ZIGA MEMORIAL DISTRICT HOSPITAL

Tabaco CityTel. Nos. (052) 830-5200, 487-5903

“A PHIC Accredited Health Care Provider”
Note Taking Guide for Midwifery Licensure Examination
PROFESSIONAL GROWTH
&
DEVELOPMENT
Prepared by: Eduard E. “Kuya” Gandul Jr., R.M,R.N
Adjustment:

An educational process referring to changes in behavior towards better life,

better relationships and better contribution to society
Profession:

A calling by which members profess to have

special knowledge by training
,
by experience
or
both
on that they may guide or advice or serve other in that field.
CRITERIA OF A PROFESSION
1.Mastery of the Craft- the profession must possess the necessary skills and
attitude.2.Service orientation-Hall mark of the profession3.Autonomy-reasonable
independent being (self-regulated)Accountability-the essence of
profession4.Political Power- Adhere own sets of values5.Professional Organization-
Must be a member of an accredited Organization (e.g IMAP)
EVOLUTION OF MIDWIFERY IN THE PHILIPPINESCare of the sick in Primitive Times
•
Animism. Babaylan, catalonan,
•
Superstitious and mystical beliefs: wind theory, natural Order and forces
(mangkukulam or manggagaway)
Spanish Period
•
Individual sin (Gaba or Bad Karrma), poot and Aswang
•
Materia medica (MOrga. Governador-General in 1595-1596 noted used of wine as
medicine:Lambanog and Tuba)
•
Fore runner of Filipino Red Cross
American Period
•
Separation of Producers, distributors, and consumers of health
•
Exchange calue
•
Iloilo Mission Hospitals School of Nursing (1906)
Contemporary
Dr. Jose Fabella, first secretary of the department of health founded the first
midwifery school inthe 1922 as a response to high infant mortality rate.
Objectives of the First Midwifery Schools:
•
Train young women to replace hilots (traditional birth attendant)
•
Train doctors and nurses for Rural assignments and
•
Provide health service and education with emphasis on maternal and child health
(MCH)

PROFESSION OF MIDWFERY
Is the performance or offer to perform or render for a fee, salary, or other reward
or compensationof service recurring an understanding of the principles and
application of procedures and techniques in thesupervision of and care of women
during pregnancy, delivery and puerperium.1.Management of Normal
Delivery2.Performance of Internal examination during Labor, except when patient has
antenatal bleeding.3.Health education of patient family and community, including
nutrition and family Planning4.Carrying out the written order of the physician with
regards to ante-natal, intra natal and postnatal care of the normal pregnant
women5.Giving Immunization6.Oral and parenteral dispensing of oxytocic after the
delivery of the placenta7.Suturing perineal laceration to control bleeding8.Giving
intravenous fluid during obstetrical emergencies provided they were trained for
that purpose9.May inject vitamin K to new born
Characteristic of Profession
•
There is especial preparation and training
•
With clearly defined permanent membership
•
Acceptance of the service motive
Determinants of Professional Practice
•
Problems and needs by the people
•
Policies and regulation
•
Current socio-economic political and cultural system
SPHERE OF MIDWIFERY PRACTICE IN THE PHILIPPINES
1.
Traditional Function of the Midwife
(R.A No. 7392). The Philippine Midwifery Act of 1992 provides the midwife:a.Gives
supervision care and advice to women during pregnancy, labor and post-partum
period. b.Conduct deliveries on her own responsibilityc.Cares of the newborn
including the detection of abnormalities and counseling of parentsor couple.d.Gives
health Educatione.Executive emergencies measuresf.Procures medical supplies
2.Expanded Function of the Midwifes
a.Oral and parenteral dispensing of oxytocic drugs after delivery of the placenta
b.Suturing perineal lacerations to control bleedingc.Giving of intravenous fluids
during obstetrical emergenciesd.Injecting of vitamin K. to the Newborn

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PROFESSIONAL ORGANIZATION OF MIDWIVESINTEGRATED MIDWIVES ASSOCIATION OF THE

PHILIPPINES (IMAP)Brief History:
In the 1961 two organization were founded the Philippine Midwives association of
thePhilippines or the PHIMIDAS with Atty. Angelina Fonce as first president and the
National Federation of Filipino Midwives or the NFFM with Mrs. Leoncia Chuatoco as
first president.In 1974, the two were integrated to become IMAP with Ms. Juana
Reyes as its first president. It is presently the only professional midwives
association recognized by the Philippine RegulatoryCommission (PRC)
Letter of Instruction 1980
Compulsory membership to professional association accredited by the professional
regulationscommission
ETHICO-MORAL RESPONSIBILITYEthics –
 part of philosophy that deals with systematic approaches to questions of morality.
•
A term for the study of how we make judgments regarding right and wrong.
•
A system of MORAL PRINCIPLES or moral standards governing conduct.
Morals-
Human conduct in the application of ethics. Concerned with JUDGMENT PRINCIPLES of
rightand wrong in relation to human actions and character.
CODE OF ETHICS
•
Fundamental responsibilities of midwife
•
Render medical services regardless of the religious belief , political belief or
creed
FREEDOM OF RELIGION
No law shall be made respecting the establishment of a religion or to prohibit the
free exercisethere of. The fee exercise and enjoyment of religious profession and
worship without discrimination shallforever be allowed.
Two aspects of freedom of Religion
a.
Freedom to Believe
- Absolute b.
Freedom to Act
– Relative (It must be in conformity to the law, morals, customs and traditions)
•
Render medical services on the ground medical neutrality – don’t take the
background of pt.
•
Protect life and respect the dignity of man
Trained Worker
•
Dignity – respect Bill of Rights
•
One who perform lethal injection to the person found guilty
The Patients Bill of Rights (Filipino)
1.The patient has the right to considerate and respectful care, irrespective of
socioeconomic status2.The patient has the right to obtain from his physician
complete current information concerninghis diagnosis, treatment and prognosis in
terms the patient can reasonably be expected andunderstand. When it is not
medically advisable to give such information to the patient, the

