PROFESSION OF MIDWIFERY

Profession
- is an occupation or calling requiring advanced training and experience in some
specific or specialized body of knowledge, which provides advice society in that
special field.
- an occupation that properly involves a liberal education and its equivalent and mental
rather than manual labor; especially one of the three learned professions as law,
medicine or theology
- It is a calling in which the members profess to have acquired special knowledge by
training or by experience or by both so that they may guide or advice or serve others
in that special field.

Midwifery
- defined as the practice of obstetrics
- it is the practice of delivering babies or assisting women in childbirth, by a person
who is not a physician but who is trained in obstetrical procedures
- a person who, having been regularly admitted to a midwifery educational program
duly recognized in the Philippines where it was established, has successfully
completed the prescribed course of studies in midwifery and has acquired the
requisite qualifications to be registered and legally licensed to practice midwifery.

The student midwife should be made to realize the expanded role in the practice that she will
be entrusted with. She should be well prepared so that she will be able to carry on these
functions and responsibilities.

Sphere of Midwifery Practice in the Philippines

1. Traditional functions of the Midwife (RA 7392). The Philippine Midwifery Act of 1992
provides that the midwife:
a. Give supervision, care and advice to women during pregnancy, labor and the
post-partum period
b. Conducts deliveries on her own responsibility
c. Care for the newborn, including the detection of abnormalities, counseling
d. Give health education
e. Executes emergency measures
f. Procures medical supplies
2. Expanded functions of the Midwife
a. Oral and parenteral dispensing of oxytocic drug after delivery of the placenta
b. Suturing perineal lacerations to control bleeding
c. Giving the intravenous fluid during obstetrical emergencies
d. Injecting of Vitamin K to the newborn, when necessary
From the Field Manual for Rural Health Nursing Personnel, DOH, 1976, DOH Progress
Manual

1. The midwife participates in the implementation of DOH programs, such as:

a. Expanded program on immunization
b. Control of diarrheal disease
c. Control of acute respiratory infection
d. Under five clinics
e. Nutrition program
f. Family planning
g. National tuberculosis program
h. Control of sexually transmitted diseases

2. Carries out emergency and first aid measures under the following conditions:
a. The doctor is not available
b. The patient is in a very isolated area
c. The weather is bad and/or transportation is not available
d. The patient and/or family refuses hospitalization
e. The transport of the patient endangers her life or aggravates her condition

3. Delegating nursing functions of midwives assigned in hospitals and clinics

a. Care of the patient and his environment
b. Care and sterilization of hospital equipment and instruments
c. Performance of basic procedures like collection of specimen, intake and
output, taking the vital signs of the patient, oxygen therapy, hydrotherapy,
steam inhalation, enema and catheterization

Skills and abilities of a Professional Midwife

1. Technical Skills - the skills that a midwife should apply in performing procedures
assigned to her
2. Communication skills - is the skill a midwife should use and apply in expressing her
thoughts either orally or in writing
3. Analytical skills - the skill that she should use in decision-making

The License to Practice Midwifery

License
- a legal document given by the government, that permits a person to offer to the
public his skills and knowledge in a particular field.
- It is also defined as the authority or liberty granted to do or omit an act
- a permission to practice (in law)
- the most important tool for legal control and enforcement of midwifery practice.

Registration
- the recording of the names of persons who have qualified under the law to practice
their respective professions
The Midwifery Licensure Examination

Scope of Examination
The 5 board exam subjects are:
1. Primary Health Care
2. Professional Growth and Development
3. Obstetrics
4. Fundamentals of Health
5. Care of Infant and Children

Professional Ethics
- branch of moral science which treats of the obligations which members of a
profession owe to the public, to the profession, to his colleagues, and to his clients.
- it emphasizes the ideal practices which have crystallized from men’s professional
privileges and responsibilities

Covers a wide variety of attributes:

a. physical mein
b. dress
c. poise
d. initiative
e. interest
f. oral expression
g. adaptability
h. capacity for the job
i. capacity for growth
j. appearance
k. alertness
l. judgment
m. ability to present ideas
n. emotional stability
o. self confidence
p. friendliness
q. enthusiasm

Professional ethics serves as a guideline for the members of a profession. Established

standards, referred to as codes of conduct or codes of ethics, set forth the rules and
ordinances used for guidance of the member’s professional activity.

