Independent Midwifery Practice 2ccj

• " I was scared - I had heard so many horror stories, but you just walked in and I felt my worries fade.You spend a lot of time on your knees, having the time to do those things that make every pregnancy unique is what makes your job so special, a familiar face makes all the difference & most important that a woman knows a wise women (midwife) is there"

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

INDEPENDENT MIDWIFERY PRACTICE

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

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Definition Midwifery Model of care Need of IMP Clinical statistics Midwifery practice package for independent practice • Standards required for the practice of midwifery. • Challenges Mrs. Neeta Rajesh Bhide, M.Sc. (N)

Who is an Independent Midwife? • Independent Midwives are fully qualified ed nurse-midwives to utilize their knowledge, skills, judgement and authority in the provision of primary women's health services while maintaining ability for the management of patient care in accordance with midwifery/ nursing council of ones own country

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

The Midwifery Model of Care The Midwifery Model of Care is based on the fact that pregnancy and birth are normal life processes. The Midwifery Model of Care includes: • monitoring the physical, psychological and social wellbeing of the mother throughout the childbearing cycle; • providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum ; • minimizing technological interventions and identifying and referring women who require obstetrical attention.

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

The application of this womancentered model of care has been proven to reduce the incidence of birth injury, trauma, and Cesarean section.

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

WHY THERE IS INCREASE NEED OF INDEPENDENT MIDWIFERY NURSING

• Health advisors and government policy makers have promoted Independent Midwives style of care as the ‘Gold Standard’ care in the future. • Independent Midwives womens' choice • In India every pregnant women is considered as ‘high risk’. • IMP is one of the measures & challenges to assist in reduction of maternal death Mrs. Neeta Rajesh Bhide, M.Sc. (N)

Cont---• Independent Midwives may also have undertaken extra training such as newborn examinations, tongue tie division, pain management, Hypnobirthing, acupressure, relaxation techniques & more

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

Clinical Statistics

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

WHAT WE CAN PROVIDE IN MIDWIFERY PRACTICE PACKAGE FOR INDEPENDENT PRACTICE • Access to a midwife 24 hours a day, 7 days a week. • Two midwives available alternatively & provide women centred antenatal, intrapartum & postnatal midwifery care. Antenatal care in privacy. • Continuity of care throughout labour either at home or hospital or referral to an obstetrician if necessary. • Postnatal care up to six weeks. • Knowledgeable breastfeeding Mrs. Neeta Rajesh Bhide, M.Sc. (N)

STANDARDS REQUIRED FOR THE PRACTICE OF MIDWIFERY • Standard- I = Midwifery care is provided by Qualified Practitioners. • Standard- II =Midwifery care occurs in safe environment within the context of the family, community & a system of health care • Standard- III = Midwifery care s individual rights & self-determination within boundaries of safety • Standard- IV = Midwifery care is comprised of knowledgeable, skill & judgment that foster the delivery of safe, satisfying & culturally competent care

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

• Standard- V = Midwifery care is based on knowledge, skills & judgement which are reflected in written practice guidelines. • Standard- VI =Midwifery care is documented in a format that is accessible and competent. • Standard- VII = Midwifery care is evaluated according to an established programme for quality management that includes a plan to identify & resolve problems. • Standard- VIII = Midwifery care may be extended beyond the set competencies to incorporate new procedures that improve care for women and their families. Mrs. Neeta Rajesh Bhide, M.Sc. (N)

CHALLENGES FOR INDIAN MIDWIVES • PRACTICE CHALLENGES *Rights & Responsibilities * Health care system should be integrated to midwifery services * Standards to be set * Ensure care , collaboration, consultation & referral Mrs. Neeta Rajesh Bhide, M.Sc. (N)

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Challenges for law regulation Educational challenges Challenges for research activities Challenges for policy makers. Develop a Midwifery practitioner course Salary Structure Develop nursing network Develop drug act policy for nurse.

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

CONCLUSION • The strong voices of powerful midwives, working close to government & civil society institutions & major external entities committed to improving maternal & newborn health status, have realized the goal of achieving IMP • Midwives many strengths and contributions have not been fully utilised to meet today’s health care needs.

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

THANK YOU

Mrs. Neeta Rajesh Bhide, M.Sc. (N)