The document provides a history of obstetrics from ancient times to the present. It discusses how obstetrics originated from the Latin word for midwife and evolved from being the domain of village dais to the involvement of male physicians. Key developments included the first textbook on obstetrics in the 18th century, the introduction of forceps and anesthesia in childbirth, and advances in antenatal care, ultrasound, and cesarean sections. Contemporary perspectives emphasize reducing maternal mortality through early prenatal care, risk identification, clean delivery practices, and expanding health services. Future practices may involve genetic research, intrauterine techniques, and improved infection control.

1. GOOD AFTERNOON

2. HISTORY ANDHISTORY AND
CONTEMPARYCONTEMPARY
PERSPECTIVESPERSPECTIVES
Submitted By:Submitted By:
Archana BhattiArchana Bhatti
M.SC. 1M.SC. 1stst
yr.yr.

3. Obstetrics word is come from a latin wordObstetrics word is come from a latin word
““OBSTETRIX”OBSTETRIX”
meansmeans
““MIDWIFE”MIDWIFE”

4. ORIGIN OF OBSTETRICSORIGIN OF OBSTETRICS
As we all know that birth is the complex finalAs we all know that birth is the complex final
act of nature’s greatest miracle i.e. formation andact of nature’s greatest miracle i.e. formation and
arrival of a child in the world. And the sciencearrival of a child in the world. And the science
and art that deals with human reproduction isand art that deals with human reproduction is
called Obstetrics.called Obstetrics.

5. ““SORANUSSORANUS
OF EPHESUS”OF EPHESUS”
Is theIs the
FATHER OFFATHER OF
OBSTETRICSOBSTETRICS
He was theHe was the
first to writefirst to write
about theabout the
PodalicPodalic
Version.Version.

7. CONTD…CONTD…
Earlier man were not welcomed in this field.Earlier man were not welcomed in this field.
During Middle Ages in Europe midwives were ofDuring Middle Ages in Europe midwives were of
low types and executioner and barbers werelow types and executioner and barbers were
called to help with difficult deliveries.Later on incalled to help with difficult deliveries.Later on in
1616thth
&17&17thth
century Ambroise Pare of Paris andcentury Ambroise Pare of Paris and
Chamberlens stimulate men to take interest inChamberlens stimulate men to take interest in
obstetrics.obstetrics.

8. HISTORY OF MIDWIFERY IN INDIA:HISTORY OF MIDWIFERY IN INDIA:
 In Ancient India,care of women and practice ofIn Ancient India,care of women and practice of
Midwifery were totally in the hands of villageMidwifery were totally in the hands of village
dais.dais.
 Women were subject to the purdah system.Women were subject to the purdah system.
 The occupation of dais was hereditary and allThe occupation of dais was hereditary and all
dais was from lower caste as the period ofdais was from lower caste as the period of
childbirth was considered a time of impurity.childbirth was considered a time of impurity.
 The worst room in the household was alloted forThe worst room in the household was alloted for
delivery.delivery.

9. CONTD…
 Dais gained their skill through observation andDais gained their skill through observation and
practice.practice.
 And when dais could not handle the situtationAnd when dais could not handle the situtation
serious morbidity and mortality were the resultserious morbidity and mortality were the result
and these all were explained as “Beyond humanand these all were explained as “Beyond human
control phenomena.”control phenomena.”

10. The historic taboo
associated with the
examination of female
genitilia has long inhibited
the science of
gynaecology. This 1822
drawing by Jacques-Pierre
Maygnier shows a
"compromise" procedure,
in which the physician is
kneeling before the
woman but cannot see her
genitalia. Modern
gynaecology has shed
these inhibitions.

11. ……DURING BRITISH INDIA:DURING BRITISH INDIA:
In 1900 A.D. Dr. Ida sophia Scudder after got newsIn 1900 A.D. Dr. Ida sophia Scudder after got news
from the village people that 3 women died duringfrom the village people that 3 women died during
delivery who were actually calling her to helpdelivery who were actually calling her to help
then she decided and started with Christianthen she decided and started with Christian
Medical College & Hospital (CMCH) atMedical College & Hospital (CMCH) at
Vellore.Later in 1950,the doors of CMC & HVellore.Later in 1950,the doors of CMC & H
opened for male training.opened for male training.

12. CONTD…
 In 1899,Zenana Bible and medical missionIn 1899,Zenana Bible and medical mission
started training of nurses.started training of nurses.
 In 1883 Lady Dufferin came to India alloted fundIn 1883 Lady Dufferin came to India alloted fund
to start maternity hospitals and training ofto start maternity hospitals and training of
nurses and midwives all over the country.nurses and midwives all over the country.
 It was with help of this Fund that Lady ReadingIt was with help of this Fund that Lady Reading
Health School was established in 1918 at Delhi.Health School was established in 1918 at Delhi.

