Transcript Maureen Mc Cabe Lecture 2014 - Irish Nursing Board, An

The Role of the Midwife in Ireland –An
Historical Perspective
A.L.Mulhall.
Maureen Mc Cabe
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Elizabeth O’ Farrell
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Surrender of Patrick Pearse
 ‘For social practices like nursing and midwifery ,
konwledge of the past informs understanding of
historical developments and establishes contexts for
current developments ‘
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( Fealy and O Doherty 2005 p.11)
Midwife and her role
Bible
Egypt
Greece
Rome
Celtic
ebers papyrus
Birth stool Temple of Amen Luxor 1780 Mutemua is seated on
birth stool a midwife holds newborn baby
Bridget Goddess
Bridget / St Bridget
Midwife Role in 7th-11 century
 Brehon Laws
 800-1600
 Irish Annals (6)
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 Norse -The Vikings
Midwife and Witch Hunts
Malleus Maleficarum 1486 written by James Springer & Henry Kramer –judicial case book for the
detection and persecution of witches.
Power of Church and Role of the Midwife
 Church Act 1512
 Council of Trent 1540’s
In Paris 1560 had a set of statutes and rules which
 provided a legal framework for the practice of
midwifery
 Louise B0urgeois ( 1563-1636)Complete Midwife’s
Practice
 Catherina Schrader-Fresian Midwife (1693-1740)
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birth stool
 Mary Donally –first c/s in Ireland 1738 on Alice O’
Neale using a razor , mother survived.
Rise of the Man Midwife
Drawings from dissections
 Fetus in utero Leonardo Da Vinci (1452-1519)
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Making Their Case
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Ambroise Pare 1510-1590
College of Physicians Charter Dublin1784
James Wolveridge ‘Irish Midwives Handbook’ 1671
Fielding Ould ‘Treatise of Midwifery 1841
Founding of the Lying- In Hospitals-Hotel Dieu Paris
Dublin Lying-In Hospital 1745
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Donegal St Belfast 1793
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Coombe Lying –In Hospital 1826
Institution for poor Lying In Women and Diseases of the Female Mercers Street 1827
Anglesley Lying-In hospital Peter Street 1828
Lying –In hospital Townend Street closed 1836
South Eastern Lying –In Hospital & Dispensary St Cumberland Street 1836
Western Lying –In Hospital 24 Arran Quay 1835
Kingstown Lying –In Hospital Clarence Street 1842
Sir Patrick Dunns Hospital 1858
Development of
Maternity Services
 Home –doctor , midwife, handywoman ,female
relative
 Lying-In Hospital- the poor
 Poor Law Act -1838 Work Houses
 Charities Act 1862- dispensary districts - doctor & midwife
 1864 Civil Registration of Births ,Marriages, Deaths 136,414
births registered( 105 boys to 100 girls)
 Local Councils established 1898
 District nursing services –Lady Dudley, Jubilee Nurses
 Local Government Board 1910
Regulation of Medicine and Midwives
 Medical Registration Act 1858-extended to Ireland
 Regulation of Midwives practice in United Kingdom
 The debate –Royal College of Physicians
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Midwives
Lying –In Hospitals –recognition of certificates of training
 Obstetrical Society in London 1870
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Midwives Act 1902 Roll, Rules, Education & Training, Recognition
Midwives Act 1915 –Scotland
Midwives Act 1918 – Central Midwives Board of Ireland
Midwives act 1931,1944,
Nurses Act 1950,1985 An Bord Altranais, definition of nurse, midwife
Nurses and Midwives Act 2011 -
Role of Midwife 1900- 1950
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Where practice was carried out
Education and training.
Maternal and infant mortality rates
Organisation of maternity services
Associations- Irish Nurses and Midwives Union-INO
Problems, New State , Civil War, finance, social and
obstetrical problems incl. poverty, multiparity, anaemia, budget ,
disease,
 Developments
 Central Midwives Board of Ireland –Nurses Act 1950
Role of Midwife 1950-1990
 Practice-regulation-rules
 Maternal & Infant Mortality Rates
 Maternity and Infant Care Scheme 1956
 Decline in Home Births
 Medicalisation of births
 Comhairle na nOspideal Report 1976
 ICM Definition of the Midwife 1972
 Eu Directive 1980
 International Confederation of Midwives
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Definition of the Midwife
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A midwife is a person who has successfully completed a midwifery education
programme that is duly recognized in the country where it is located and that is
based on the ICM Essential Competencies for Basic Midwifery Practice and the
framework of the ICM Global Standards for Midwifery Education; who has
acquired the requisite qualifications to be registered and/or legally licensed to
practice midwifery and use the title ‘midwife’; and who demonstrates
competency in the practice of midwifery.
