Midwife

Terminology

Midwife Terminology
Obstetrics : It derived from Latin word
'obstetrex' meaning midwife rendering aid
to parturient (Obs is spelled as Ops (aid)
and stare (woman).
Obstetrics is newer terminology used last
four decades, older terminology is
midwifery (mid means 'with' and wif
means 'wife' (women): obsetetric deals
with that branch of medicine providing
care for parturition (childbirth), is
antecedents (pregnancy) and sequels
(Postnatal)

Contd
Neonatology : Means branch of medicine
dealing with neonate (newborn) Neonatal
period is 4 weeks of infant's life after birth.
Reproduction : Means process by which a
fully developed offspring of its kind is
produced.
Genetic (of origin) : means study of
heredity and its variation. Pregnancy is
state of carrying fetus inside uterus
(womb) by a woman from conception to
birth. Baby inside uterus is called fetus.

Contd
Gestation : means pregnancy. Duration of
normal pregnancy is 280 days (from 1st
day of last menstrual period) or 40 weeks
or 9 calendar months and 7 days.
Gestational age : Is the duration of
gestation from first day of last menstrual
period. Gestational age is expressed in
completed days or completed weeks.
Trimester : Of pregnancy is 3 months
period.
First Trimester : Is 12 weeks period from
first day of last menstrual period.

Contd
Second Trimester : Is second three
months from 13 to 28 weeks.
Third Trimester : Is third three months
from 29 to 40 weeks.
Labor (delivery) : means process of
childbirth.
Natal : means 'of birth.
Antenatal or prenatal : means before
births. Intranatal or natal means during
birth. Post natal means after birth.

Contd
Maternal : Relates to state of production
in a woman (pregnancy, childbirth and
postnatal period up to 24 days).
Perinatal : Is the period from 28 weeks of
pregnancy (or 1000 gm and above fetus)
to 7th days of birth (early neonatal life). In
view of increased survival of very low birth
weight babies by improved perinatal care.
Extended perinatal period means period
from 22th weeks of pregnancy (or 500 gm
and above fetus) to 7th days of life (an per
WHO, 1976).
Gravida : is pregnant state irrespective of
its duration.

Contd
Para : refers to state of a woman who has
given birth to a baby at or after the age of
viability i.e. 22 weeks.
Primigravidae : is a woman carrying first
pregnancy.
Multigravidae : is a woman carrying
pregnancy more than once.
Primiparae : is a woman who delivered
once of a fetus or fetuses at or after the
age of viability (22 weeks).
Multiparae : is a woman who delivered
more than one fetus or fetuses at or after
the age of viability.

Contd
Nulliparous : is a woman who has not given
birth to fetus at or after age of viability.
Expected date of delivery (EDD) : this is
calculated by adding nine calendar months and
7 days to first day of last menstrual period
provided menes are regular and normal 28 days
cycle. This is called Naegele's Rule, if the cycle
are longer, extra days beyond 28 is added for
calculation of EDD.
Maternal and Child Health (MCH) : Related
to the health of mother during pregnancy,
childbirth and postnatal period and that of child
up to 5 years.

Contd
Birth : is complete expulsion or extraction
of a fetus weighing 500 gm or more
whether or not umbilical cord has been cut
or the placenta is attached.
Live birth : is complete expulsion or
extraction of a product of conception,
breathe or show any other 'evidence of
life' such as beating of the heart, pulsation
of the umbilical cord or definite
movement of voluntary muscles; each
product of such a birth is considered live
born.

Contd
Abortion : An expulsion or extraction or
products of conception weighing less than
500 gm (22 completed weeks of
gestation), whether or not the abortion
was spontaneous or induced. Medico-legal
age of viability is taken at 28 weeks and
above. Previously abortion is taken as
termination of pregnancy before 28 weeks.
Embryo : is early fetus up to 8 weeks of
pregnancy.
Fetus : is intrauterine baby from 9-40
weeks pregnancy.
Immature fetus : 500 or less than

Contd
Premature fetus : 28 weeks to less than
37 completed weeks (less than 259 days).
Term : pregnancy 37 completed weeks to
less than 42 completed weeks (259 to 293
days).
Preterm : is pregnancy from 28 to less
than 37 completed weeks (less than 259
days). It is currently extended from 22th
week to less than 37 completed weeks
(less than 259 days).
Post term : is pregnancy of 42 completed
weeks or more (293 days or more).

Contd
MTP : is medical termination of pregnancy.
This is procured legal abortion done as a
health measure to protect a woman against
death and disease due to criminal abortion.
Birth weight : The first weight of an infant
within first 60 completed minutes after birth.
Birth time : In hour and minute at the time
of complete expulsion of baby from birth
canal.
Low birth weight : is baby weighing less
than 2500 gm (up to and including 2499
gm). Full size baby weigh 2500 gm or more.

Contd
Intrauterine growth retardation :
(IUGR) is baby with lower weight than
gestational age (below 10th percentile of
weight curve).

History of
Midwifery

Contd
Midwifery functions is starts mainly from
16th century.
Men were not allowed to help in labour.
Therefore experienced women who have
knowledge and skills takes such type of
care. These functions passed to their
daughters or sisters from generation to
generation.
First book on midwifery was published in
1513 A.D. in Germany.

Contd
First person to practice the modern art of
obstetrics was a French Surgeon named
Ambroise Pare.
In 18th century, formal instruction on midwifery
was started in Edinburgh.
In Nepal, births were attended by experienced
person. They were called 'Sudeni', TBA or Ajee
and who were called upon if the spontaneous
birth was delayed.
Training for midwives was stared by Nepal Red
Cross Society and Womans Organization. Then
it is given by Department of Health Services and
training section of health department (NHTC).

Contd
In 1928 AD (1985 BS) first group of ladies
were sent to India (Allahabad) for 18 months
midwifery training in Rana period namely
Vidyawati Kansakar, Radha Devi Malakar,
Dharma Devi Kansakar, Bishnu Devi Rai,
who upon returning worked at Bir Hospital.
Then 2nd lot, two ladies (Dr. Uma Devi Das
and Rumkini Charan Shrestha ) were sent to
India on 1952 AD (2009 BS) for 3 and half
years nursing course with 1 year internship.
After then, on 1953 AD, 3rd lot ladies were
sent to Delhi for midwifery training.

Contd
After establishment of the Maternity Hospital
Thapathali, midwifery training began in Nepal.
In curriculum of TU, CTEVT, KU, NAMS and
BPKIHS midwifery is included in the 3 years
programme on PCL nursing programme.
Midwifery is main component of ANM curriculum.
In 1977, the Bachelor of Midwifery started.
The first two batches of nurses comprised a total
of 22 nurses.
Under affiliation of Purbanchal University,
Bachelor of Midwifery was started from 2002.

Contd
Now-a-days, NHTC provide training to
nurse on essential obstetric care,
Midwifery refresher training, emergency
management etc
WHO provide training guidance for nurses.
Safe motherhood and NFHP in
collaboration with Family Health Division of
DoHS providing SBA, CAC & PAC training
for different level of health worker in
Nepal.