13. MIDWIFERY IN INDEPENDENT
INDIA:
In 1946,Bhore committee laid the foundation forIn 1946,Bhore committee laid the foundation for
public health planning in India laid great stresspublic health planning in India laid great stress
on the need for qualified midwives and healthon the need for qualified midwives and health
visitors.visitors.
In 1947,INC combine the Nursing and MidwiferyIn 1947,INC combine the Nursing and Midwifery
courses into single course.courses into single course.
In 1955,Shetty Committee recommended trainingIn 1955,Shetty Committee recommended training
and posting ANMs in health services with aand posting ANMs in health services with a
qualification of class VIII & supervised by LHV.qualification of class VIII & supervised by LHV.
In 1959,Bischoff supported the training ofIn 1959,Bischoff supported the training of
personnel.personnel.

14. CONTD…
ANMs for 3 yrs. And midwifery for 1 yr.ANMs for 3 yrs. And midwifery for 1 yr.
 In 1975,MPHW scheme launched by KartarIn 1975,MPHW scheme launched by Kartar
Singh Committee.Singh Committee.
 MPHW were registered as ANMs and wereMPHW were registered as ANMs and were
designated as Female Health Workers ,posted atdesignated as Female Health Workers ,posted at
subcentres for 5000 rural population.subcentres for 5000 rural population.
 They supervise the deliveries conducted by dias.They supervise the deliveries conducted by dias.

15. HISTORICAL DEVELOPMENT INHISTORICAL DEVELOPMENT IN
OBSTETRICSOBSTETRICS
 In 1739,in London,Willam Smellie and hisIn 1739,in London,Willam Smellie and his
student Willam Hunter become obstetrican andstudent Willam Hunter become obstetrican and
work for the same.work for the same.
 In 1744,Willam Smellie introduce steel lockIn 1744,Willam Smellie introduce steel lock
forceps.forceps.
 In 1752,Willam Smellie publish ‘Textbook ofIn 1752,Willam Smellie publish ‘Textbook of
Obstetrics’.Obstetrics’.
 In 1760,Puerperal fever was on peak in LondonIn 1760,Puerperal fever was on peak in London
in Lying-in hospital.in Lying-in hospital.

16. CONTD…CONTD…
 On Jan 14On Jan 14thth
,1794 first Cesarean operation was,1794 first Cesarean operation was
performed by Dr. Jesse Benaett of Virginia on hisperformed by Dr. Jesse Benaett of Virginia on his
wife.wife.
 First school of midwives was established at PareFirst school of midwives was established at Pare
instigation at the hotel Dieu in Paris.instigation at the hotel Dieu in Paris.
 In 18In 18thth
century National regulation of educationcentury National regulation of education
and practice of midwifery begans.and practice of midwifery begans.

17. CONTD…CONTD…
 In 1807,Samuel Bard publish first book onIn 1807,Samuel Bard publish first book on
obstetrics on four stages of labour.obstetrics on four stages of labour.
 In 1847,Semmelweis,in Vienna,demonstrate thatIn 1847,Semmelweis,in Vienna,demonstrate that
washing of hands in chlorine of lime solutionwashing of hands in chlorine of lime solution
before examining women in labor reducebefore examining women in labor reduce
puerperal fever.Chloride of lime used aspuerperal fever.Chloride of lime used as
antiseptic.antiseptic.

18. CONTD…CONTD…
 Obstetrical forceps was developed by Dr. PeterObstetrical forceps was developed by Dr. Peter
Chamberlen.In the past only Greeks used varietyChamberlen.In the past only Greeks used variety
of hooks and tractors to deliver dead fetus.of hooks and tractors to deliver dead fetus.
 In 1853,Dr. James Y.Simpson of GlasgowIn 1853,Dr. James Y.Simpson of Glasgow
suceeded in introducing the use of Chloroformsuceeded in introducing the use of Chloroform
anesthesia as an aid in obstetrics called “ERA OFanesthesia as an aid in obstetrics called “ERA OF
MODERN OBSTETRICS”.MODERN OBSTETRICS”.

19. CONTD…CONTD…
 Then,Pinard Fetoscope was developed and IanThen,Pinard Fetoscope was developed and Ian
Donald from Glasgow introduce Ultrasound inDonald from Glasgow introduce Ultrasound in
Obstetrics.Obstetrics.
 In 1950,Fritz Fuch of Copenhagen performedIn 1950,Fritz Fuch of Copenhagen performed
Amniotomy identified the fetal cells present in itAmniotomy identified the fetal cells present in it
which identify sex of the baby by barr bodies.which identify sex of the baby by barr bodies.