GENERAL APPEARANCE

Personality
- refers to the total person
- it is the expression of what you are and what you do
- it is the core of each individual, the product of all responses that are expressed in
everyday living
 - includes the things that you say as well as think, in the many different situations that
you constantly meet
- it is shown through a person’s total behavior and by the responses of other people to
that behavior.
- it can be acquired or can be developed and this depends more upon the individual
than upon anyone else

A woman with a strong personality possesses the following qualities:

1. She is physically, mentally and morally well-balanced
2. She avoids going extremes
3. Her best powers have been developed symmetrically in a proper way
4. She has the sense of the proportionate values of things in general

Points to be remembered to acquire good personality;

1. The development of those gifts and qualities which are good
2. The checking or correcting of tendencies that are detrimental
3. The strengthening of the person’s weak points
4. The cultivation of a pleasing personality

Importance of Pleasing Personality:

1. It commands respect
2. It wins appreciation, admiration and recognition
3. It conveys hospitality in one’s feelings of willingness to be a friend and to be of
service
4. It comforts patients and other people who are not physically ill
5. It is an asset to get a good position
6. It contributes a pleasant atmosphere to the place
7. It is an asset to a successful daily living and undertaking

Factors which Contribute to Pleasing Personality:

1. The face must not have a frowning expression
2. It is best accustom its muscles to assume an expression that is as natural as
possible, which is always ready to smile or show recognition when meeting people
3. Likewise it can also express sympathy and anger when the occasion calls for it
4. A smiling face always finds a warm welcome
5. The make-up must be as natural as much as possible
6. The expression of showing romantic affection through the eyes is not always to the
liking of people who can see it. It must therefore be directed only to the person
concerned
7. The face and the eyes must be trained to disguise personal worries and problems. It
must therefore be shown in the right places and to the right people
8. The expression of the face and the eyes is a menace to the person doing it and not
to the person for whom it is intended.
Grooming
- personal cleanliness, which includes care of the skin, hands, and hair, skillful
application of make-up and attention to your clothes
- to achieve good grooming, you must develop personal habits of neatness,
cleanliness and tidiness

Uniform
- served as dress code among health workers, students in schools, colleges,
universities, employees in offices and institutions
- easily identifies the discipline of the wearer

In this particular situation, the midwife should be guided by the following considerations
where wearing the uniform is concerned:
a. Be neat and clean from your hairdo down to the shoes you wear. The shoes should
be properly shined.
b. The cut of the uniform should allow freedom of movements for the one wearing it
c. Missing buttons should be replaced not secured by pins
d. A short hairstyle allows better movements for the person. In case the hair is long, this
should be secured by a braid or pinned properly
e. When in uniform, use make-up sparingly.
f. While in uniform, a watch with a second hand is only allowed.

Health
Basic elements:
1. A simple but balanced diet
2. Exercise
3. Proper elimination, enough sleep
4. Lots of fresh air
5. Cleanliness, which includes proper care of the: hair, face, hands, neck, eyes, nose,
mouth, teeth and feet

Voice
- A sound produced by the vocal organs of a person or animal
- There is so much power, attraction, motivation and concern in the voice of a midwife
that can spell the kind of attitudes, trust and/or confidence the patient can be inspired
to show.
The following points serve as reminder:
a. The voice must convey sincerity, appreciation, love, care, sympathy and interest, as
the case may be.
b. It must be firm but not insulting any or hurting one’s feelings, when one intends to
order and be obeyed.
c. It must always assume a humble tone and the vocal expression must not lead to
mistakes or blunder.
d. Remember that a woman’s voice must be gentle, soft but clear
e. The voice must not be too low and not too loud. It must be moderate and be heard
clearly to get the attention of the listeners;
f. The voice speaks of a well-bred person.
Whether a midwife is habitually loud-mouthed or gentle voiced, the information below will be
of much help of her personal and professional undertakings;

1. The tone of her voice greatly influences the positive acceptance and the reaction of
the patient to her,
2. The midwife should be able to discipline her voice, which is a mark of self-respect,
3. Without the midwife being aware of it, a loud and undisciplined voice causes
unnecessary discomfort to her patient;
4. The volume of the voice should be regulated especially in situations where the
patient is ill or suffering.

