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Definition of midwife • is a professional in obstetrics. The midwife providing care to women during pregnancy and birth, some midwives may also provide primary care related to reproductive health, including annual gynecological exams, family planning, and menopausal care. Many developing countries are investing money and training for midwives and other community health workers so that they can provide well-woman primary care services that are currently lacking.
The definition of midwife was developed by International Confederations of midwives (ICM) in 1972, which was later adopted by international federation of Gynecology & obstetrics (IFGO), followed by World Health organization .
The ICM Global Midwifery Education Standards • The ICM acknowledges that all midwifery programmers should be accountable to public, mothers, and their families, the profession, employers, students as well as one another.
Scope of practice • The midwife is recognized as responsible and accountable profession who works in partnership with women to give the necessary support, care, advice during pregnancy, birth, and postpartum. • The midwife conducts birth on her responsibility and provides care for new born and infant. This care includes preventive measures, the promotion of normal birth , the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and caring of emergency situations.
Scope of practice • The midwife has an important role in health counseling & educations no only for the women but also for family and community. This work should involve antenatal education and preparation for parenthood sexual, reproductive health and child care. Amidwife may practice in any setting including the home, community, hospitals, clinics or health units.
The Millennium Development Goals (MDGs) • The MDGs have placed the poverty reduction, gender and wider social inequalities on the international agenda; some would argue that the blueprint or framework has its flaws given that the goals must be achieved by the 2015.
The core aims of the ICM (2013) GlobalStandards for Midwifery Education • 1. Essentially, to assist countries that do not have robust training programme(s) but are • 2. To support countries striving to improve and/or standardize the quality of their • 3. Offer a framework to countries with established programme(s) for midwifery education who may wish to compare the quality of their existing standards of midwifery education against the ICM minimum standards. • This can be achieved during the design, implementation and evaluation of the ongoing quality of the midwifery programme.
The eight Millennium Developmental goals • Eradicate extreme poverty and hunger • Achieve universal primary educations • Promote gender equality and empower women • Reduce child mortality • Improve maternal health • Control fetal disease such as AIDs and other • Ensure environmental sustainability • Global partnership for development
The emotional context of midwife • The midwife need to have an emotional awareness and able to recognize and acknowledge the women feeling and their response. The midwife not only aware to her own feeling but how this feeling met by woman. The midwives need to have a good communication skill with mothers and other team work. Some women complain that they did not receive affair emotional support from the medical team during their pregnancy & birth journey.
What is emotional work? • Emotional labour defined as the work that is undertaken to manage feelings so that they are appropriate for a particular situation. This will be done according to feeling rules and social norms and culture.
Sources of emotion work in midwifery practice • Midwife women relationship • Collegial relationship • The organization of maternity care
Midwife women relationship • The midwife work with women and family starting from pregnancy to post- delivery sharing the mother admixed of feeling and emotions. Pregnancy not always joyful experience for example midwife may work with women with: • Unwanted or unplanned pregnancy' • Illegal pregnancy • Pregnancy with congenital abnormality
In such cases the support need to be according to the situation the midwife need to be intelligent in her reaction she need to be good listener . Some relation called short live (birth) while other called long live (pregnancy & antenatal). The relationship should be with mutual relation exchange of benefit the midwife has to use her effective communication in dealing with aggressive and hostile women.
Collegial relationship Workings with multidisciplinary and multiagency team are the key source of emotion. Positive collegial relationship provides emotional and practical support. Midwives provide each other's with mutual support build on trust, compassion, and solidarity.
The organization of maternity care The maternity care that given to any client should be well organized. The fragmented task-oriented nature of much hospital based maternity care create difficult situations for midwives as it reduce the chance for establishing meaningful relationships with women and colleagues. One study prove that frustration with the organization of maternity care consider as one reason why midwives leaves the profession.
Managing emotions in midwifery • Two different approaches to emotion management • Affective neutrality • Affective awareness
Affective neutrality Describe as professional detachment which mean that emotion need to be suppressed in order to get the work done efficiently so the work will be emotion free zone. The care is given to client with avoidance of discussing emotional issue and focus on practical tasks. This can be problem for midwives who like to work in more emotional awareness way and this affect the quality of care.
Affective awareness This agrees with the new trend of midwifery approach of practice strategy. In this approach it is important to be aware of feeling and express them when it possible. Sharing feeling encourage women for trust, explore feeling and positive relation. This approach emphasize on the effective role of midwife as counselor and psychotherapist
Challenges A lot of challenges face the midwives to practice or to adopt the affective awareness such as: • Stress • Unsustainable workloads • Staff shortage • Conflict with colleagues • cultures • political and social norms
Developing emotional awareness Emotional awareness can be develops through processes of feminization, emotionally responsive leadership style, language of feeling , and this can be achieved by attending on counseling and assertiveness courses.
