From Big Medical Encyclopedia

MIDWIFE (fr. accoucher — to deliver) — the health worker with vocational secondary education giving treatment-and-prophylactic obstetric and gynecologic help. In 1757 in Moscow and St. Petersburg on an initiative P.Z. Kondoidi (see) obstetric schools were for the first time open. Upon termination of a 6-year course of the graduate; were entitled «jury midwives» with the right to carry out «babichyyu a position» in the cities. «Scientific grandmas» in turn for 3 — 4 trained midwives for rural areas (see. Midwives ). In 1797 — 1801 at the St. Petersburg and Moscow educational houses the first were open «povivalny institutes» with 3-, and then a 2-year course. The first professor St. Petersburg in-that was N. M. Ambodik-Maksimovich (see). From the second half of 19 century in Moscow, St. Petersburg and other university cities one-year schools were open for training of rural midwives of the second category. The most qualified midwifes-feldsherits were trained in St. Petersburg and Moscow by medical assistant's and obstetric courses.

After Great October socialist revolution in connection with creation of the state system of protection of motherhood and the childhood before And. along with its fundamental obligations on assistance in labor the task to conduct scheduled and sanitary and educational maintenance of an obstetric and gynecologic profile was set.

The midwife will see off preventive, medical and diagnostic and sanitary and educational work as under the direct guide of the doctor (in maternity homes, obstetric and gynecology departments of hospitals, clinics for women), and independently, under the general guide of the doctor, generally in the conditions of rural areas (on medical assistant's and obstetric, obstetric points, in collective-farm maternity homes).

The midwife makes dynamic overseeing by the course of pregnancy, gives help at uncomplicated childbirth and in a puerperal period. In case of diseases of the pregnant woman, pathological childbirth or complications And. calls the doctor or directs the pregnant woman to it. In a duty And. also patronage — visit at home and overseeing by the woman during pregnancy and at first after the delivery enters (see. Patronage , pregnant women), an explanation of features of the mode and food during pregnancy, rules of care of the newborn etc.

The midwife helps the doctor at the routine maintenances of women performed for early detection of gynecologic diseases and on outpatient appointment of patients; carries out appointments of the doctor at out-patient treatment of gynecologic patients and at home.

The role of the Midwife in the village where they work in medical and obstetrical centers and collective-farm maternity homes is especially considerable.

In rural areas the Midwife is obliged to take on dispensary observation each pregnant woman in early durations of gestation, to watch the course of pregnancy, to reveal diseases at pregnant women and to timely direct them to the doctor, to carry out psychoprophylactic preparation for childbirth, to give help to women in labor, women in childbirth and newborns. In the conditions of rural areas the Midwife shall make overseeing by the child of the first year of life and do it necessary inoculations. In a case of the child A. is obliged to call the pediatrician. If necessary And. assists in rendering to women and children of social legal aid.

The midwife has the right to make a venipuncture, intramuscular and hypodermic administration of medicinal substances, catheterization of a bladder, etc. Introduction strong, drugs is intravenously allowed only on doctor's orders, and in its absence — according to vital indications (an eclampsia, a preeclampsia, a depressed case, acute blood loss). On doctor's orders and under its direct control And. has the right to carry out hemotransfusion, an inhalation anesthesia, and also to assist during operation, to carry out a role of the instrument nurse. In urgent cases (when timely arrival of the doctor is impossible) under the corresponding conditions and indications the Midwife has the right and is obliged to make without use of the general anesthesia manual department and allocation of a placenta or its parts, control manual inspection of a uterus at bleeding in an early puerperal period, mending of ruptures of a crotch of the I—II degree, ruptures of a neck of uterus in connection with bleeding, a manual grant at pelvic presentation, version on a leg and its extraction, manual removal of fetal egg (at an abortion), a tamponade of a vagina at profuse bleeding.

In the USSR Midwifes medical schools with the term of training 3,5 years (on the basis of 8-cool) and 2,5 years (on the basis of 10-cool) prepare educations (see. Medical education ).

For professional development of Midwifes the training in a workplace in large maternity homes is held, periodic seminars on the job and two-month courses with a separation from production will be organized.

The number of midwifes in the USSR increases: in their 1940 there were 68,1 thousand, in 1960 — 139,3 thousand, in 1970 — 216,0 thousand, in 1972 — 231,7 thousand

See also Health care workforce , Obstetric aid .

Bibliography: Grenades H. E. The decree of 1754 on the organization of «babichy schools» in Russia, Akush. and ginek., No. 5, page 88, 1954.

N. N. Volova.