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information should be made available to an appropriate person in his behalf. He has

the right toknow by name and in person, the physician and nurse responsible in
coordinating his care.3.The patient has the right to receive from his physician
information necessary to give informedconsent prior to the start of any procedure
and/or treatment. Except in emergencies, suchinformation for informed consent
should include but not necessarily limited to the specific procedure and/or
treatment, the medically significant risks involved, and the probable duration of
incapacitation. Where medically significant alternatives for care or treatment
exist, or when the patient requests information concerning medical alternatives,
the patient has the right to suchinformation. The patient has also the right to
know the name of the person responsible for the procedures and/or treatment.4.The
patient has the right to refuse treatment/lifegiving measures, to the extent
permitted by law,and to be informed of the medical consequences of his action.5.The
patient has the right to every consideration of his privacy concerning his own
medical care program. Case discussion, consultation, examination and treatment are
confidential and should beconducted discreetly. Those not directly involved in his
care must have the permission of the patient to be present.6.The patient has the
right to expect that all communication and records pertaining to his careshould be
treated confidential.7.The patient has the right to expect that within its
capacity, a hospital must make reasonableresponse to the request of patient for
services. The hospital must provide evaluation, serviceand/or referral as indicated
by the urgency of care. When medically permissible a patient may betransferred to
another facility only after he has received complete information concerning
theneeds and the alternatives to such transfer. The institution to which the
patient is to be transferredmust first have accepted the patient for transfer.8.The
patient has the right to obtain information as to any relationship of the hospital
to other healthcare and educational institutions in so far as his care is
concerned. The patient has the right toobtain information as to the existence of
any professional relationship among individuals, byname, who are treating him.9.The
patient has the right to be advised if the hospital proposes to engage in or
perform humanexperimentation affecting his care or treatment. The patient has the
right to refuse or participatein such research project.10.The patient has the right
to expect reasonable continuity of care; he has the right to know inadvance what
appointment times the physicians are available and where. The patient has the
rightto expect that the hospital will provide a mechanism whereby his physicians or
a delegate of the physician of the patient’s continuing health care requirements
following discharge informs him.11.The patient has the right to examine and receive
an explanation of his bill regardless of source of payment.12. The patient has the
right to know what hospital rules and regulations apply to his conduct as a
patient.
Bill of Rights of Patients
1. Right to informed consent2. Right to refuse and/or withdrawal from participation
or autonomy3. Right to privacy4. Right to confidentiality5. Right to quality care
1. Right to Informed ConsentConscious
– all medical practice are not authorized ŝ consent
Unconscious
– all medical practice are authorized as if consent is given to you
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Rule in Giving Consent

•
Patient her/himself
•
If the Pt. is married the consent of the spouse is not necessary, provided of sound
mind and legalage.
2. Right to Make Decisions Or Autonomy
- Right to Self Determination- Justice Cardozo“A Person who is of a sound mind and
of legal age shall have the right to determine what is supposed to be done to his
body.”
PERSONS TO MAKE DECISIONS IN CONSCIOUS PATIENT
1.parents2.grandparents

paternal

maternal3.eldest brother/sister 4.relatives/guardians5.teachers
Telephone
– overheard by two credible witnesses
Fiancé
– authorize to give consent for conscious if no parents, grandparents,
brother/sister, guardians.
Q:
How do you respect the dignity of patient?
A:
By respecting the bill of rights of patient.Between the conflict of pt. and doctor,
loyalty will always be on the patient.
3. Right to Privacy and Confidentiality
Privacy of Communication
“It shall be inviolable except upon the lawful order of the court and when public
safety, public healthrequires it.”*Cannot be violated at all – SECRECY ACT LAW
Q:
Who owns the medical chart?
A:
Hospital
Q:
Who owns the communication in the medical chart?
A:
Doctor and Patient
*Duty: Keeps in proper place (medical chart rack) with honesty, confidentiality,
and integrity
Relative Privacy Absolute PrivacyDoctor – PatientMidwife – SpouseMidwife – Patient
Midwife – lawyer (case)Midwife – Priest (religion)
Husband – wife
= absolute privacy; order from court, no order to divulge/ reveal or right not to
tell
Q:
What is Privacy?

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