Hey there, I hope you’re doing well. As you all know, every woman needs extra care during & after the pregnancy period. That is what you are gonna read in this blog. ‘What does midwifery mean’, its advantages & disadvantages. Moreover, Why there should be a close liaison between Domiciliary AND Institutional Delivery Services?
Childbirth is a normal physiological process, but complications may arise because of that. Septicemia may arise as a result of unskilled and septic manipulations, and also tetanus neonatorum from the use of unsterilized instruments. The need for effective intranatal care is therefore indispensable, even if the delivery is going to be a normal one.
The emphasis is on cleanliness. It entails- clean hands and fingernails, a clean surface for delivery, clean cutting care of the cord, and keeping the birth canal clean by avoiding harmful practices.
Hospitals and health centers should be equipped for delivery with midwifery kits, a regular supply of sterile gloves and drapes, towels, cleaning materials, soap, and antiseptic solution, as well as equipment for sterilizing instruments and supplies should be there, There are delivery kits available with the items needed for basic hygienic for delivery at home, where a midwife with a midwifery kit is not likely to be present, The aim of good intranatal care are:
- Through asepsis
- Delivery with minimum injury to the infant and mother
- Readiness to deal with complications such as prolonged labour, antepartum hemorrhage, convulsions, malpresentation, proplase of the cord, etc.
- Care of the baby at delivery-resuscitation, care of the cord, care of the eyes, etc.
Mothers with normal obstetric history may be advised to have their confinement in their own homes, provided the home conditions are satisfactory. In such cases, the Health Worker Female or trained ‘Dai’ may conduct the delivery. This is known as ‘domiciliary midwifery service’.
The advantages of the Domiciliary Midwifery service are:
- The Mother delivers in the familiar surroundings of her home and this may tend to remove the fear associated with delivery in a hospital.
- The chances for cross-infection are generally fewer at home than in the nursery/hospital and
- The mother is able to keep an eye on her children and domestic affairs, this may tend to ease her mental tension.
Domiciliary Midwifery is also not without disadvantages:
- The mother may have less medical and nursing supervision than in the hospital.
- The Mother may have less rest.
- She may resume her domestic duties too soon.
- She may not get a proper diet.
Strictly speaking, many homes in India are unsuitable for even a normal delivery. The argument that childbirth is a natural event and should take place at home does not guarantee that everything will be normal.
Since Seventy Four percent of India`s population lives in rural areas, most deliveries take place in the home with the aid of Female Health Workers or trained ‘dais’. Domiciliary outreach is a major component of intranatal health care.
The Female Health Worker who is a pivot of domiciliary care should be adequately trained to recognize the danger sign during the labor and seek immediate help in transferring the mother to the nearest Primary Health Centre or Hosptial. The danger signs are:
- Sluggish pains or no pains after rupturing membranes
- Good pains for an hour after rupturing of membranes, but no progress
- Prolapse of the cord or Hand
- Meconium–stained liquor or a slow irregular or excessively fast foetal heart rate
- Excessive show or bleeding during labour
- Collapse during labour
- A placenta not separated within half an hour after delivery
- Postpartum hemorrhage or collapse
- A temperature of deg thirty eight celsius or over during labour
So, in the end, we can say that there should be a close liaison between Domiciliary and Institutional delivery services.
Blog by: Remya Renjan Ma’am
Department of Nursing
Biyani Group of Colleges
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