Post-Graduate Midwifery Training

Kai Tiaki : the journal of the nurses of New Zealand, Volume XIV, Issue 2, 1 April 1921, Page 57

Post-Graduate Midwifery Training

The trained nurses of the present clay are more and more realising the value of a post-graduate course m obstetric work. They feel that their knowledge of their profession is not complete without this very important branch of nursing, and as they conclude their general hospital course their thoughts turn to the need of obtaining a vacancy m a maternity hospital at as early a date as possible.

They are disappointed to find that owing to the large number of applicants they cannot be -accepted for many months after making their application. We sympathise with them m this, but must point out that it is quite unavoidable. About 200 nurses qualify m general, medical and surgical nursing each year m New Zealand. Only about 150 midwifery nurses can be trained m the maternity hospitals during 12 months. It is necessary, under the Midwives Act, that each pupil must conduct or nurse 20 cases. In the State maternity hospitals the number of pupils is only limited by the number of cases available. If the desire of the trained nurses to obtain this knowledge is to be granted it will be ne-

cessary for more maternity hospitals to be established, and this is being done gradually by the State and by the general hospitals m country places establishing maternity wards or cottage hospitals. There is, however, still another factor to be considered. Though trained nurses desire to hold the certificate of registration of a midwife, m the great majority of cases they have no desire or intention of practising midwifery. Therefore it is necessary that opportunity to train must be given to women without previous training as nurses, who desire to take up midwifery only. A wise provision was made when the Midwives Act was first passed, m 1904: that only 50 per cent, of trained nurses could be taken m the class of pupils each term. This was the only way to provide for the needs of the public, which is the aim and object of all professional training. The provision of maternity nurses for the expectant mothers is one of the great necessities of the day. In the hands of the midwifery nurse lies the welfare and com-

fort, even oftentimes the life, of mother and babe. As midwives m the full sense, our private maternity nurses do not very often practise. They prefer to nurse their cases under a medical practitioner, and only when acting as district midwives, matrons and on the staff of maternity hospitals, do they undertake work without this protection, and then, of course, they call for a doctor when necessary. At the same time it is frequently the case that a private nurse has to conduct her case herself m the absence of the doctor, and therefore she should have the full training of a nurse-midwife. We do not consider good the method m England, where there are two grades of trainees m some midwifery hospitals— the midwife and the maternity nurse. The maternity nurse conducts no deliveries or examinations; she has only the after-care of the patient. She acts as a nurse only. The midwife does not nurse her case throughout or care for the baby after the confinement is over, though she does carry out a certain part of the treatment for ten days after. In New Zealand, and also m Australia, there is the one class of trainee only — the midwife, — who not only conducts the de-

livery, but nurses mother and babe during the puerperium. An important part of the training of midwives is the antenatal care of prospective . mothers, by a system of booking of patients for some months before the date of confinement and by the ante-natal climes to which women are invited. This treatment beforehand simplifies much of the aftertreatment and averts much of the possible abnormality. Trained nurses do not realise before entering a maternity hospital what a great deal they will have to learn, and are rather apt to look down upon the midwifery nurse as one of partial training only. They forget that the training, though only a third of the time required for that of a medical or surgical nurse, is a concentrated or intensive one. Midwifery pupils are pushed forward and given responsible duty long ,before a probationer m a general hospital is entrusted with anything, but the minor nursing duties. It is indeed to be regretted that every nurse should not be able to add this training to that for her general certificate, but the needs of the public and the lack of sufficient training-schools at the present time forbid it.