• " I was scared - I had heard so

many horror stories, but you just

walked in and I felt my worries
fade.You spend a lot of time on
your knees, having the time to do
those things that make every
pregnancy unique is what makes
your job so special, a familiar face
makes all the difference & most
important that a woman knows a
wise women (midwife) is there"

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
 INDEPENDENT
MIDWIFERY PRACTICE

Mrs. Neeta Rajesh Bhide, M.Sc. (N)

• Definition
• Midwifery Model of care
• Need of IMP
• Clinical statistics
• Midwifery practice package for
independent practice
• Standards required for the practice
of midwifery.
• Challenges

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
 Who is an Independent
Midwife?
• Independent Midwives are fully qualified
registered nurse-midwives to utilize their
knowledge, skills, judgement and authority
in the provision of primary women's health
services while maintaining accountability
for the management of patient care in
accordance with midwifery/ nursing council
of ones own country

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
 The Midwifery Model of
Care
The Midwifery Model of Care is based on the fact that
pregnancy and birth are normal life processes.
The Midwifery Model of Care includes:
• monitoring the physical, psychological and social well-
being of the mother throughout the childbearing
cycle;
• providing the mother with individualized education,
counseling, and prenatal care, continuous hands-on
assistance during labor and delivery, and postpartum
support;
• minimizing technological interventions and identifying
and referring women who require obstetrical
attention.

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
The application of this woman-
centered model of care has been
proven to reduce the incidence
of birth injury, trauma, and
Cesarean section.

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
 WHY THERE IS INCREASE
NEED OF INDEPENDENT
MIDWIFERY NURSING
• Health advisors and government policy makers
have promoted Independent Midwives style of
care as the ‘Gold Standard’ care in the future.
• Independent Midwives support womens'
choice
• In India every pregnant women is considered
as ‘high risk’.
• IMP is one of the measures & challenges to
assist in reduction of maternal death

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
 Cont----
• Independent Midwives may also have
undertaken extra training such as
newborn examinations, tongue tie
division, pain management,
Hypnobirthing, acupressure,
relaxation techniques & more

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
Clinical Statistics

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
Mrs. Neeta Rajesh Bhide, M.Sc.
(N)
Mrs. Neeta Rajesh Bhide, M.Sc.
(N)
WHAT WE CAN PROVIDE IN MIDWIFERY
PRACTICE PACKAGE FOR INDEPENDENT
PRACTICE
• Access to a midwife 24 hours a day, 7 days a
week.
• Two midwives available alternatively & provide
women centred antenatal, intrapartum &
postnatal midwifery care. Antenatal care in
privacy.
• Continuity of care throughout labour either at
home or hospital or referral to an
obstetrician if necessary.
• Postnatal care up to six weeks.
• Knowledgeable breastfeeding support

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
STANDARDS REQUIRED FOR THE
PRACTICE OF MIDWIFERY
• Standard- I = Midwifery care is provided by
Qualified Practitioners.
• Standard- II =Midwifery care occurs in safe
environment within the context of the family,
community & a system of health care
• Standard- III = Midwifery care supports
individual rights & self-determination within
boundaries of safety
• Standard- IV = Midwifery care is comprised of
knowledgeable, skill & judgment that foster the
delivery of safe, satisfying & culturally competent
care

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
• Standard- V = Midwifery care is based on
knowledge, skills & judgement which are
reflected in written practice guidelines.
• Standard- VI =Midwifery care is documented
in a format that is accessible and competent.
• Standard- VII = Midwifery care is evaluated
according to an established programme for
quality management that includes a plan to
identify & resolve problems.
• Standard- VIII = Midwifery care may be
extended beyond the set competencies to
incorporate new procedures that improve care
for women and their families.
Mrs. Neeta Rajesh Bhide, M.Sc.
(N)
 CHALLENGES FOR
INDIAN MIDWIVES
• PRACTICE CHALLENGES
*Rights & Responsibilities
* Health care system should be
integrated to midwifery services
* Standards to be set
* Ensure care , collaboration, consultation
& referral

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
• Challenges for law regulation
• Educational challenges
• Challenges for research activities
• Challenges for policy makers.
• Develop a Midwifery practitioner course
• Salary Structure
• Develop nursing network
• Develop drug act policy for nurse.

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
 CONCLUSION
• The strong voices of powerful midwives,
working close to government & civil society
institutions & major external entities
committed to improving maternal &
newborn health status, have realized the
goal of achieving IMP
• Midwives many strengths and
contributions have not been fully utilised
to meet today’s health care needs.

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)
THANK YOU

Mrs. Neeta Rajesh Bhide, M.Sc.

(N)