TRENDS IN THE MIDWIFERY AND

OBSTETRICAL NURSING
• 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.

• 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, number of
procedures carried out, and number of referrals
requested.
• Expanded roles for nurses
Increasing nursing responsibility for
assessment and professional judgment and providing
expanded roles for nurse practitioners, such as the
nurse-midwife.
• 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
• 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:
Increase the proportion of persons with health
insurance.
Increase the proportion of persons who have a
specific source of ongoing care.
Increase the proportion of pregnant women who
begin prenatal care in the first trimester of pregnancy
• Shortening Hospital Stays
Women who have begun 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.
• 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.
• 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 other
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 to them.
• 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.
 AN INDEPENDENT PRACTITIONER
SLILLS OF THE MIDWIFE
• Promotion of health
• Assessment
• Managing care
• Independent action
• Initiating the action of others
• Undertaking care prescribed by a docter
• Communication
 SLILLS OF THE MIDWIFE
• Research awareness
• Evidence based practice
• A team member
• Keeping the law
• Ethical issues
• Assignment of duties to others
 RESPONSIBILTIES OF THE MIDWIFE
• Competence
• Responsibility to keep records
• Responsibility to the family
• Responsibility to the profession
• Responsibility to the society
THANK YOU