A Comprehensive Textbook of Midwifery & Gynecological Nursing Annamma Jacob
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Annamma Jacob MSc (N) Principal Bhagawan Mahaveer Jain College of Nursing Bengaluru, Karnataka, India FormerlyProfessor St. Philomenas College of Nursing Bengaluru, Karnataka, India Principal Graduate School for Nurses Board of Nursing Education South India Branch Christian Medical Association of India Bengaluru, Karnataka, India Nurse Supervisor Suburban Medical Center Paramount, Southern California, USA Assistant Director of Nursing Al-Sabah Hospital, Ministry of Public Health Kuwait, Arab, Western Asia Sister Tutor Leelabai Thackersey (College of Nursing)Shreemati Nathibai Damodar Thackersey (Women's University) Mumbai, Maharashtra, India Junior Tutor College of Nursing Christian Medical College (Hospital) Vellore, Tamil Nadu, India Foreword Krishnaveni TM
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A Comprehensive Textbook of Midwifery and Gynecological Nursing
First Edition: 2005
Second Edition: 2008
Third Edition: 2012
Fourth Edition: 2015
Printed at
A Comprehensive Textbook of Midwifery and Gynecological Nursing offers a unique opportunity to midwifery students as well as teachers, to assimilate an evergrowing body of scientific knowledge and to develop the technical and analytical skills necessary to apply the same into practice.
The book strives to provide the students with various aspects of midwifery to become competent and caring midwives. It includes the most accurate and clinically relevant information available, in a clearly written, visually appealing and logical format.
The book includes 12 Sections divided into 71 Chapters with an exhaustive Appendix and Glossary at the end. Each chapter is ending with a list of bibliography, which is useful to find out detailed information. In addition, a number of diagrams, tables, illustrations and nursing processes have been presented, wherever necessary. The book is in simple language.
The current concept on Community Midwifery has been included, which stresses on Preventive Obstetrics and Domiciliary Care in Maternity Nursing. A detailed discussion on Primary Health Care, the Organization of Maternal and Child Health Programs, and the Current Evolution of Reproductive and Child Health Programs is included, which is of much use to the students to deliver Community, Maternal and Child Health Services.
I hope and trust that this midwifery textbook will be of a great help not only to midwifery students but also to the midwifery teachers, for study as well as for ready-reference.
With best wishes.
Krishnaveni TM PHN
Former Assistant Director
Directorate of Health and Family Welfare Services
Government of Karnataka
Bengaluru, Karnataka, India
FM6 FM7Preface to the Fourth Edition
The fourth edition of A Comprehensive Textbook of Midwifery and Gynecological Nursing is prepared with the realization that nurses today need knowledge and skills in technology, communication and interpersonal relations to be effective members of the collaborative healthcare team as well as to meet the demands of the changing healthcare system. Critical thinking and creativity are essential, as nurses implement care to the clients of diverse backgrounds.
This edition of the textbook retains most of the contents, which has been well-received by the faculty and the students of midwifery, who have used the previous editions.
Few chapters are replaced with more information added to its existing contents. Changes in the healthcare policies and plans of the Government of India, and the revised guidelines of American Heart Association for Basic Life Support (BLS) procedures are added.
It is hoped that the content of the present edition of the textbook with added information, probable nursing care plans and questions for every chapter will enable the students of midwifery and practicing midwives to provide quality care for mothers and children in safe and effective manner.
Annamma Jacob
FM8 FM9Preface to the First Edition
The book is the culmination of ideas of a nurse educator who has practiced and taught maternal-neonatal nursing in India and in the United States of America. It is the fulfillment of often stated need among nurse educators and nursing students in India. Since long, teachers of midwifery have been relying on books written with an orientation for practice in the developed countries or those written by physician authors. As a midwifery educator, I became aware of the frustrations of students in trying to piece together the information from English and American midwifery texts or from physician-authored book. The former were too much in-depth and generally oriented to conditions in the developed countries, while the latter lacked nursing care aspects in order to plan, and provide comprehensive care to maternity clients and newborns.