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Scope of Practice
The midwife is recognised as a responsible and accountable professional who
works in partnership with women to give the necessary support, care and
advice during pregnancy, labour and the postpartum period, to conduct births
on the midwife’s own responsibility and to provide care for the newborn and the
infant. This care includes preventative measures, the promotion of normal birth,
the detection of complications in mother and child, the accessing of medical
care or other appropriate assistance and the carrying out of emergency
measures.
The midwife has an important task in health counselling and education, not only
for the woman, but also within the family and the community. This work should
involve antenatal education and preparation for parenthood and may extend to
women’s health, sexual or reproductive health and child care.
A midwife may practise in any setting including the home, community, hospitals,
clinics or health units.
Revised and adopted by ICM Council June 15, 2011
Role of Midwife 1950-1990 Contd
 Education and Training
 Working Party Report on General Nursing 1980
 Academic Accreditation of Midwifery Tutors
 District Services and Flying squads ceased 1987/8
 Expansion of Midwife’s role
 Research into Midwifery Practice, Expansion
 Continuing Education
 Nurses Act 1985 –An Bord Altranais 3 Midwife
Members (29)
Role of Midwife 1990- 2014
 An Bord Altranais –Education and Training Registration, Fitness
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to Practice, Advice
INO – Trade Union-strike
Commission on Nursing-recommendations CNO
clincal,education,midwife-distinct,education,research,
National Council for Professional Development of Nursing and
Midwifery- Scope of Practice, CMS,AMP,ANNP
Review of Maternity and Infant Care Scheme –pilot schemes
Expansion of role
Education -University (undergraduate Midwifery 2006) Degrees
CME 2008
Kinder Report –MLU Drogheda,Cavan –research Midu study.
KPMG Report
Issues that will effect the role of
the midwives
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Practice Standards (9)for Midwives July2010
Philosophy,Standards, Competencies
Models of care- increase in choice, ETHS,Domino,Home Birth
Delivery on Choice – Home birth options for women in Ireland
Midwifery Led Care – Hatem et al
Mid U study 2009
Appointment of National Lead for Midwifery in HSE & 4 DMO
Nurses and Midwives Act 2011National programme in Obstetrics & Gynaecology
Guidelines
Perinatal Statistics
Maternal Mortality Triennial Reports
Reports and Inquiries- Recommendations and their implementation
Future of Maternity Services- midwives input & influence on outcomes
Recession
 With the rising Caesarean Section rate ( 28.1% (2012)
23.1% (2003))and decreasing Spontaneous Vaginal
Delivery Rate ( 56.36% (2012) 61.8% (2003) ) what can
we do as midwives to SVD rates?
 When we see the ICM Definition of the Midwife - the
promotion of normal birth ,Midwifery Standards
& Philosophy of the The Irish Nursing and Midwifery
Board and our knowledge of morbidity of Caersarean
Sections what will historians say in 30 years time
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that is our challenge
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Thank you
References
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Barrington Ruth ‘Health Medicine & Politics in Ireland 1900-1970 Institute of Public Administration
Dublin 1987
Boyd Gary A. Dublin 1745-1922 Hospitals,Spectacle & Vice Four Courts Press Dublin 2006
Brown J ‘Professional Language;Words that Succeed’ Radical History Review 34 1986 pp33-51
Clear Caitriona’ Women of the House Women’s household Work in Ireland 1922-1961 ‘Irish Academic Press
,Dublin pp96-125
Condren Mary ‘The Serpent and the Goddess Women, Religion and Power in Celtic Ireland’ New Island
Books, Dublin 2002 p 231
‘Customs peculiar to certain days formerly observed in County Kildare’ Journal of the Kildare
Archaeoliogcal Society 5 (1906-1908)439-55 439
Carmina Gadel ica ed alexander Carmichael 2 vols Edinburgh constable 1900
Devane Declan,Murphy Lawless Jo. Scene and Obscene Childbirth in Ireland History in Care to Remember,
