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The role of the midwife.


 The role of midwife is unique in the care and treatment of a mother and child throughout the birth process; the role is comprehensive and involves education, treatment, and collaboration with a more skilled medical team. The Safe Motherhood Initiative of 1987 aimed at a 50% reduction in maternal mortality by the year 2000. The root causes of maternal mortality were identified as poverty, low status of women, female illiteracy, inadequate primary health care, poor communication networks, and harmful traditional practices in, for instance, childbirth or circumcision. The estimate of mortality due to poor delivery practices was over 110 maternal deaths/100,000 live births. Females with frequent pregnancies, prolonged lactation, heavy work, and local food taboos were at greater risk. About 40-60% of death to women aged 15-34 years was attributed to pregnancy and childbirth. The medical complications precipitating death, hemorrhage, hypertension, and infection, were also the major causes of mortality related to abortion. Women under 20 years old were at greater risk of anemia and preeclampsia. The midwife must be prepared for all emergencies, including medical factors such as obstetric complications, referral problems such as transportation inadequacies, and belief factors such as fear of hospitals. Specific actions that can reduce maternal mortality include training midwives and delivery personnel; increasing the availability of blood supplies and well-equipped hospitals and clinics; and providing grassroots health education. Traditional practices, such as confining new mothers indoors for the first 40 days or more, may contribute to thromboembolism. Risk can be reduced by frequent consultations with health workers during pregnancy, using a trained attendant at every birth, being aware of danger signs, spacing pregnancies over two years apart, avoiding pregnancies at young or old ages, maintaining proper nutrition and work load, and involving midwives at all levels of care.
