2. INTRODUCTION
• Midwifery, the first holistic profession in the world, is the
art of providing supportive care for women during their
childbearing years.
• Traditionally, midwifery was an unregulated practice in
which females took the initiative based on their societies
inquiries, They were primary healers, and they took on the
role of nutritionists, doctors, and spiritual advisors.
3. Midwifery during Egyptian Era (3500 BC – 100 BC)
• Egyptian civilization and its social construction were the
main macro-social factors that shaped midwifery as a
unique, social and female vocation. It shaped midwifery
as an artistic and autonomous profession supported by
advanced and scientific knowledge.
• Egyptian midwives were more clinically orientated
compared to midwives in the earlier eras.
• Egyptian midwives were famous in prescribing herbs as
drugs, and they were aware of it’s pharmaceutical actions,
particularly during labor.
4. Midwifery during Greco-Roman Era
(500 BC to 400AD)
• The Greek civilization, which we consider it as one of the
major macro-social factor during that era, shaped
midwifery as an art and a scientific profession.
• It was functioned as respected, social, autonomous, and
paid vocation for women.
• The traditional Greek ancient practices of midwifery were
religiously beliefs.
5. The modern midwifery
• Midwifery is defined as “skilled, knowledgeable and
compassionate care for childbearing women, newborn
infants and families across the continuum from pre
pregnancy, pregnancy, birth, postpartum and the early
weeks of life”.
6. • The evidence shows us that midwifery plays a “vital” role,
and when provided by educated, trained, regulated,
licensed midwives, is associated with improved quality of
care and rapid and sustained reductions in maternal and
newborn mortality.
7. • All women and newborns have a right to a quality of care
that enables a positive childbirth experience that includes
respect and dignity, a companion of choice, clear
communication by maternity staff, pain relief strategies,
mobility in labour and birth position of choice. Midwives
are essential to the provision of quality of care, in all
settings, globally.
8. • Who is a midwife?
• A midwife is a person who, having been regularly
admitted to a midwifery educational program, duly
recognized 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.
9. Who is a skilled birth attendant?
• Skilled health personnel, are competent maternal and
newborn health (MNH) professionals educated, trained
and regulated to national and international standards.
• They are competent to: (i) provide and promote evidence-
based, human-rights based, quality, socio culturally
sensitive and dignified care to women and newborns; (ii)
facilitate physiological processes during labour and
delivery to ensure a clean and positive childbirth
experience; and (iii) identify and manage or refer women
and/or newborns with complications.
10. • When midwives are educated to international standards,
and midwifery includes the provision of family planning, it
could avert more than 80% of all maternal deaths,
stillbirths and neonatal deaths.
11. • Midwives can provide about 90% of the service care
needed, but they account for less than 10% of the global
workforce. The world needs 900,000 more midwives. By
2030, the midwife shortage will be smaller (750,000), but
there will still be a major gap between the number
required and the workforce available in midwifery
12. • The gap between low-income countries and high- and
middle-income countries is projected to widen by 2030,
increasing inequality. To close the gap by 2030, 1.3 million
new (mostly midwives and mostly in Africa) need to be
created in the next 10 years.
13. Magnitude of Maternal Health problem
• Maternal mortality is one of the health indicator which
shows the burden of disease and death; the greatest
differential between developing and developed countries.
• More than 150 million women become pregnant in
developing countries each year and an estimated 500,
000 of them die from pregnancy related causes.
14. • Other than their health problems most women in the
developing countries lack access to modern health care
services and increase the magnitude of death from
preventable problems.
• Lack of access to modern health care services has great
impact on increasing maternal death.
15. • Most pregnant women do not receive antenatal care;
deliver with out the assistance of trained health workers
etc.
• The life time risk of death as a result of pregnancy or child
birth is estimated at one in twenty – three for women in
Africa, compared to about one in 10,000 for women in
Northern Europe 75% of Maternal morbidity and mortality
related to pregnancy and child birth are due to five
obstetric causes.
• Hemorrhage, sepsis (infection), toxemia obstructed labor
and complications from unsafe abortion.
16. • As Ethiopia is one of the developing countries with
inadequate facilities and resources having highest
maternal morbidity and mortality and poor coverage of
maternal is estimated to be 1000/100,000 live birth.
• In Ethiopia women get antenatal care are around 905,
283 and overall the national antenatal care coverage in
34.7%. Among this pregnant woman only 259,083 are
attended institutional delivery making the national
coverage of 10%. Unwanted and unplanned pregnancies
are important determinants of maternal in health.
17. • In Somaliland, maternal mortality is an unfortunately very
high about two hundred ninety five thousand mothers lost
their life due to pregnancy, delivery and their
consequences.
• Most of these dangerous complications are difficult to
predict, but they can be prevented by getting the basic
and comprehensive obstetric emergency services.
18. midwifery concepts that define
the unique role of midwives
• Partnership with women to promote self-care and the
health of mothers, infants, and families.
• Respect for human dignity and for women as persons with
full human rights.
• Advocacy for women so that their voices are heard.
• Cultural sensitivity, including working with women and
healthcare providers to overcome those cultural practices
that harm women and babies.
• A focus on health promotion and disease prevention that
views pregnancy as a normal life event.
