Midwife

Definition

The the World Health Organization (WHO) defines the midwife as:

“A person who followed a training program recognized in her country, made a success of successfully the related studies and acquired the qualifications necessary to be recognized or laid off as midwife. She must be able to give the supervision, the care and the councils with the expectant mother, in work and period postpartum, to help during childbirth under her responsibility and to lavish care with the new-born babies and the infants. Its care includes precautionary measures, the tracking of the abnormal conditions in the mother and the child, the recourse to medical help where necessary and the execution of certain emergency measures in the absence of a doctor. She plays a big role in medical education, not only for the patients, but for the family and the preparation with the role of parents and must extend in certain spheres from gynecology, family planning and the care to give to the child. The midwife can practice in hospital medium, in private clinic, in residence or in any other place or its presence is necessary. ”

This definition is often introduced like the international definition midwife.

History

Since Antiquity

. Historically, the occupation of midwife ( midwife/midwife children's nurse in English) one of rare will have been dominated by experts. Since Agnodice in ancient Greece, the assumption of responsibility of the expectant mothers and parturients (women in labor) were regarded as raising primarily of the female circle .

The Middle Ages and Rebirth

Before the creation of this profession, the childbirth was assisted by women called of the matrons. In France, in the parochial registers, one also met the term “midwife” to designate the matron (for example if it had owed ondoyer the newborn) or, in a very marginal way, that of “obstétrice”.

It is possible that the restriction on the men to exert is related to the need to preserve the possible variations of the unmarried mothers under secrecy, and also with a puritan perception of all that touches with the female genital apparatus. It was then frequent that a girl mother dissimulates her pregnancy with the profit of her mother and that the midwife is then the only confidante of the family secrecy. In companies machists, where the woman is, for religious reasons primarily, still seen sometimes like the instrument of malignant and where the reputation of the women has a value in oneself, the wise woman was to then be a woman.

The December 22nd 1779, the first midwife exerting with the Hospital of Montmorency (Val-d'Oise) is named. It is about Elisabeth Bourgeois, woman of the sior Baudrang, surgeon of the Hospital.

Today

At the 18th century, a division was done between the surgical practice (which raised, it, of the Chirurgie N), and that of the midwives. The rise of science, perhaps associated with a certain contempt, in practice saw ancestral and allegedly folk midwives a less effective and sure art. At the 19th century, in England, the majority of the births were assisted by a surgeon.

New tendencies

The occupation of midwife, one of oldest which is, also one of is ignored general public.

This defect of knowledge is undoubtedly explained by a defect of recognition: blottie with the crossroads of several professions, it would seem that the midwife pained to delimit her own space, its own field of competence.

Since 1982, in France, the profession opened with the men midwives. The terms of “maieutician” and “obstetrician” also appear in the dictionary, but “midwife” remains the most current name for the experts of the two sexes (the etymology of the word " wise-femme" meaning " who has the knowledge of the femme" ; thus, the men can as well use this denomination).

It is about a profession Médicale with definite competence ( and not limited, this term appearing in no moment in the French legislation ).

In France, to become midwife, it is necessary from now on to make a first year of medicine (PCEM1), to pass the contest and to study four years at the school. Thus, on the university level, in France, the current challenge is to integrate the assets of the training of the Midwives into the system LMD (License - Master - Doctorat) and to encourage the ways of research by this skew. The objective of the council of the order is thus to obtain for any diploma of State an equivalence master, that is to say baccalaureat + 5.

Etymology of the term

An initially disputed etymology

In ancient Greece, one spoke about Maïeutique , or art to be confined , which with the time and under the influence of Socrate ended up indicating a philosophical mode of exchange.

In midwife , the word woman refers to the woman who has as a trade to be confined the others. And yet the exact origin of the made up word remains disputed. Historically, it seems that the expression refers not to the expert but to the parturient: when the woman was going to be confined, it was considered formerly that it with was orée of a new knowledge and that the act to put at the world constituted in oneself the border towards this knowledge.

Another position is that to apply the term to the expert itself, it is only reserve besides nowadays since it indicates a Profession.

This employment thus makes the synthesis of the two uses seen previously: woman remainder thus impersonal, it thus does not give a report on the sex of the expert.

Since, a clear-cut position

; Sage-femme n.f is attested in this form in 1212 One finds also the alternatives “woman wise” like “wise-mother” (14th century) and “wise mother” (1609). The word is composed of “wise” meaning “expert, skilful in its art” (1155, “wise” in this direction) and of “Femme” the profession opening to the men (since 1982), one proposed “wise-man”, “matron” (on female “the matron”), “maieutician” (proposed by the Académie) or “maieutist” (Hellénisme S scientists), “parturologist”, terms finally isolated for the benefit of “midwife” for the two sexes in spite of the bizarrery of the expression applied to a man. ”

( the Robert - historical Dictionary of the French language - Alain Rey and coll, Paris 1992).

Maïeuticien and obstetrician is the names recommended for the men exerting the trade of midwife (in France: less than 300, vis-a-vis 15 500 women). The term maieutician on the other hand is regarded as a barbarism. One also meets midwife man , man midwife or wise-man .

The Pluriel midwife is midwives .

University characteristics according to the countries

Midwife in Canada

Midwife in Quebec

At present, only the Université of Quebec with Three-Rivers (UQTR) offers to the program of baccalaureat in practice midwife, one 4 years duration (130 appropriations). The program is fixed quotas for with 24 students per year.

