• Rights and obligations of the midwives, who work independently under General guidance of the doctor
  • The midwife (from France. accoucher - to assist in delivery) - health care workers with secondary medical education, whose responsibilities include assisting pregnant women during childbirth, postpartum and newborn care.
    In obstetric institutions (maternity hospitals, antenatal clinics, health posts), working directly under the supervision of doctors, a midwife has the right to independently perform medical manipulations within the limits stipulated by the regulation on the rights and duties of midwives, approved by the Ministry of health of the USSR.
    The duties of a midwife is also patronage (visited and monitored at home pregnant women and mothers in the first time after the birth), carrying out sanprosvet (especially as regards hygiene during pregnancy, childbirth and prevention of women's diseases), working with sanitary asset.
    A. also conducts preventive examination of women with the purpose of early detection of gynecological diseases and their division.
    Especially great is the midwives in rural areas where they are headed obstetrical centers and collective maternity hospital. In these institutions, they are required to register each pregnant woman, to observe the course of pregnancy, to reveal pathology at early stages for timely referral, to conduct psycho preparation for childbirth, organize and carry out school mothers, to assist mothers in childbirth in the collective farm maternity hospitals or at home, postpartum, newborn and infants.
    In cases of abnormally flowing childbirth or complications A. causes of a physician; but when the doctor to call impossible, and complications become dangerous for the mother and fetus, it is obliged itself to make the necessary obstetric operations aimed at saving the lives of mothers and children.
    Prepare midwives medical school; the period of training is 3 years (with 8-year General education) and 2 years (10-11 years of General education). Cm. also the medical Assistant.

    The midwife is a medical officer with secondary special education, providing treatment and prevention of obstetric-gynecological care.
    The term of training for midwives in the medical schools in the 8-cool (incomplete secondary) education - 3,5; 10-cool (complete secondary education) education - 2,5 years. In accordance with the procedure established by law on the office of a midwife can work the persons who have received this title.
    The work of midwives in the USSR under construction in accordance with approved by the Ministry of health of the USSR "Regulation on the rights and duties of midwives."
    The midwife can work: a) under the direct supervision of a doctor in urban and rural medical institutions, maternity hospitals, maternity hospitals, antenatal clinics and other; b) independently, under the General supervision of a doctor obstetrician-gynecologist of the district or precinct hospitals, mainly in rural areas - in midwifery and obstetric points, in the collective farm maternity hospitals, antenatal clinics and other
    Rights and obligations of the midwives, who work under the direct supervision of a physician
    The midwife is obliged to take on dispensary account of all pregnant women with early pregnancy and to ensure systematic observation. It is obliged to timely identify diseases of a pregnant woman and send it in necessary cases to the doctor to decide on the date of the birth of a child, to prevent complications of pregnancy. Outpatient reception midwife met with passport data pregnant; detects disease in the family: mental, malformations, alcoholism and others, women diseases and operations in childhood and Mature age, paying particular attention to rickets, various infectious diseases, diseases of cardiovascular system and other
    The midwife asked the woman about menstrual function, noting the agein which appeared the first menstruation, its type (3 - or 4-week cycle), the duration, the number of loose blood and other, date of last menstrual period, explains secretory (having whiter, character), sexual and reproductive functions. The midwife collects obstetric anamnesis: finds out what account the pregnancy, during the previous pregnancy (abortion, the threat of termination of pregnancy and other) and what they ended (urgent, premature birth, miscarriage, and so on), the nature of previous births (complications of surgery, stillbirths, or death of the child after birth, bleeding during and so on). The midwife finds out her husband health of pregnant women, paying special attention to the disease, venereal diseases and tuberculosis, and get acquainted with conditions of work and life of the pregnant woman. The obtained data is shared and obstetric anamnesis midwife records in the individual map pregnant or birth history.
    The midwife examines a pregnant (notes the body type, the power, the degree of development of the mammary glands, swelling of the body, the skin and visible mucous membranes, the shape of the abdomen and lumbar vertebral diamond), and carefully examine it (measures the growth and the weight of the body, the outer dimensions of the pelvis, abdominal circumference, height of standing of the fundus of the uterus, determines the position, the presentation of the fetus, listens and suscitavit the heartbeat of the fetus in the 2nd half of pregnancy, and others), will study the discharge from the nose, throat on carriage staphylococcal infectionsof the vagina, cervix (to avoid diseases gonorrhoea and trichomoniasis), blood for determination of RH supplies and performances reaction Wasserman, defines the blood group and conducts other research by a doctor (see Midwifery research).
    During pregnancy a woman is supervised by midwives. In the first half of pregnancy midwife examines a pregnant 1 time, in the second half to 2 times a month, if there are no indications to more frequent inspections. If a pregnant timely did not appear for another midwife visits her at home (patronage). At each visit, in addition to the General and midwifery studies, the midwife systematically measure blood pressure, explores the urine protein and monitors the weight of a woman's body, which is important to identify toxicosis of pregnancy.
