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THE ROLE OF

SPECIALIZED
NURSING:
GYNAE &
OBSTETRIC
NURSES IN
UNIVERSITY
HOSPITAL OF
FUENLABRADA

A BRIEF HISTORICAL OVERVIEW


OF MIDWIFERY IN SPAIN

Up until the early 20th century nursing and


midwifery in Spain were kept apart and were
regulated by different laws.

It was in 1992 when the midwifery training


program was established as a specialty of the
nursing degree. This program acknowledges the
scope of midwives in both community and
specialized hospital care.

THE ROLE OF THE COMMUNITY


MIDWIFE

In Spain, community midwives are enabled to take part in both


sexual and reproductive health programs at all stages of the
woman's life. This role includes:
- Parental education.
- Contraception advice.
- Co-operation in early diagnosis of breast and gynaecological cancer.
- Co-operation and early diagnosis of sexually transmited diseases.
- Management of midwifery clinics to attend parents during
uncomplicated pregnancy and normal postpartum.
- Supporting couples who experience difficulties with breastfeeding and
parenting.

THE OBSTETRIC & GYNAE TEAM

In order to provide excellence in care,


midwives are able to work harmonious
and effectively within the health team,
which includes obstetricians, general
nurses, health care assistants and
porters.
Moreover, midwives also communicate
effectively with other hospital units
involved in women's care, such as
Neonatology, Anaesthesia and the
surgical team.

THE ROLE OF THE MIDWIFE IN


THE EMERGENCY ROOM

To assess and deliver care to all women who


experience heath problems during pregnancy,
specially from the 24th week of gestation.
The midwife will carry out a full revision of the
woman's clinical history, laboratory and ultrasound
tests, as well as a physical, abdominal and vaginal
examination (from the 36th week).
From the 24th week of pregnancy the midwife must
listen to the fetal heart rate and carry out fetal
cardiotocography when indicated.

THE ROLE OF THE MIDWIFE IN


THE EMERGENCY ROOM

The midwife is able to decide when a woman with


a full term pregnancy needs to be admitted to
hospital or when she needs to be seen by a doctor.
In this hospital we have been pioneers, since we
have a protocol which enable midwives to
discharge some women from the emergency room.
Midwives also provide care to women during the
postpartum, specially with breastfeeding problems.
There is a 24 hour phone number for women to
adress their feeding problems to the midwife.

THE ROLE OF THE MIDWIFE IN


THE DELIVERY SUITE (DS)?

WHAT DO MIDWIVES DO IN
FUENLABRADA'S DS?

Midwives provide care to mothers and partners


during labor, assessing fetal well-being.
We also assist spontaneous vaginal deliveries in
cephalic presentation.
We are able to take care of women who want to
keep the process of labour as low risk as possible.
Our job is to ensure the mother and baby's safety,
so if we see any abnormalities we call the
obstetrician.

WHAT DO MIDWIVES DO IN
FUENLABRADA'S DS?

We are able to provide care to the


newborn, although the is always a
paediatric nurse at the time of delivery.
Midwives help to stablish the bond
between the new parents and the baby,
through the uninterrumped skin to skin
contact and the early start of
breastfeeding, even in the case of
having a caesarean section, with the cooperation onthe Recovery Room staff.
The midwife also administrates the
antibiotic and antihaemorrhagic
prophylaxis to the newborn

WHAT DO MIDWIVES DO IN
FUENLABRADA'S DS?

Mothers, fathers and babies leave the DS


approximately two hours after the birth takes
place. Midwives must ensure their safety at all
times and need to give advice to the new parents
about care during the postpartum period.
Two years ago we started to collect cord blood
samples, which are processed and kept in a public
bank for anyone who may need them.

THE ROLE OF THE MIDWIFE IN


THE MATERNITY WARD

Midwives carry out fetal heart


rate monitoring of babies
whose mothers ae admitted to
the ward due to health
problems during pregnancy.
When required, midwives
may go to the ward to assess
women who refer regular
contractions from the 37th
week of gestation.

FUTURE PROSPECTS

In a few months time mothers


and babies will be discharged
home 24 hours after delivery, if
there are no complications.
These mothers will come back
to see the midwife 48 hours
after delivery to ensure their
well-being and to help them
with breastfeeding.

FUTURE PROSPECTS

Midwives are not involved in the care of women


and babies during pregnancy in two units:
- 37th week low risk pregnancy clinic, currently conducted
by a general nurse.
- Fetal physiopathology clinic, were women with high risk
pregnancies undergo fetal monitoring and are assessed
by an obstetrician. Again, itis currently conducted by
ageneral nurse.

We believe that midwives are the most suitable


professionals to take care of women, and hope to
develop these functions in the near future.

THANK YOU!