3. INTRODUCTION
History of midwifery
• Obsterics is derived from Latin word “Obstetrix” that means
midwife
• Midwife:-it is thought to derive from obstare obs means
“aid”& stare means “women”.
• Older terminology is midwifery – Mid means “with” wif
means “women”
5. Cont…
• GYNAECOLOGY Greek word “gyne” means women & “logos”
means disclosure”
• it means it is the study of diseases those peculiar to female
genital organ .
• GYNAECOLOGY A branch of medicine that deals with the
diseases and routine physical care of the reproductive
of women.
6.
7.
8. Cont…
GREEK AND ROME
• Greek medicine was dominated first by Greek god appollo,diana,mercury
and then by the writing of Hippocrates,
• A Greek physician neamed ‘soranus’ known as the “father of
obstetrics”wrote his gynaecology book in Greek and described that fetus
could take up various positions in the uterus.
9. Arestotle(384-322BC)
The father of embryology described
the uterus and female pelvis organs.
He also discussed essential qualities
of the midwife.
10.
11.
12. Egypt (6000-1200BC)
• In Egypt ,the womens urine was used to water wheat and barleys corns.if
plants grew rapidly,pregnancy was confirmed.
• If the barley grew faster than the wheat the fetus was a female.
13.
14.
15.
16.
17.
18. 17th century
• The development of the obstetrics forceps was a major break through in 17th
century.
• Obstetrics forceps suggested by jacon rueff about 1554.
• Peter chamberlin invented in 1598.Invention and development of the
instrument to save the lives of contless number of infant and mothers.
19.
20.
21.
22. Cont…
• William Harvey ( 1578-1657, discoverer of the circulatory system
development embryology.
• Francosis Mauriceau (1637 – 1709)was the first to observe that puerperal
fever was epidemic.
• He was described a mechanism for breech extraction and may have been the
first to advocate in bed rather that on birthing stool.
23. 18th century
• 18th century is known as “age of reason”
• Two british physicisns ,William smilliam smellie(1697-1763) and William
hunter(1718-1783) had significant influence on obstetric practice.
• Smillier master of british midwifery observed and recorded the mechanism
of labor,invented curved and locked forceps and advocated a conservative
III rd stage of lobour.
24. Cont…
• Hunter discovered the separate nature of maternal and fetal circulations and
established the first lying in ward in London.
• Charles white (1728-1813) stressed the need for cleanliness to avoid the
onset of puerperal sepsis.
• The first caesarean section in Russia, was performed by Erasmus johann
friedrich in 1756.
25. Cont..
• Louis Pasteur in 1879, wrote the thesis on Puerperal sepsis.
• The first antenatal clinic was started about the time of First
World war.
• Florence Nightingale in1862, organized a small training school
with King’s college Hospital where she conducted training for
midwives.
26. 19th century
• Gynaecology developed separately from midwifery Ephraim Mc
Dowell(1771-1830) in 1809 performed an ovariotomy on
mrs.crawford,Kentucky.
• His success led to an unsurge of interest in gynaecological surgery.
• James Mario Sims(1813-1883)carried out first successful repair of fistula in
1849 and introduced sims speculum and sims position for gyneacological
examination.
27. Cont…
• The first abdominal hysterectomies were carried out by A.M.Health and
Charles clay of Manchester in 1843 .
• The discovery of anesthesia in the 19th century is of major importance to
obstetrics.
• The arguments continued for several years and finally ceased when Victoria
delivered prince leopold after receiving chloroform.
28. Cont…
• Kroning in 1912 introduced lower segment vertical incision and it was
popularized by De Lee(1922).
• Munro kenri in 1926 introduced the present technique of lower segment
caesarean operation and popularized it.
32. Development of midwifery in india
maternal and child health services in India were started with the
help of voluntary organizations. Modern maternal and child
health work was begun in India by foreign missionaries with an
effort to train dais. The time line are as follows:
33. Cont…
• 1885 – An association for medical aid by the women of India
was established by the Countess of Dufferin.
• 1918 – Lady Reading Health School was started in Delhi,
offering health visitors course, which was another stepping
stone in MCH Services
• 1921 – Lady Chelmsford League was formed in India for
developing maternity and child welfare services.
• 1931 – The Indian Red Cross society established MCH Bureau
in association with the Lady Chelmsford League & Victories
memorial.
34. Cont….
Madras was the first state then to set up a separate section for
maternal and child welfare in the public health department
under the charge of an Assistant Director of Public Health. It
again Madras state which first attempted to replace by the
better qualified personnel such as midwives and nurse
midwives.
35. Cont…
• 1938 – Indian Research Fund Association was established which formed a
committee that undertook the investigation into the incidence and cause of
Maternal and infant morbidity and mortality. Sir A. Mudaliar was the key
person of the committee.
• 1911 ANM programmes
• 1931 CMAI
• nurses league in 1946 had two boards of nursing education .( The mid India
board of nursing education and the board of nursing education).
• INC constituted in 1949. STD’s of nursing education.
• 1940’s Rooming in
• 1960’s obstetric care to maternity care
36.
37. Cont…
• Changing pattern of childbirth and Their Effects on Maternal-
infant Mortality Statistics
• Perinatal risk factors
• Technical advancement
38. Current problems
• Decrease length of Hospital Stay
• Higher patient acuities
• Lack of facilities in the rural areas
• Changes in Maternal newborn Nursing
• Family- centered care
• Labor, delivery, recovery and postpartum care(LDRP)
• Mother Baby Couplet care
39. The major interventions
Include:-
1. Essential obstetric care
2. Emergency obstetric care
3. 24 hours delivery services at PHCs/CHCs
4. Referral transport
5. Safe abortion services
6. The medical Termination pf Pregnancy Act, 1971.