Nursing and Midwifery In Ireland Fealy GM (Ed) Mercier Press Cork pp138-157
Donnison Jean Midwives and Medical Men A history of the struggle for the Control of Childbirth Historical
Publications London 1988
Ehrenreich, barbara, English Deirdre (2010) Witches Midwives and Nurses A History of Women Healers (2nd
Edition ) The Feminist Press
Farmar Tony Holles Street 1894-1994 The National Maternity Hospital –A centenary History A&A Farmer
Dublin 1994
Fealy G.M O’Doherty M Lessons from History in Care to Remember Nursing and Midwifery In Ireland
Fealy GM (Ed) Mercier Press Cork pp 11- 27
References contd
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Ferguson JC Auscultation; The only unequivocal evidence of pregnancy Dublin Med Transact 1830 ;I;64
French Valerie (1986”) Midwives and Maternity Care in the Roman World( Oxford Oxford University Press
Fleetwood JF The History of Medicine in Ireland Skellig Press Dublin p189
Greenhills William Alexander (1867) Agnodice
Hensey Brendan The Health Services of Ireland Institute of Public Adminstration ,Dublin 1979
ICM Definition of the Midwife International Confederation of Midwives The Hague 2005
Jackson Ralph (1988) Doctors and Diseases in the Roman Empire ( Norman University of Oklahoma press p.97
Jochens Jenny M Women in Old Norse Society Ithaca: Cornell Univ. Press 1995
Heinsohn Gunnar , Steiger Otto ‘Witchcraft, Population catastrophe and economic crisis in Renaissance Europe ; an
alternative macroeconomic explanation’ University of Bremen, 2004
Kelly James The Emergence of Scientific and Institutional Medical Practice in Ireland ,1650-1800
Kelly Mary A The development of Midwifery at the Rotunda in Masters Midwives and Ladies- in- Waiting the Rotunda
Hospital 1745-1995 ed Alan Browne A&A Framer Dublin.pp77-117
In Medicine ,Disease and the State in Ireland 1650-1940 Ed Malcolm Eliz Jones Greta Cork University Press Cork 1999,
pp21-39
Marland Hilary Rafferty Midwives, Society and Childbirth London Routledge 1997
Mc Mahon Ann Regulating Midwives The role of the RCPI in Care to Remember Nursing and Midwifery In Ireland
Fealy GM (Ed) Mercier Press Cork pp 158-171
Mulhall Ann Louise The Founding of the Coombe Lying –In Hospital 1826-1851 assignment for Certificate in Local
History NUI Maynooth.
Murphy –Lawless The Silencing of Women in Childbirth or lets hear it for Bartholemew and the Boys in Irish Women’s
Studies Reader ed Ailbhe Smyth Attic Press Dublin pp9-19
References contd.
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Murphy Lawless editor Childbirth 1742-1955 in The Field Day Anthology of Irish Writing Cork University Pres,s Cork
pp896-913
The Office of the Midwife –some historical background www.nursing.manchester.ac.uk /ukchnm/midwives/office of
midwife.pdf on 16/03/2014
O’Dowd M J and Philipp EE The history of obstetrics and gynaecology Carnforth:Parthenon Publishing Group 1994
O’Dwyer Ita, Mulhall Ann Louise Midwifery in Nursing and Midwifery in Ireland in the Twentieth Century ed Joseph
Robins An Bord Altranais Dublin 2000.
O’Sullivan John F Two Hundred Years of Midwifery 1806-2006 Ulster Med Journal2006 75(3) 213-222
O’Sullivan JF Some highlights of obstetrics in Ireland Ulster Medical Journal 1980 49 (2) 105-116
Parliamentary Reports
First Annual Reports of the Board of Superintendents of Dublin Hospitals February 1858 Alex Thom. Dublin.
Radcliffe Walter Milestones in Midwifery Wright John & sons Bristol 1967
Report of the administration of local government services (1921-23)Belfast HMSO 1924
Scanlan Pauline The Irish Nurse A Study of Nursing in Ireland History and Education 1718-1981 Drumlin
Manorhamilton 1991
Schrader Catherina “ Mother and Child were Saved the memoirs (1693-1740) of the Fresian Midwife Translated by Hilary
Marland Rodopi, Amsterdam 1987
Tierney B Working Party on General Nursing Government Publications March 1980
Towell Jean, Braimal Joan ( 1986 ) Midwives in History and Society ( London: Croom Helm,1986)
Witz Anne Professions and Patriarchy London Routledge pp104-127
White NB A Licence from the bishop of Ossory to a Midwife in Journal of Archeological society Kilkenny and Southeast
Ireland 1886 pp412-413