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Maternity Services, Including Antenatal Services
Published in Arthur Newsholme, International Studies Volume 3, 2015
Medical obstetric work in the past has usually consisted in booking a confinement, and expecting not to hear of the patient from the monthly nurse until parturition has made considerable progress. Antenatal supervision has been a natural result of the efforts made by official and voluntary bodies to lower the heavy puerperal mortality which still persists; and happily the medical profession generally is now alive to its serious importance. The real difficulty for them is to obtain from their prospective patients remuneration which will be on an adequate scale for the care which is needed.
Exclusion in maternity care
Published in Michael Purdy, David Banks, Health and Exclusion, 2005
In the debates which preceded the 1902 Act, there were three ways in which different interests approached the issue of care around childbirth with vastly different implications for midwives.To secure highly skilled midwives who would effectively be specialised medical practitioners. The women's organisations which took this position were seen as too challenging to win powerful allies.To dissolve the independent midwifery role into that of an obstetric or monthly nurse who ‘under the charge and supervision of a medical man, carries out that portion of attendance which is more suitable to a mere woman, the changing of sheets and attending to the patient, and attentions of that kind’ (HMSO 1892:133). This option was much supported by GPs and was what prevailed in the USA.To preserve the role of the midwife as an independent practitioner within the strictly defined sphere of normal childbearing. Such a role admitted the superior status of doctors but relieved them of ‘tiring and unremunerative work’ (ibid.: 22). This fitted the world view of many of the aristocrats of British medicine, who saw midwifery as ‘an occupation degrading to a gentleman’ (Smith 1979:23).
Conclusion
Published in Adrian Wilson, The Making of Man-Midwifery, 2018
Among the poor the traditional ritual was observed throughout the eighteenth century and beyond. This is especially apparent in the bitter conditions of the 1790s, which brought to the attention of middle-class commentators the plight of the poor, their own response to that plight in the form of Friendly Societies, and the local welfare arrangements made under the Poor Law. The resulting documentation makes it clear that childbirth and lying-in had a high priority. Sir Frederick Morton Eden, the most systematic observer, stated that the central purpose of “Female Benefit Clubs” (women’s friendly societies) was “to ensure a decent subsistence during the lying-in month”. Eden also found that workhouses in the larger towns made provision for childbirth.52 Especially revealing are the agricultural labourers’ budgets collected by Eden’s contemporary, the Anglican minister David Davies. Davies reckoned the expenses of lying-in at 20 shillings, assumed that this happened once in two years, and so concluded that 10 shillings per year was required. Out of an annual family budget of £7 this was a very large sum.53 The lying-in expenses included the midwife’s fee, “attendance of a nurse for a few days”, “a bottle of gin or brandy always had upon this occasion” and “half a bushel of malt brewed, and hops”. The fact that these expenses were standard among the poorest families in a time of extreme hardship vividly attests to the popularity of the lying-in ritual. Indeed, some features of that ritual persisted well into the nineteenth century, such as the “monthly” nurse (so named from the 1830s) and the popularity of the churching service; and medical men of the late nineteenth and early twentieth centuries endorsed the need for prolonged rest after childbirth.54 Relatedly the personal recollections of working women — published in the striking Maternity letters of the Women’s Co-operative Guild (1915) — suggest that in this respect, there was no difference between having a doctor and having a midwife.55 Thus it seems that nineteenth-century medical men supported at least some aspects of the traditional ritual.
Too busy to care? Analysing the impact of system-related factors on maternal mortality in Zanzibar’s Referral Hospital
Published in Journal of Obstetrics and Gynaecology, 2022
Eline D. Veenstra, Tanneke Herklots, Khairat Said Mbarouk, Tarek Meguid, Arie Franx, Benoit Jacod
All diagnoses were categorised according to The WHO Application of ICD-10 to deaths during pregnancy, childbirth and the puerperium (ICD-MM) (WHO 2012). In cases with more than one diagnosis, only the diagnosis that was deemed most relevant to the maternal outcome after consultation with a consultant in obstetrics and gynaecology was included. In nine MD and twelve MNM, two diagnoses were deemed equally relevant to the maternal outcome and therefore both were included. The location of residence was categorised as urban or rural, reflecting a high or low density of health care facilities, respectively (Fakih et al. 2016). The number of surgical interventions was drawn from the anaesthesia records kept in the maternity theatre. The number of admissions was computed from monthly nurse reports. The number of doctors and nurses working at any given time is not recorded systematically, therefore, it was based on work rosters from November and December 2018.
Cost-effectiveness analysis of anti–IL-5 therapies of severe eosinophilic asthma in Spain
Published in Journal of Medical Economics, 2021
Francisco Javier González-Barcala, Xavier Muñoz-Gall, Esther Mariscal, Andrea García, Shibing Yang, Gijs van de Wetering, José Luis Izquierdo-Alonso
One medical visit a year was assumed for the administration of biological treatment and a monthly nurse visit for MEP and RES. For BEN, it was one medical visit and six nurse visits the first year and 5.5 nurse visits the following years, according to the treatment scheme. Likewise, one medical visit and three nurse visits a year were considered for SoC. In all the cases, time for administration by the physician/nurse was 10minutes. Medical visit cost was €242.04/h and nurse visit cost was €26.55/h41.