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European Midwives Association . Postnatal care . G.C. Rijninks van Driel MSc RM. 2005/36/EC directive. European Midwives Association. Provision of sound family planning information and advice
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European Midwives Association Postnatal care G.C. Rijninks van Driel MSc RM
2005/36/EC directive EuropeanMidwivesAssociation • Provision of sound family planning information and advice • Diagnosis of pregnancies and monitoring normal pregnancies; carrying out the examinations necessary for the monitoring of the development of normal pregnancies • Prescribing or advising on the examinations necessary for the earliest possible diagnosis of pregnancies at risk • Provision of programmes of parenthood preparation and complete preparation for childbirth including advice on hygiene and nutrition
2005/36/EC directive EuropeanMidwivesAssociation • Caring for and assisting the mother during labour and monitoring the condition of the foetus in utero by the appropriate clinical and technical means • Conducting spontaneous deliveries including where required episiotomies and in urgent cases breech deliveries • Recognising the warning signs of abnormality in the mother or infant which necessitate referal to a doctor and assisting the latter where appropriate; taking the necessary emergency measures in the doctor’s absence, in particular the manual removal of the placenta, possibly followed by manual examination of the uterus
2005/36/EC directive EuropeanMidwivesAssociation • Examining and caring for the newborn infant; taking all initiatives which are necessary in case of need and carrying out when necessary immediate resuscitation • Caring for and monitoring the progress of the mother in the postnatal period and giving all necessary advice on infant care to enable her to ensure the optimum progress of the newborn infant • Carrying out treatment prescribed by doctors • Drawing up the necessary written reports
Postnatal care survey EuropeanMidwives Association • Survey conducted after the EMA AGM in Slovenia in 2009. • Developed by Marianne Mead, in collaboration with Susanne Simon and Kerstin Belfrage • Bristol on Line december 2009- january 2010 • Corrections by March 2010 • 25 countries participated: • Austria, Belgium, Croatia, Cyprus, Denmark, Estonia, Finland, France, FYR Macedonia, Germany, Greece, Ireland, Italy, Latvia, Luxembourg, Malta, Norway, Portugal, Slovakia, Slovenia, Spain, Sweden, The Netherlands, Turkey and the United Kingdom
Number of professionals EuropeanMidwivesAssociation
Birth statistics EuropeanMidwivesAssociation
Professionals per 1000 births EuropeanMidwivesAssociation
Length of time of care EuropeanMidwivesAssociation • Most EU countries the “ legal definition” of the postnatal period is 42 days (6 weeks) • However length of time postnatal care by midwife
Provision of care EuropeanMidwivesAssociation • Estonia: • At home • Public hospital • Private hospital • Health centre • The Netherlands: • At home • Public hospital • Birth centre • Health centre
Required examination EuropeanMidwivesAssociation • Estonia: • Mother gynecologist (midwife) • Baby GP or paediatrician • The Netherlands: • Mother none • Baby none
Maternal choice EuropeanMidwivesAssociation • Estonia: • Midwife, but not as the only professional • GP • Obstetrician • The Netherlands: • Midwife, can be the only professional • GP • Obstetrician, in case of pathology
Maternal care EuropeanMidwivesAssociation
Neonatal care EuropeanMidwivesAssociation
Family planning EuropeanMidwivesAssociation By midwife or by other health professionals? • Estonia: • By midwife 10-25% • Most likely other: obstetrician in hospital • The Netherlands: • By midwife 75-90% • Most likely other: obstetrician in hospital
Postnatal care in the netherlands 96.4 % of all women have a part of their postpartum period at home with help of health care assistant After a normal delivery in hospital they go home within 6 to 12 hours After a CS they go home after 4 to 5 days After homebirth 80% breastfeeding After hospital birth 63% breastfeeding
Dutch traditions “ Beschuit met muisjes”
Dutch Traditions We believe baby's are brought by storks……. And decorate our houses to announce a baby arrived….
Dutch traditions Family visiting Announcement of birth Postnatal care visits
Questions? EuropeanMidwivesAssociation