The occupation of midwife is regulated since 1999 with the Quebec, after several years of pilot scheme with houses of birth. The last details of insurance making it possible to the midwives to follow childbirth to residence were regulated in April 2005. It is necessary to belong to the Ordre of the midwives of Quebec (bond) to have right to carry the title.

Midwife in Switzerland

Since the signature of the agreements of Bolognes by Switzerland, the diploma for the occupation of midwife is recognized by the European countries. The profession remains however a ancillary medical trade as well as nurse. In French-speaking Switzerland there exist two ways of becoming midwife. First is to integrate the die midwife of the High School of Health of Geneva (HEdS) (bond). This school accommodates a score of pupils each year. This course lasts 4 years and led to a Bachelor diploma. Second is to integrate the school of Lausanne, this one lasts 2 years and requires already the diploma for the occupation of nurse.

Midwife in the United States

There exist two ways to become midwife with the the United States: that of the nurses midwives, and that of the midwives.

Nurse midwife

In the United States, the nurses midwife are nurses nursery nurses, having followed an additional training for two years additional, that is to say in control, to specialize as midwives.

Midwife: direct way

Their formation varies according to the mode of obtaining the diploma: some are directly graduate of a school of midwife, who offers various formations of different size and nature. Some choose to be registered with the College of the nurses midwives ( American College off Children's nurse-Midwives or ACNM ): all the midwives who borrow this way must then pass the same training certificate: the others acquire the statute of midwife to the seniority.

See too

Association for Childbirth At International Home (ACHI)

Midwife in France

A course in five years in France

Since 1992 with Grenoble and 2002 in France, the entrance examination in school of midwives is common to that of medicine. The midwives bénificient moreover of an access to the masters of Health. In spite of the five years of studies necessary, the diploma for the occupation of midwife has only one equivalence with the license, that is to say a vat +3.

To note that, in spite of the characteristics in the training of the midwives at the national level, any diploma of State obtained in an European country is valid in any other European country, in spite of the disparities of formations.

The field of competence of the midwife

Traditionally, the midwife is a woman who helps with the Accouchement.

Traditionally, the midwife is a woman or a man who helps with the childbirth.

In the industrialized companies, it is about a medical or ancillary medical profession with whole share - medical when the midwife has the right to prescribe (case of France: stopped of February 23rd, 2004 modified by the decree of October 12th, 2005 fixing the list of the drugs which the midwives can prescribe), ancillary medical when it can only apply the regulation of a doctor (case of Belgium where only doctors and dentists have the right to prescribe in human medicine).

In France, she answers the following definition:

Following a medical occupation, the midwife ensures, in all autonomy, the diagnosis, the declaration (L. 2004-806 of August 9th, 2004 Article 101-1) and the monitoring of the normal pregnancy, work and the childbirth, like that of the mother and the child after the childbirth.
It practices the clinical examinations and para-private clinics necessary (echography,…) and takes an active part in all preventive actions in the field of health. It prescribes the examinations and therapeutic (drug, vaccine,…) necessary to the good progress of the pregnancy, the childbirth, the continuations of layers.
In the event of pathology, it exerts in collaboration with the doctor obstetrician, the anesthetist and the pediatrist.
In addition, the exercise of the occupation of midwife is not reduced to the practice a childbirth. The midwife ensures also the antenatal monitoring, the preparation with the childbirth of the expectant mother and the follow-up in residence of the women and the new-born babies in the event of early exit of maternity until the seventh day which follows the childbirth.
It also practices the consultations, echography obstétricales, including within the framework of the prenatal diagnosis. It also practices the postnatal consultation (L. 2004-806 of August 9th, 2004 Article 101-2)
the midwife ensures the follow-ups of the pathological pregnancies in cabinet or in residence.
It supervises, advises, accompanies the mother and the child after the birth. It practices also the uro-gynaecological rehabilitation of the patients. She advises the couples and takes part in the follow-up of the various modes of contraception. She can prescribe a hormonal contraception (except the intra-uterine device) in post-partumn, during the postnatal consultation or after an voluntary interruption of pregnancy (Stopped of February 23rd, 2004 modified by the decree of October 12th, 2005).
It can also have an active place in the services of family planning, gynecology, procreation médicalement assisted.
Lastly, like the other medical professions, the midwives raise of a professional Code deontologic and must justify, to be able to exert, of their inscription in the table of the national council about the midwives.

Code deontologic

The first subparagraph of the R.4127-325 article of the Public health code lays out that, since it agreed to answer a request, the midwife commits herself ensuring personally with conscience and devotion the care in conformity with the scientific data since the patient and the newborn require. The personal character of the exercise of the occupation of midwife and the concept of responsibility are closely dependant. Here chapters of the Public health code relating to the midwives (modified by the decree 2006-1268 of October 17th, 2006):

PUBLIC HEALTH CODE

Professions of health → Organization of the medical professions → Deontology

Section 3 : Code of conduct of the midwives

general Duties of the midwives
Duties towards the patients and the new-born babies
Rules particular to the various forms of exercise
Duties of confraternity
Duties with respect to the members of the other professions of health
various Provisions

Midwife in the United Kingdom

With the the United Kingdom, the midwives practice the majority of the childbirth according to different methods.

Some follow a eighteen months formation (classification dismantles) after obtaining their diploma of Infirmière. Others follow three years a formation more independent. All the midwives must refer themselves with the Nursing and Midwifery Council .

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