UNIT 1

UNIT 1: BEGINNING FAMILY PART 1


Prepared by: Anthonette Patterson-Bartley MScN, RM, RMN, RNMay 17 - July 26, 2021

Objectives

  • Discuss: Historical perspectives of maternity nursing in Jamaica.

  • List: Current trends and issues impacting maternal and child health.

  • Define: Terms used in reference to vital statistics related to maternal and child health in Jamaica.

  • Compare: Vital statistical data for Jamaica with selected developed and developing countries.

  • Describe: Processes of registration of births and deaths in Jamaica.

  • Discuss: Legal and ethical issues relating to maternal and child health.

Historical & Current Perspectives of Maternity Nursing in Jamaica

Overview of Midwifery

  • Midwifery is a specialized nursing field focused on childbirth.

  • Definition: Midwife is a certified individual under the midwives act authorized to perform deliveries.

Historical Context

  • The practice of midwifery dates back to Biblical times, with references in Exodus and Genesis.

  • The first midwifery school opened in England in 1875.

The Role of Nanas

Pre-emancipation Practices

  • During the pre-emancipation era (before 1807), medical facilities were essential for the health of slaves.

  • Each estate had a hospital (Yaw hut) and a "Grandy" (older woman) caring for pregnant women.

  • The Grandy supervised infants and was not responsible for actual deliveries.

Tradition of Nanas

  • Nanas, traditional birth attendants, are usually older women post-menopause who have had their children.

  • They operate within their community, holding authority in childbirth.

Historical Developments in Jamaican Maternity Services

History of the Victoria Jubilee Hospital

  • In 1887, a maternity hospital idea was established during Queen Victoria's Jubilee celebration.

  • The hospital was opened in 1891 with a capacity for 12 patients, a teaching facility for midwives, and a resident matron.

  • Dr. Michael Grabham, a benefactor, left $200,000 to expand maternity services after his death in 1938.

Growth of the Hospital

  • By 1947, hospital capacity rose to 110 beds, with significant annual deliveries.

  • 1952: Larger antenatal clinic built, home delivery service initiated.

  • 1958: Construction of a new maternity block with advanced facilities.

  • Current bed capacity at V.J.H is 230 with modernized labor wards.

Training of Midwives

  • Midwives were primarily trained at Victoria Jubilee Hospital and other private institutions recognized by the government.

  • Laws established in 1919 recognized graduate midwives officially.

  • Training expanded in the 1970s to increase workforce effectiveness in maternal health services.

Current Training Institutions

  • V.J.H Kingston School of Nursing Midwifery offers one and two-year programs for Registered General Nurses (RGNs).

  • Cornwall School and University Hospital also provide midwifery training programs.

Pioneers in Obstetrics

Key Figures

  • Ambroise Pare (1510-1590): French surgeon who changed obstetric practices.

  • William Harvey (1587-1657): Discovered blood circulation, advocated for midwifery education.

  • Dr. Peter Chamberlen (1569-1683): Introduced obstetric forceps.

  • William Smellie (1697-1763): Laid foundations of British obstetrics, developed clinical teaching.

  • Dr. Semmelweis (1818-1865): Identified cross-infection concerns in obstetric settings, advocated for hygiene.

Contemporary Trends in Maternity Nursing

Major Changes

  • Advances in technology and medicine influence childbirth practices.

  • Increase in cesarean births and labor induction.

  • Birth rates, maternal and infant health statistics show significant evolution.

Statistics in Maternal and Infant Health

Key Terms

  • Crude Birth Rate: Total births per 1,000 people.

  • Fertility Rate: Live births per 1,000 women of reproductive age.

  • Infant Mortality Rate: Death before the first birthday.

  • Maternal Mortality Rate: Death of a woman related to pregnancy/within 42 days post-termination.

Registration of Births & Deaths in Jamaica

Birth Registration Process

  • Births must be registered by Local District Registrar (LDR).

  • Parents should decide the child's name prior to delivery for registration.

  • All births need registration within 3 months after delivery.

Death Registration Requirements

  • Death classification as natural, sudden, or violent; must be certified by a medical professional.

Ethical & Legal Issues in Maternal & Child Health

  • Ethical concerns in pregnancy and childbirth practices involve complexities, particularly regarding assisted reproductive technologies and abortion.