20. CONTD…CONTD…
 Later on emphasis on Antenatal check-ups,bloodLater on emphasis on Antenatal check-ups,blood
pressure,urine analysis was came in attention.pressure,urine analysis was came in attention.
 In 1892,Dr. Pierre Budin initiated consulation forIn 1892,Dr. Pierre Budin initiated consulation for
nursing mothers.nursing mothers.
 In 1949,first world health organization expertIn 1949,first world health organization expert
committee on maternal child health met incommittee on maternal child health met in
Geneva.Geneva.

21. CONTD…
 In 1950,Oral contraceptives was introduce for theIn 1950,Oral contraceptives was introduce for the
control of fertility.control of fertility.
 Then b-HCG tracing was done with chorion villusThen b-HCG tracing was done with chorion villus
sampling at 10sampling at 10thth
wk.wk.
 Identification of IUGR was done by NS test.Identification of IUGR was done by NS test.
 Later on Raoul Palwer & Patrick steptol discoverLater on Raoul Palwer & Patrick steptol discover
Laproscopic Sterlization.Laproscopic Sterlization.
 In 1960,Witness abortion get started.In 1960,Witness abortion get started.

22. CONTD…
 1971 – MTP Act1971 – MTP Act
 1974 – Family Planning Services Incorporated In1974 – Family Planning Services Incorporated In
MCH CareMCH Care
 1977 – Renaming Family Planning To Family1977 – Renaming Family Planning To Family
WelfareWelfare

23. CONTD…
 1978 – Expanded Programme on Immunization1978 – Expanded Programme on Immunization
 1985 – Universal Immunization Programme1985 – Universal Immunization Programme
 1992 – Child Survival& Safe Motherhood1992 – Child Survival& Safe Motherhood
ProgrammeProgramme

24. CONTD…
 1996 – Target Free Approach
 1997 – RCH Programme Phase-1 (15-10-1997)
 2005 – RCH Programme Phase-2 (01-04-2005)

25. CONTEMPARY PERSPECTIVE OFCONTEMPARY PERSPECTIVE OF
OBSTETRICSOBSTETRICS
 In current view all the focus from obstetrics careIn current view all the focus from obstetrics care
shifted to perinatal care.shifted to perinatal care.
 Advancement in Obstetrics care has reduces theAdvancement in Obstetrics care has reduces the
MMR.MMR.
 Govt. has started programme to identify highGovt. has started programme to identify high
risk mothers.risk mothers.
 Training of health personnels,Allocation ofTraining of health personnels,Allocation of
facilities & equipment decreases MMR.facilities & equipment decreases MMR.

26. CONTD…
 MMR can be reduces:MMR can be reduces:
 Early registration of pregnancy.Early registration of pregnancy.
 Atleast three antenatal check-ups.Atleast three antenatal check-ups.
 Dietary supplements can correct anemia.Dietary supplements can correct anemia.
 Prevention of infection and haemorrhage duringPrevention of infection and haemorrhage during
puerperium.puerperium.
 Prevention of complications e.g.Prevention of complications e.g.
Eccalmpsia,malpresentation,ruptured uterus.Eccalmpsia,malpresentation,ruptured uterus.

27. CONTD…CONTD…
 Treatment of medical conditions e.g.
hypertension,DM,TB.
 Anti-malaria and tetnus prophylaxis.
 Clean delivery practice.
 Institutional deliveries for women with BOH and
risk factors.
 Promotion of family planning.

28. CONTD…CONTD…
 MCH services has started which aims atMCH services has started which aims at
reduction in morbidity and mortality rate ofreduction in morbidity and mortality rate of
mother and baby.mother and baby.
 Baby friendly hospital scheme has launched inBaby friendly hospital scheme has launched in
1993 for effective breastfeed to child.1993 for effective breastfeed to child.
 Genetic counselling to the couples.Genetic counselling to the couples.
 Screen the mother for HIV.Screen the mother for HIV.

29. FUTURE EVIDENCE BASEDFUTURE EVIDENCE BASED
PRACTICE:PRACTICE:
 Mapping of human genome and genetic research.Mapping of human genome and genetic research.
 Use of intrauterine shunts.Use of intrauterine shunts.
 Aseptic techniques to be used during PV,PROM.Aseptic techniques to be used during PV,PROM.
 Care of mother during labor.Care of mother during labor.
 Care after delivery for puerperium infections.Care after delivery for puerperium infections.

30. BIBLIOGRAPHY:BIBLIOGRAPHY:
 Nurse Midwifery Helen Varney 2Nurse Midwifery Helen Varney 2ndnd
edition pageedition page
no.19-20no.19-20
 Obstetrics nursing Erna Ziegel/Carolyn conantObstetrics nursing Erna Ziegel/Carolyn conant
van Blarcorn 6van Blarcorn 6thth
edition page no. 771-797edition page no. 771-797
 The Indian Journal of Nursing and MidwiferyThe Indian Journal of Nursing and Midwifery
Vol 1,Number 3 Dec 1998Vol 1,Number 3 Dec 1998