HISTORY AND CONTE MPRY PERSPE CTIVES

ORIGIN OF OBSTETRICS

As we all know that birth is the complex final act of nature’s greatest miracle i.e. formation and arrival of a
child in the world. And the science and art that deals with human reproduction is called Obstetrics.

HISTORY OF MIDWIFERY IN INDIA:

In Ancient India, care of women and practice of Midwifery were totally in the hands of village dais.

 Women were subject to the purdah system.

 The occupation of dais was hereditary and all dais was from lower caste as the period of childbirth
was considered a time of impurity.
 The worst room in the household was alloted for delivery.

CONTD…
Dais gained their skill through observation and
practice.
And when dais could not handle the situtation
serious morbidity and mortality were the result
and these all were explained as “Beyond human
control phenomena.”
DURING BRITISH INDIA:
In 1900 A.D. Dr. Ida sophia Scudder after got
news from the village people that 3 women died
during delivery who were actually calling her to
help then she decided and started with Christian
Medical College & Hospital (CMCH) at
Vellore.Later in 1950,the doors of CMC & H
opened for male training.
CONTD…
In 1899,Zenana Bible and medical mission
started training of nurses.
In 1883 Lady Dufferin came to India alloted fund
to start maternity hospitals and training of
nurses and midwives all over the country.
It was with help of this Fund that Lady Reading
Health School was established in 1918 at Delhi.

MIDWIFERY IN INDEPENDENT
INDIA:
In 1946,Bhore committee laid the foundation for
public health planning in India laid great
stress on the need for qualified midwives and
health visitors.
In 1947,INC combine the Nursing and Midwifery
courses into single course.
In 1955,Shetty Committee recommended training
and posting ANMs in health services with a
qualification of class VIII & supervised by LHV.
In 1959,Bischoff supported the training of
personnel.
CONTD…
ANMs for 3 yrs. And midwifery for 1 yr.
In 1975,MPHW scheme launched by Kartar
Singh Committee.
MPHW were registered as ANMs and were
designated as Female Health Workers ,posted at
subcentres for 5000 rural population.
They supervise the deliveries conducted by dias.

HISTORICAL DEVELOPMENT IN
OBSTETRICS
In 1739,in London,Willam Smellie and his
student Willam Hunter become obstetrican and
work for the same.
In 1744,Willam Smellie introduce steel lock
forceps.
In 1752,Willam Smellie publish ‘Textbook of
Obstetrics’.
In 1760,Puerperal fever was on peak in London
in Lying-in hospital.
CONTD…
On Jan 14th,1794 first Cesarean operation was
performed by Dr. Jesse Benaett of Virginia on his
wife.
First school of midwives was established at Pare
instigation at the hotel Dieu in Paris.
In 18th century National regulation of
education and practice of midwifery begans.

CONTD…
In 1807,Samuel Bard publish first book on
obstetrics on four stages of labour.
In 1847,Semmelweis,in Vienna,demonstrate that
washing of hands in chlorine of lime solution
before examining women in labor reduce
puerperal fever.Chloride of lime used as
antiseptic.
CONTD…
Obstetrical forceps was developed by Dr. Peter
Chamberlen.In the past only Greeks used variety
of hooks and tractors to deliver dead fetus.
In 1853,Dr. James Y.Simpson of Glasgow
suceeded in introducing the use of Chloroform
anesthesia as an aid in obstetrics called “ERA OF
MODERN OBSTETRICS”.

CONTD…
Then,Pinard Fetoscope was developed and Ian
Donald from Glasgow introduce Ultrasound in
Obstetrics.
In 1950,Fritz Fuch of Copenhagen performed
Amniotomy identified the fetal cells present in it
which identify sex of the baby by barr bodies.
CONTD…
Later on emphasis on Antenatal check-ups,blood
pressure,urine analysis was came in attention.
In 1892,Dr. Pierre Budin initiated consulation for
nursing mothers.
In 1949,first world health organization expert
committee on maternal child health met in
Geneva.

CONTD…
 In 1950,Oral contraceptives was introduce for the
control of fertility.
Then b-HCG tracing was done with chorion villus
sampling at 10th wk.
Identification of IUGR was done by NS test.
Later on Raoul Palwer & Patrick steptol discover
Laproscopic Sterlization.
In 1960,Witness abortion get started.
CONTD…

1971 – MTP Act

1974 – Family Planning Services Incorporated In

MCH Care
1977 – Renaming Family Planning To

Family Welfare
CONTD…

1978 – Expanded Programme on Immunization

1985 – Universal Immunization Programme

1992 – Child Survival& Safe Motherhood

Programme
CONTD…

1996 – Target Free Approach

1997 – RCH Programme Phase-1 (15-10-1997)

2005 – RCH Programme Phase-2 (01-04-2005)

CONTEMPARY PERSPECTIVE OF
OBSTETRICS
In current view all the focus from obstetrics care
shifted to perinatal care.
Advancement in Obstetrics care has reduces the
MMR.
Govt. has started programme to identify high
risk mothers.
Training of health personnels,Allocation of
facilities & equipment decreases MMR.
CONTD…
MMR can be reduces:
Early registration of pregnancy.
Atleast three antenatal check-ups.
Dietary supplements can correct anemia.
Prevention of infection and haemorrhage during
puerperium.
Prevention of complications e.g.
Eccalmpsia,malpresentation,ruptured uterus.
CONTD…
Treatment of medical conditions
e.g. hypertension,DM,TB.
Anti-malaria and tetnus
prophylaxis. Clean delivery practice.
Institutional deliveries for women with BOH
and risk factors.
Promotion of family planning.
CONTD…
MCH services has started which aims at
reduction in morbidity and mortality rate of
mother and baby.
Baby friendly hospital scheme has launched in
1993 for effective breastfeed to child.
Genetic counselling to the couples.
Screen the mother for HIV.
FUTURE EVIDENCE BASED
PRACTICE:
Mapping of human genome and genetic research.
Use of intrauterine shunts.
Aseptic techniques to be used during PV,PROM.
Care of mother during labor.
Care after delivery for puerperium infections.
BIBLIOGRAPHY:
Nurse Midwifery Helen Varney
2nd edition page no.19-20
Obstetrics nursing Erna
Ziegel/Carolyn conant van
Blarcorn 6th edition page no.
771-797
The Indian Journal of Nursing
and Midwifery Vol 1,Number 3
Dec 1998