Carriage
- A person’s deportment and bearing are personal assets that cannot be taken for
granted.
- Your daily appearance reveals a great deal of you as a person.

It would do well to practice in front of a mirror, so remember to:

1. Walk firm and erect, neither too fast nor too slow,
2. See that your movements are gentle and must convey politeness and refinement.
3. Have a quiet, even, steady, firm, walk, which can be quickened when the occasion
calls for it
4. Maintain a balance or regulated carriage

Develop habits to enjoy proper carriage by:

1. Avoiding standing as if the backbone is weak and needing support.
2. Sitting in correct posture
3. Learning not to drag footsteps

Poise

- It is the dignity or in carriage.

- Sy says that the poise of the soul comes from careful thinking from meditation on the
great principles which affect personal life.
- The possession of poise of the lack of it tremendously affects the estimation in which
an individual is held by the people whose respect she desires to secure.

The following contributes to good poise:

a. Correct posture adds to your appearance and lends poise and confidence
to your bearing. Your posture is almost as revealing as your facial expression. It
is difficult to be alert and be interested if you are constantly slouching.

b. Poor sitting postures are not only unattractive, but they may produce body
aches and pains. Crossing the feet is the most comfortable, the easiest to
assume and keep, and the most attractive to the observer. The woman strikes a
good poise in this position.

c. In rising, push forward to the front of the chair, move one foot slightly back
and under the edge of the chair. Raise your body by using the strength in your
 legs rather than by trying to pull yourself up by your shoulders. Whether sitting,
standing, one need not lose poise.

d. In walking there is greater ease and freedom of movement when the body
is correctly aligned. Thrusting your head forward, like a chicken, is not
contributing to good posture. To develop a comfortable, graceful walk, give your
attention first to the way that you place your feet and second, to the position of
your body as you walk.

Practice walking, sitting and standing until you are confident that your posture is all that is all
it should be to achieve the poise you intend to develop.

Conduct

- Is one’s course of action or behavior, or the way an individual acts. ( Funk and
Wagnalls)
- Your professional conduct in public should bring credit to you as a person, as a
student or as a professional.
- Unprofessional conduct means conduct which violates the rules of ethical conduct of
midwifery.
- Dishonorable conduct is such an act, deportment, or behavior of a person as would
elicit or bring censure, reproach or shame upon him or any act or conduct on his part
which tends to stain his character or lessen his reputations.

Manners

- Refer to polite, civil, well-bred behavior, according to Funk and Wagnalls.

- Manners are the heart of courteous behavior.
● Manners and Common Sense
● Manners in the Family
● Manners in Public
● Manners in Entering a Room
● Table-Manners

Ethical Behavior

a. Punctuality
- To maintain a good attendance record, observe punctuality.
- This is important because being habitually on time is absolutely essential in the
course we pursue or the kind or work we have gone into.
- A patient’s life may depend on carefully timed care.
- Punctuality is a trait which is primarily concerned with the equal disturbance of
time.

b. Trust and Confidentiality

- Trust is a confident reliance in the integrity, veracity or fairness of another.
- It is something committed to one’s care for use or safekeeping, while the
meaning of confidence is reliance upon something or someone or belief in a
person or thing.
c. Honesty
- Is a most important quality in anyone, whether an employee, a professional, a
private person and/or a midwife.
- It means being truthful, trustworthy, and upright in one’s dealings with others as
well as refraining from lying, cheating or stealing.
- One’s actions are free of fraud and deceit.
- It is a quality of action centered in justice and can be discussed in terms of
truthfulness, honor and integrity.
- Involves respect for the property of others.

d. Truthfulness
- This is the quality of being in agreement with the facts, reality, or experience.
- It reflects the accuracy and honesty of a situation.

e. Honor
- This means keeping faith and making good on commitments.

f. Integrity
- It means that a person adheres to his own set of moral values.
- One with integrity can be counted on and trusted.

g. Economy
- This can be related to the use of time, money and many other things.
- “Beware of little expenses; a small leak will sink a great ship.”