    The midwife conducts sanitary-educational work among pregnant women, conducts lessons in the school of mothers, gives advice on personal hygiene and food hygiene, takes measures to improve the working conditions and life of the pregnant woman. The midwife provides prevention of complications of pregnancy; if you see any signs of the disease (cardiovascular system, kidneys, liver and other organs), the first signs of pregnancy complications (toxicosis of pregnancy, the threat of premature termination of pregnancy, bleeding from the uterus), and abnormal position of the fetus, multiple pregnancy, polyhydramnion the trends peremeshivanie and other midwife shall send the woman to the doctor.
    From the 32nd week of pregnancy, the midwife should conduct psycho training pregnant for the birth.
    The midwife is obliged to provide medical care in childbirth and the postpartum period. In obstetric hospitals (maternity hospital, maternity hospital, where the number of doctors is not possible to provide an hour of their work (shift), the midwife may be obliged (at certain times of the day) to bear independently the duty and conduct normal deliveries; in necessary cases, it calls the doctor.
    The midwife has been accepting in obstetric institutions pregnancy, labor and, in some cases, mothers with newborns. She met with the overall condition of entering, identifies having contact with infectious patients, produces primary examination, paying particular attention to the skin, mouth, genitals, measures the heart rate, body temperature, collects history, measuring height, weighs, explores urine protein. The data obtained midwife writes in the history of childbirth. With the help of the nurse midwife produces toilet pregnant and lying-in women (shaving, enema, a shower).
    In the first period of labor, the midwife carefully monitors the health of mothers (measuring blood pressure, pulse , and others), nature of descent (frequency, duration and strength of contractions), promotion predlagay part, fetal heart rate, rupture of amniotic fluid (their quantity and quality) and for the action of the bladder and intestines. The midwife must numb childbirth, using the methods of psychological prevention and, where necessary medications.
    In the second stage of labor to the midwife is the duty of delivery (protection crotch against damage and careful removal of the fruit of the generic ways), carrying out the primary processing of the newborn (primary his toilet, prevention of infections of the eye, transection and ligation of the umbilical cord), secondary treatment of the newborn (re toilet, secondary treatment of umbilical cord, weighing, measuring, swaddling).
    The midwife should be able to detect signs of fetal asphyxia fruit, to carry out its prevention and apply the methods of recovery of children born in asphyxia.
    In the following period the midwife carefully monitors the condition of the pregnant woman, the division and allocation of the placenta, height of standing of the fundus of the uterus and blood loss.
    Postpartum postpartum women and newborn remain under the observation of the midwives during 2-3 hours. It monitors the state of postpartum women and adolescent girls (pulse, blood pressure, the tone of the uterine hemorrhage, and so on) and the newborn (breathing, colour of skin, and so on).

    In the postpartum period midwife carefully watching the postpartum women (General condition and health, the condition of the Breasts, the nipples, the function of the bladder and intestines); checks the height of standing of the fundus of the uterus, its texture, character lohii; measures the heart rate, body temperature; ensures proper treatment and care of postpartum women and newborns. In the function midwives includes detection of pathological childbirth and postnatal period and immediately call a doctor in necessary cases.
    Monitoring travaileth after discharge from hospital, midwife holds by outpatient admissions and nursing at home.
    When providing treatment and preventive gynecological care for the midwife has the responsibility of identifying gynecological diseases and direction of women to the doctor when establishing she disease or suspected him. In order to identify gynecological patients midwife conducts mass prophylactic medical examinations on the attached enterprises, examination rooms clinics , etc.
    The midwife together with a doctor treats patients gynecological patients and the doctor is treating (if necessary by a doctor - at home).
    In order to prevent pregnancy and anti - abortion midwife recommends contraceptives (mechanical, chemical and others) and teaches women how to apply them.
    The midwife has to observe rules of personal hygiene (change Bathrobe and a shower after contact with infectious patient), rules of aseptics and antiseptics, sterilization and storage bandages and dressings, surgical and obstetric instruments, items of care and linen; if necessary, to perform the role of the operating sisters in obstetric-gynecological practice; widely carry out sanitary-educational work on the protection of the health of pregnant mothers, the newborn; to monitor compliance with laws on the protection of the health of women and children, including the implementation of legislation the work of women; shall be carried out medical accounting and reporting documentation. The midwife is obliged to provide emergency first medical aid in case of accidents.
    Performing of medical-preventive work, the midwife has the right to make venipuncture for blood tests, to kateterizatia bladder, apply chromosone banks, leeches, mustard plasters, poultices, carry on doctor various conservative methods of treatment of gynecologic patients (vaginal baths, tampons, douche, various medicinal substances), administered subcutaneously and intramuscularly drug solutions. According to doctor, the midwife intravenous drug enters solutions.
    The midwife has the right by a doctor in his presence and under the direct guidance and supervision of intravenous pour the blood, give inhalation anesthesia and to assist during the operation.