Midwifery Scope

The scope of midwifery practice in Ireland is the range of roles, functions, responsibilities and activities which a registered midwife is educated, competent, and has authority to perform. This definition of the scope of midwifery practice must be understood in the context of the EEC Directive on the activities of a midwife and the definition of a midwife as outlined by the WHO/ICM/FIGO (1992). The scope of midwifery practice is outlined within the EEC (currently known as The EU) Council Directive of 1980 (80/155/EEC). This directive, concerning the coordination of provisions laid down by law, regulation or administrative action in respect of the activities of midwives, outlines the minimum knowledge and clinical experience necessary for midwifery and outlines the activities that midwives are at least entitled to take up and pursue. EEC Council Directive of 1980 (80/155/EEC): Member States shall ensure that midwives are at least entitled to take up and pursue the following activities: 1. To provide sound family planning information and advice. 2. To diagnose pregnancies and monitor normal pregnancies; to carry out the examinations necessary for the monitoring of the development of normal pregnancies. 3. To prescribe or advise on the examinations necessary for the earliest possible diagnosis of pregnancies at risk. 4. To provide a programme of parenthood preparation and a complete preparation for childbirth including advice on hygiene and nutrition. 5. To care for and assist the mother during labour and to monitor the condition of the foetus in utero by the appropriate clinical and technical means. 6. To conduct spontaneous deliveries including where required an episiotomy and in urgent cases a breech delivery. 7. To recognise the warning signs of abnormality in the mother or infant which necessitate referral to a doctor and to assist the latter where appropriate; to take the necessary emergency measures in the doctors absence, in particular the manual removal of the placenta, possibly followed by the manual examination of the uterus. 8. To examine and care for the new-born infant; to take all initiatives which are necessary in case of need and to carry out where necessary immediate resuscitation. 9. To care for and monitor the progress of the mother in the post-natal period and to give all necessary advice to the mother on infant care to enable her to ensure the optimum progress of the new-born infant.

10. To carry out the treatment prescribed by a doctor; to maintain all necessary records.

The Midwifery Scope of Practice

The midwife works in partnership with women, on her own professional responsibility, to give women the necessary support, care and advice during pregnancy, labour and the postpartum period up to six weeks, to facilitate births and to provide care for the newborn. The midwife understands, promotes and facilitates the physiological processes of pregnancy and childbirth, identifies complications that may arise in mother and baby, accesses appropriate medical assistance, and implements emergency measures as necessary. When women require referral midwives provide midwifery care in collaboration with other health professionals. Midwives have an important role in health and wellness promotion and education for the woman, her family and the community. Midwifery practice involves informing and preparing the woman and her family for pregnancy, birth, breastfeeding and parenthood and includes certain aspects of women's health, family planning and infant well-being. The midwife may practise in any setting, including the home, the community, hospitals, or in any other maternity service. In all settings, the midwife remains responsible and accountable for the care she provides. he right for a midwife to establish an independent practice is given in the Medical Service Law, and the obligation to patient confidentiality is stated in the penal code. In addition, the title "Birth Control Instructor" is given under the Maternal Protection Law. 1. Independent practice (Administration of the midwifery home) When a midwife has established a midwifery home, she has to notify the governor of the prefecture where the midwifery home is located, of the fact within ten days of the establishment. (Medical Law, Article 8) 2. Birth Control Instructor Maternal Protection Law, Article 15 states as follows: "the practice of instructing women about birth control utilizing the contraceptive device specified by the Minister of Health, Labour and Welfare is only allowed to physicians and those who are designated by the governor of the prefecture". Those who may be designated by the governor of the prefecture are midwives, public health nurses or nurses who has finished the courses which the governor of the prefecture certifies according to the standard set by the Minister of Health, Labour and Welfare. (Article 15, Paragraph 2) 3. Obligation to confidentiality Article 134 of the Penal Code states that physicians, vendors of the pharmaceutical products, midwives, layers, defendants and notaries, as well as those who used to be

engaged in these occupations, are to be given a punishment by imprisonment for six months or over, or maximum fine of 100,000 yen, when they have breached the confidentiality without legitimate grounds and disclosed others the clients' information obtained through their practice.
Community midwives

These midwives often work in teams and provide a degree of continuity of care. In pregnancy they see you either at home or at a clinic. When you go into labour they are available for a home birth, or in a few places, they may come into the labour ward in the hospital to be with you. Once your baby is born, theyll visit you at home for up to ten days after birth. Community midwives also provide postnatal care for women who have been looked after during labour by hospital midwives.
What Will You Do as Certified Nurse-Midwife/Family Nurse Practitioner?

As a result of the nurse-midwifery specialty courses, you will be prepared to manage the obstetric and primary health care needs of women across the lifespan as well as newborn infants. Curriculum and clinical experiences in the Family Nurse Practitioner program will expand your delivery of primary care to children and men, so that you can also treat these individuals with acute illnesses such as bronchitis or headache and chronic illnesses such as diabetes, high blood pressure and obesity. Preventive health services, patient education, disease management, illness prevention and other kinds of care are provided within the context of family and community. Through the combination of specialties, you will be prepared as a family nurse practitioner and midwife to deliver comprehensive primary care to individuals from preconception through adulthood.
How Will Vanderbilt Prepare SHN - Sexual and Reproductive Health endorsed RN - Queensland Austral ME - Menopause Educator

MATERNAL ROLE ATTAINMENT THEORY Formulated to serve as a framework for nurses to provide appropriate health care interventions for nontraditional mothers so they could successfully attain a strong maternal identity. Provide appropriate health care intervention for nontraditional mothers Assist nontraditional mothers to attain a strong maternal identity. CONCEPTS Maternal Role Attainment Primary Concept-Developmental and interactional process occurs over a period of time Mother bonds with infant, acquires competence in caretaking tasks, enjoys and expresses joy and pleasure in the role Maternal Identity-Personal state of harmony, confidence and competence. End point of maternal role attainment.

Process follows 4 stages of acquisition Anticipatory: Social and psychological adaptation to role; learning expectations. Fantasizes about the role "What to expect when you are expecting." Formal: Assumption of role at birth; Behaviors guided by others in social system/ network; "My mother always told me" Informal: Mother develops own ways of mothering; not conveyed by social system Personal: Joy of Motherhood; Harmony, confidence, and competence in maternal role.; " Im ready to have another one"