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Midwives competences, statute versus reality
HORÁKOVÁ, Kateřina
Obstetric assistance is a part of a complex system of maternal and child nursing care which is provided by a number of medical staff members. The role of a midwife is crucial in this system. She is a partner. She is mainly a partner of the mother-to-be and her family, the obstetrician and the whole medical team. A midwife of the 21st century is a well-trained medical staff member. She is specialized in the care for a woman with physiological pregnancy. She provides a highly specialized care for women before, during and after the birth and also for their healthy newborns and infants up to the age of six weeks. Together with the planned accession of the Czech Republic to the European Union, a gradual harmonization of education occurred in regulated professions. Midwifery is recognized as a regulated profession in the EU and its educational standards were adapted according to the EU directives. These directives set the basic objectives of the medical branch, the minimum content of the educational program, its length, the previous education of applicants and also the competencies of graduates. Nowadays the Law No.96 from 4th February 2004 and its executive regulation No. 424/2004 of the collection of Law is pivotal. A heated discussion on that Law after its formation was the impulse for this thesis. The aim of the thesis is to find out what the accordance of midwives´ competencies with the valid legistative is like in practice. The research part of the thesis took place in gynaecological-obstetrical departments in the Czech Republic. During the investigation conducted by the questionnaire method we made inquiries about the allocation of competencies in the labour ward, the midwives´ awareness and their satisfaction with the range of the care provided. The results are interesting. The ignorance of current legal regulations of midwives´ competencies was surprising. The research showed midwives´ great satisfaction with the scope of entrusted competencies. In more than a half of hospitals midwives assist physiological deliveries and carry out work activities stated by the Law. The only exception is treatment of birth injuries and the ultrasound diagnostics during birth. According to the contemporary Law the obstetrician may, but does not have to, shift a part of his or her responsibility on the midwife. It depends on the hospital and they vary a lot in this sense. But the results show that the situation is not so black and white as it is denoted by many midwives. In any case it is necessary to find such a form of cooperation from which mainly the expecting mothers will benefit. There must be a professional partnership between doctors and other medical staff members. The team cooperation and mutual respect are fundamental.
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