As the concept of nursing process has been incorporated into midwifery education, a chapter on nursing process is included to familiarize midwifery students to the appropriateness of using the problem-oriented approach with their maternity and newborn clients. With a few selected topics, the nursing processes that can be carried out are included, which are hoped to serve as guidelines. In the chapter on Drugs, nursing considerations are included with a view to foster the use of nursing process in drug administration. Pertinent information from other health sciences is included throughout the book, particularly as it relates to the childbearing and child-rearing periods in the life of the family and from preconception through the first 6 weeks’ postpartum.
This book is organized into 11 Sections in logical sequence including all the units outlined in the syllabus prescribed by the Indian Nursing Council for Midwifery Course (INC syllabus, 1986). Additional information includes the Chapters on Nursing Process, Childbirth Education and Preparation, and the current trends in National Reproductive and Child Health (RCH) Program. This book is written completely in the Indian context and in a simple style, and easy to understand language for the benefit of Indian nursing students. Practicing nurses will also find the content understandable and useful. Advances in the field of obstetrics and practice of midwifery in the developed countries are included wherever relevant.
Each chapter begins with a list of learning objectives. This tells the reader specifically what she/he should know after reading the chapter. The students can use this as a study aid. A large number of informative diagrams, tables and illustrations have been included and they have been designed to convey information in readily comprehensible form.
I sincerely hope that this book will greatly benefit the midwifery teachers, students and nurses practicing maternal-child nursing.
Annamma Jacob
FM10 FM11Acknowledgments
One of the most pleasant parts of writing a book is the opportunity to thank those who have contributed to it. I am deeply appreciative of Dr Krishnaveni TM, Former Assistant Director, Directorate of Health and Family Welfare Services, Government of Karnataka, Bengaluru, Karnataka, India, for the patient and wholehearted efforts in editing the book.
Special thanks to Mr Joji George RN and Miss Aswathy Alexander BSc (N) who drew many figures in this book.
There have been many people who have touched and shaped my life and beliefs in maternal child nursing. I am indebted to Mrs Nesamoni Lazarus, my teacher at College of Nursing, Christian Medical College and Hospital, Vellore, Tamil Nadu, India from whom I learned a lot and Mrs Phyllis Berg and Miss Chris Hamilton, Nursing Managers at Suburban Medical Center, Paramount, California, USA who have influenced me profoundly.
I am thankful to my personal friends and professional colleagues in the institutions I had worked and with whom I shared my knowledge and aspirations. The inspiration for writing this book came as a result of my association and involvement with my former student at Leelabai Thackersey College of Nursing, Shreemati Nathibai Damodar Thackersey Women's University, St. Philomenas College of Nursing and Graduate School for Nurses, Board of Nursing Education (BNE), South India Branch (SIB), and Christian Medical Association of India (CMAI), Bengaluru, Karnataka, India.
My special thanks go to my niece Pinky Ann Thomas, nephew Pinku Cherian Thomas and brother-in-law Mr George K Cherian for their suggestions, support and assistance in ways big and small.
It is essential to have sustained interest and determination to keep a book updated to meet the changing needs in the field of nursing education, necessitated by the advancing trends in diagnostic and therapeutic technologies in managing healthcare.
Encouragement, support and cooperation of many are essential and I am deeply thankful to many who provided comments and suggestions after reviewing and using the textbook.
Management personnel of Bhagwan Mahaveer Jain College of Nursing permitted the use of the facilities of college library and laboratories for which I am extremely grateful to them.
For the many photographs and illustrations included in the book, staff of Bhagwan Mahaveer Jain Hospital, patients and their family members along with staff and students of BMJ College of Nursing offered themselves and their efforts, and I record my sincere thanks to everyone of them.
Most importantly, I thank God Almighty for giving me the physical and emotional strength required to carry out this work. Not least but most, I thank my husband Jacob AJ who encouraged me and worked with me tirelessly to complete this book and in whose honor I have decided to publish this book.
Finally I thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Mr Tarun Duneja (Director–Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, Mr Venugopal Vishnumurthy [General Manager-Sales and Marketing (South)], Bengaluru and all other staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, Bengaluru, Karnataka, India, for their encouragement for doing the revision work.