Document Category: Midwifery

JHPIEGO/Maternal and Neonatal Health Program xiii
PREFACE
Basic Maternal and Newborn Care: A Guide for Skilled Providers (BMNC) is based on the premise that provision of
quality basic care to women experiencing normal pregnancies, births, and postpartum periods, as well as to
their normal newborns, not only improves the health of mother and baby, but also can help save lives. Basic
maternal and newborn care includes the healthcare services that all childbearing women and newborns should
receive. Healthcare systems often focus their resources on caring for women and newborns who have
complications, not recognizing that providing quality basic care services to all women and newborns can
support and help maintain normal processes, as well as prevent many complications and/or identify and treat
them before they become life-threatening. Basic care provision also emphasizes the importance of providing
health messages and counseling to women and their families to empower them to become active participants
in their own healthcare.

The care of a woman and her baby in the immediate hours, days and
weeks following birth can make an enormous difference to their longterm health and well-being. The content and timing of postnatal care
led by midwives was formalised in the United Kingdom following a
statutory legislation that was first introduced in England in 1902. Then
there were concerns that too many women were dying following birth.
The provision of midwifery care for all women including postnatal
contacts in hospital and in the home, together with improved public
health and advances in medicine, led to a dramatic fall

Protection of the Patient in Surgery/Patient Safety

The days and weeks following childbirth – the postnatal period – is a critical phase in
the lives of mothers and newborn babies. Most maternal and infant deaths occur during
this time. Yet, this is the most neglected period for the provision of quality care. WHO’s
Postpartum care of the mother and newborn: a practical guide (WHO/RHT/MSM/98.3) was
published in 1998. Guidance from this document was included in the WHO guideline
Pregnancy, childbirth, postpartum and newborn care: a guide for essential practice, published
in 2004 (http://whqlibdoc.who.int/publications/2006/924159084X_eng.pdf). In keeping
with the WHO Handbook on development of guidelines, these documents needed to be
updated to include current best evidence-based practices.

Sally Marchant’s chapter examines how the status of midwifery and the
role of postnatal care evolved, mainly within the context of maternity
service provision in the United Kingdom. The relationship between the
health and the well-being of a woman and the care received after giving
birth are addressed in terms of major maternal morbidity, for example,
post-partum haemorrhage. In ancient Egyptian and Roman societies,
historical sources describe the role of the midwife and some of the
herbs and other preparations used in their practice. Centuries later, the
Catholic Church in mainland Europe evolved to become the dominant
power in society, with powers to license midwifery practice, wherein
midwives were required to take an oath promising that ‘magic’ would
not be used in their practice. Traditional customs and rituals related
to care after giving birth, highlighting the fear of death from sepsis or
haemorrhage, were incorporated into religious and social frameworks,
many of which persist in some cultures to the present day.