BORA INSTITUTE OF ALLIED HEALTH SCIENCES

LUCKNOW

OBSTETRICS AND GYNECOLOGY

ASSIGNMENT ON-

ROLE AND REPONSIBILITY OF MIDWIFERY NURSING

SUBMITTED TO: SUBMITTED BY:

Mrs. Sandhya Verma Roli Gautam

Associate Professor M.Sc. Nursing 1st year

Bora college of nursing Bora College of nursing

Lucknow Lucknow

DATE OF SUBMISSION: 20/02/2024

 ROLE AND REPONSIBILITY OF MIDWIFERY NURSING

INTRODUCTION

Midwife means ‘with woman’ or in France ‘wise woman’. The midwife is recognized worldwide
as being the person who is alongside and supporting women during birth. However, the midwife
also has a key role in promoting the health and well being of childbearing women and their
families before conception, antenatally and postnatally, including family planning.

If chosen as the primary care gives for pregnancy the role of the midwife will take place, of an
obstetrician. For instance, UK, approximately 75% of the prenatal care is performed by
midwives for all low-risk mothers and obstetricians only see high risk patients.

ACTIVITIES OF A MIDWIFE
The midwife has diverse and complex functions:

1. A midwife is a highly trained expert and carries out clinical examinations, provide health
and parent education and support the mother and her family throughout the child bearing
prices to help them adjust to their parental role.
2. Provides sound family planning information and advice.
3. She diagnoses pregnancies and monitor normal pregnancies to carry out examination
necessary for the monitoring of the development of normal pregnancies.
4. She gives advice regarding personal hygiene and nutrition to the pregnant mother, and
cares throughout pregnancies and first six weeks of birth.
5. Care for and assist the mother during labour and monitors the condition of the fetus by
the appropriate clinical and technical means.
6. Conducts spontaneous deliveries including where required an episiotomy and in urgent
cases of breech delivery.
7. To recognize the warning signs of abnormality in the mother or infant which necessities
referral to a qualified medical doctor ‘s absence, in particular, the manual removal of
placenta, possibly followed by manual examination of the uterus.
8. To examine and care for the newborn infant, to take all initiatives, which are necessary in
case of need and to carry out where necessary immediate resuscitation.
 9. To care for and monitor progress of the mother in the post-natal period and to give all
necessary advice to the mother on infant care to enable her to ensure the optimum process
of the newborn infant.
10. To carry out the treatment prescribed by a medically qualified doctor.
11. To maintain necessary records.
12. Midwife teaches about pregnancy, the process of labor, birth and recovery, and parenting
skills, this can promote significant improvement in maternal and infant health.
13. She plans care with each woman in labor that is tailored to meet her specific needs and
expectations.
14. Puts the care plan into practice and evaluate the care given to measure its effectiveness.
15. She is a skilled professional providing continuous care for several months and assists in
critical decision making regarding appropriate care in pregnancy, labor and the post-
partum period.
16. Plays important role in disaster and complex humanitarian emergencies at the periphery
of the health care system where there are no doctors.
17. The midwife should develop partnership with the woman from the beginning of her
pregnancy. This requires a social rather than medical model of maternity care, endorsing
the involvement of the woman and her partner in decision making and requiring the
woman to be able to voice her needs and wishes freely.
18. The midwife should strive to build a relationship of mutual trust and create an
environment in which expectations, wishes, fears, and anxieties can be readily discussed.
This requires good communication skills.
19. She should provide emotional and psychological care to woman during labor. The
attitude and reactions to childbirth vary considerably and are influenced by different
social, cultural and religious factors. For a multigravida, the previous experiences of birth
will also be important.
20. The midwife should forward as an advocate to support the woman in unknown and
unfamiliar situations and people; greater pain than expected or the effect of analgesic
pain than expected or the feeling of vulnerability, loss of personal identity and
powerfulness.

