timely
information, comfort, support and reassurance during labour and birth.
 It is also important to maintain respect and courtesy whenever possible by
explaining what are going to do and why, and by being courteous to her and
her family.

24. 20. Painless Delivery
 Painless delivery refers to the use of an epidural injection which is given by an anaesthesiologist
for pain relief during labour. It is injected in the lower back, and a plastic tube is placed through
which drugs are released around the spinal cord. It is injected only once when you are in active
labour which means you are having at least three contractions in 10 minutes.
 Epidural doesn’t always provide 100% pain relief, but it substantially reduces pain and sensations
in the lower half of the body.
 In early labour, pain can be managed using natural methods like warm showers, massages, and
exercises.
 It helps a woman cope better with post-partum depression or exhaustion.
 It relaxes the vaginal muscles and provides space for the baby to descend.

25. 21. Robotic labour
 Robots could eventually play integral roles in labor wards, according to findings from Computer Science
and Artificial Intelligence Laboratory.
 Robots are currently employed in hospitals to carry out simple actions, like dispensing medication. But
can they understand patient needs and make scheduling decisions?
 The researchers have been working for the past two years to determine whether robots can be more than
just helpful companions.
 Researchers from MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL) used a robot
that could learn from human schedulers to anticipate bed flow and suggest which nurses to assign to C-
sections and other procedures.
 While robots long have been used to perform small tasks, such as delivering linens or medications,
they’re now taking on higher-level responsibilities that can include surgery and doing rounds.