GOOD AFTERNOON

HISTORY AND
CONTEMPARY
PERSPECTIVES
Submitted By:
Archana Bhatti
M.SC. 1st yr.
Obstetrics word is come from a latin word
“OBSTETRIX”
means
“MIDWIFE”
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.
 “SORANUS OF
EPHESUS”
Is the
FATHER OF
OBSTETRI
CS

He was the
first to write
about the
Podalic
Version.
CONTD…
Earlier man were not welcomed in this field.
During Middle Ages in Europe midwives were of low
types and executioner and barbers were called to help
with difficult deliveries.Later on in 16th&17th century
Ambroise Pare of Paris and Chamberlens stimulate men
to take interest in 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.”
The historic taboo
associated with the
examination of female
genitilia has long inhibited
the science of
gynaecology. This 1822
drawing by Jacques-Pierre
Maygnier shows a
"compromise" procedure,
in which the physician is
kneeling before the
woman but cannot see her
genitalia. Modern
gynaecology has shed
these inhibitions.
…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