Many women anticipate labor with mixed feeling of fear and excitement. They may be
apprehensive about entering an unknown and perhaps threatening hospital environment and
concerned about relinquishing her personal autonomy and identity. Alternatively, expectations of
labour may be unrealistic and may be unfulfilled leading to feeling of disappointment, failure or
loss. In these situations, the midwife should support the mothers.
ROLE OF NURSE
All maternal and child health function in a variety of settings are caregivers, client advocate,
researcher, case manager and educator.

1. Care giver

The midwife understands and facilitates normal childbearing and provides the adequate care to
the mother and the baby, spreads health and well-being to women and their families

2. Client advocate

The midwife supports, facilitates and implements the woman's choice. Helps the mother to
protect her basic rights.

3.Researcher

The midwife is a good researcher and does not implement interventions with a sound based on
evidence and can critically evaluate the evidence-base for midwifery knowledge. She goes
through various studies and conduct studies to provide the best care to the mother and child.

4.Manager

A midwife quickly comprehends the range of normal maternal, fetal and neonatal well-
being practice, diagnoses factors that may adversely affect maternal or fetal well-being, locates
appropriate assistance or intervention while providing continued family support, manages
skilled emergency interventions and assists during bereavement

5.Educator

The midwife provides health education to the mother and the family members. She is a resource
to the women and their communities

EXPENDED ROLE OF NURSE

As trends in maternal and child health care changes, so do the roles of maternal and child health
nurses. Many nurses with a specified number of years of direct patient care, education program is
certified in their specialty. In addition, maternal and child health nurses’ function in a variety of
advanced practice roles.

1.Clinical Nurse Specialist

Clinical nurse specialist are nurses prepared at the master’s- degree level who are capable of
acting as consultant in their area of expertise, as well as serving as role models, researchers, and
teachers of quality nursing care. Example of areas of specialization are neonatal, maternal , child
and adolescent health care , childbirth education, and lactation consultation.

2.Case Manager
A case manager is a graduate level nurse who supervises a group of patients from the time they
enter a health care setting until they are discharged from the setting, or ina seamless care system,
into their homes as well, monitoring the effectiveness, cost and satisfaction of their health care.
Case management can be a vastly satisfying nursing role, because if the health care setting is
‘seaming’ or one that follows people both during an illness and on their return to the community,
it involves long-term contacts and lasting relationships.

3. Women health nurse practitioner

A women health nurse practitioner is a nurse with advanced study in the promotion of health and
prevention of illness in women. Such a nurse plays a vital role in educating women about
their bodies and sharing with them methods to prevent illness, in addition, they care for
women with illness such as STD’s offering information and counseling them about
reproductive life planning. They play a large role in helping women remain well so that
they enter pregnancy in good health and maintain their health through out life.

4. Family Nurse Practitioner

A FNP is an advanced practice role that provides health care not only to women but to total
families. In conjunction with a physician, an FNP can provide prenatal care for a women
with an uncomplicated pregnancy. The FNP takes the heath and pregnancy history,
performs physical and obstetric examination, orders approximate diagnostic and
laboratory tests and plans continued care throughout the pregnancy and for the family
afterwards. FNPs then monitor the family indefinitely to promote health and optimal
family functioning.

5.Neo-natal Nurse Practitioner

A neonatal nurse practitioner (NNP) is an advanced practice role for nurses who are skilled in the
care of newborn, both well and ill. NNPs may work in level1, level2 or level3 newborn
nurseries; neonatal follow-up clinics or physician groups. They also transport ill infants
to different care settings. The NNP’s responsibilities include managing and carrying out
patient care in INC, conducting normal newborn assessment and physical examination
and providing high-risk follow up discharge planning.
 SCOPE OF MIDWIFERY PRACTICES

Paramount to the practices of any health care provider is an awareness of the individual
professional scope of practice. Understanding and adhering to one’s scope of practice of
recipient of health care practices, as well as in the safe- guarding of health care professionals
themselves. For, instance, a person with a broken bone will not seek care from a psychologist.
The prevention of such inappropriate and potentially dangerous scenarios is the very reason why
defining one’s scope of practice is vital to the wellbeing of individuals seeking health care. In
midwifery education, students learn from the start of their training that safety is vital to offering
quality midwifery care, and understanding one’s scope of practice is a large part of achieving
this.