Below are additional pointers on thrift and economy:

 Use school and hospital materials economically
 Practice ways of conserving electricity
 Practice ways of conserving water
 Practice economy in the use of materials, energy, time and money
 Handle with care school and hospital equipment and materials such as books,
charts, etc
 Economize on the use of office supplies and other materials.

h. Courtesy
- Is respect in action.
- It is the manifestation of a real delicacy in our dealings with others.
- One illustration of courtesy is the handshake, this, together with a pleasant smile
and a word of salutation, has become a courteous form of greeting.
- Courtesy involves a very particular and concrete level of expression of affection
and respect for others.
- Courtesy is a medium of expression for all the fine qualities that make up
character.
- Courtesy is the riches born of a lofty humility.
i. Loyalty
- It is a quality of faithfulness or faithful adherence to a person, government, cause
and duty of work.
- Loyalty means that one will persistently strive to bring about better conditions,
first by guarding his behavior, like avoiding gossip and any form of slander and
secondly by steadfastly refusing to mention or discuss their patients with their
relatives, associates or outside acquaintances.
- This means defending your cause and the hospital that houses it against all
damaging assaults as naturally and as wholeheartedly as you would defend a
person dear to you.
- “being faithful”. It implies trust, devotion and belief in the goodness of things.

 Loyalty to duty – will safeguard us from pitfalls of carelessness,

thoughtlessness and lack of vigilance, any of which is a menace to
efficient attention to the patient.
 Loyalty to the institution – includes all those who form its staff, is the best
offering to the place of choice for you to study or to work.
 Loyalty to the patient – assuring that his rights are respected; keeping in
confidence his private affairs that is, no discussion with other patients or
with other people outside the hospital must take place.
 Loyalty to Co-workers – the midwife should combine efforts with other
members who maintain the devotion or interest in order that standards
may become the unifying force in increasing the morale of those who are
working for the upliftment of midwifery.
 Loyalty to Fellow Students – it is a must that we respect the well-being of
our fellow students and others with whom we are daily contact.
 Loyalty to Ideals – the midwife should possess those desired traits which
will make life worth living and more meaningful.

j. Sympathy
- Is putting yourself in the place of others who are experiencing grief or difficulties.
And responding to them in an understanding way.
- It is expressed by showing compassion to a person who is in trouble.

k. Reverence
- This is a feeling of profound respect often mingled with awe, affection or
veneration.
- A midwife reveals her true character to a considerable extent by her reverence or
lack of reverence for sacred things or for the solemnities of life and death.

l. Friendship
- Is a mutual regard cherished by kindred minds.
- Friendship is most necessary for living, for without friends no one would want to
live ( Aristotle)
- Genuine love means that the friend seeks and wills what is really good and
helpful for other persons. It involves a sacrifice of purely personal desires in order
to manifest genuine affection and concern for others.
 - One of the fundamental adjustments and student needs to make is to accept her
role as a learner.

Responsibilities of Midwives to:

1. Patient
- She will render service to the best of her ability in caring for, alleviating and
contributing to the recovery and health of the patient.
- Culpable neglect or carelessness resulting in harm to the mother or to the baby
would be grounds for court action well as personal moral guilt.
2. Co-workers
- Goal: to serve the sick and the needy
- The midwife is expected to be helpful, friendly, sympathetic, unselfish and
understanding, but this should not be a one-way process. Her co-workers,
equally, have their responsibilities to share.
3. Profession
- “A little learning is a dangerous thing.” (Alexander Pope)
- We should always utilize all related knowledge and skills for the patient’s benefit.
4. Self
- We should prevent professional stagnation.
- We should continue to become lifetime learners – a person interested in self-
development.
- Our goal is to continuously and consistently work for self-enrichment and
continuing self-improvement.
5. God
- Like any other Catholic or Christian we should strive to avoid sin when will disrupt
our relationship with God, ourselves and our neighbors.
- Good works are part and parcel of sacrifices made by the workers.