The scope of midwifery nursing practices is the range of roles, functions, responsibilities and
activities which a registered nurse is educated, competent and has authority to perform.

ROLE OF MIDWIFERY NURSE

A. COMPETENCE:
Competence is the ability of the registered nurse r registered midwife to practice safety and
effectivity, fulfilling his/her professional responsibilities within her scope of practice.

A competent professional midwife possesses many attributes. These include practical and
technical skills, communication and interpersonal skills, organizational and managerial skills, the
ability to practice safely and effectively utilizing evidence, the ability to adapt a problem-solving
approach to care utilizing critical thinking, the ability to perform as part of a multidisciplinary
team demonstrating a professional attitude, accepting responsibility and being accountable for
once action.

B. ACCONTABILITY AND AUTONOMY:

Accountability is the fulfillment of a formal obligation to disclose to referent others the purpose,
principles, procedures, relationships, result, income and expenditures for which one has
authority. In the course of his/her professional practice, a nurse or a midwife must be prepared to
make explicit rationale for decisions in the make explicit the rationale for decision in the context
of legislation, professional standards and guidelines, evidence-based practice and professional
and ethical conduct.

Accountability can’t be achieved unless the nurse or midwife has autonomy to practice. Nurse
are autonomous in midwifery. This means that they have the freedom to make discretionary and
binding decisions in accordance with their scope of practice. Authority is the legitimate power to
fulfill a responsibility.

C. CONTINUING PROFESSIONAL DEVELOPMENT

Continuing professional development encompasses experiences, activities, and process that
contribute towards the development of a midwife as a health care professional. This means, it is a
lifelong process of learning, both structured and informal.

Continuing education is a vital component of continuing professional development and takes

place after the completion of the pre-registration education programme for midwives and nurse.
It consists of planned learning experiences that are designed to augment the knowledge, skills
and attitude of a registered nurse or registered midwife, for the enhancement of midwifery
practices, patient care education, administration, and research.

D. SUPPORT FOR PROFESSIONAL NURSING AND MIDWIFERY

PRACTICE
In order for the midwives to practice completely and to realize this potential in the interest of
quality patient care; certain supports need to be in place. This include – local and national
guidelines, policies and protocol that have been developed collaboratively with practicing nurses
and midwives, and with reference to legislation and research- based literature.

E. DELEGATION

Delegation is the transfer of authority by a nurse midwife to another person to perform a

particular role. Each registered midwife is accountable for his/her own practice. The midwife is
accountable for his/ her own practice. The midwife who is delegating is accountable for the
decision to delegate. This means that the delegate function is appropriate and that support and
resources are available to the person to whom the role has been delegated. The midwife is
accountable for carrying out the delegated role in an appropriate manner.
CONCLUSION
The role of midwife is very important. Every midwife should know the scopes of midwifery
practices and the role played by independent nurse midwife practitioner in the society, to provide
the best and safe care for the mother and the child.

REFERENCE

BOOK

o Varney Helen, Kriebs M Jan, “Varney’s Textbook of Midwifery “, All India

Publishers and Distributors,2005, IVth edition, Page no: 3-4

o Henderson Christine, Myles midwifery, A textbook of Midwifery, published by

Davis Karlene Dame,2004, 13th edition, page no: 433-434

o Wrong L Donna, Hockenberry J Marilyn, Perry E. Shannor, Lowermilk Leonard

Dietra, Maternity Child nursing Care, published library of congress, 2006, 3rd
edition, page no:299-300

NET REFERENCE

o http://scholar.google.co.in/scholar?
q=independent+midwife&hl=en&as_sdt=2%2C5

o http://scholar.google.co.in/scholar?
hl=en&q=role+of+midwife&btnG=Search&as_sdt=2%2C5&as_ylo=&as_vis=0