24 MIDWIFERY CARE STANDARDS

PUBLIC SERVICE STANDARDS

STANDARD 1 : PREPARATION FOR HEALTHY FAMILY LIFE

Goals :
1. Provide appropriate health education to prepare for a healthy pregnancy and planned to be a
responsible parent
2. Midwife provide counseling and advice to individuals , families and communities on all matters
relating to pregnancy , including public health education , nutrition , family planning and
preparedness in dealing with pregnancy and becoming a parent candidate , avoiding bad habits
and good habits to support
3. Communities and individuals to participate in efforts to achieve a healthy pregnancy, mothers,
families and communities to increase knowledge about the function of reproductive organs and
the dangers of pregnancy at a young age
4. Midwife work with cadres of health and related sectors as needed .

STANDARD 2 : RECORDING AND REPORTING

1. goals :
1. Collecting , studying and using data for the implementation of the extension , continuity of
service and performance assessment
2. Midwife shall record all activities done carefully such that real , recording all pregnant women
in the work area , details of the service provided by the midwife to mothers throughout
pregnancy / childbirth , postpartum and newborn all home visits and outreach to the
community. In addition , midwife should be to involve volunteers to record all pregnant women
and review the community's efforts with regard to pregnant women , mothers in childbirth , the
mother during childbirth , and the newborn . Midwife regularly reviewing these records to
assess performance and develop a personal action plan to improve services.
3. Implementation of good record keeping and reporting
4. Available data for audit and self-development .
5. Increase community involvement in pregnancy , childbirth and midwifery services .
6. Have a national policy / local to record all births and maternal and infant mortality .
 7. System for recording and reporting of births and maternal mortality and infant national or
implemented in accordance with local
8. Midwife working with volunteers / community leaders and understand the local health
problems .
9. Register Cohorts mother and baby , Mrs. Card , KMS Pregnant Women , Book KIA , KIA and
PWS , partograf used for recording and reporting services . Midwives have enough supplies for
all the necessary documents .
10. Midwife are trained and skilled in the use of the above recording format .
11. Equitable pregnant women
12. Midwife have all the documents necessary to record the number of cases and work schedule
every day .
13. Recording and reporting is essential for midwives to learn about their work
14. Recording and reporting must be done at the time of service . Delaying the recording will
increase the risk of not carrying important information in reporting .
15. Recording and reporting have to be young to read, accurate and contain the date , time and
initials .

SERVICE STANDARDS ANTERNATAL

STANDARD 3 : IDENTIFICATION OF PREGNANT WOMEN
The goal :
1. Midwife doing home visits and interact with people on a regular basis to provide counseling
and motivating mothers , husbands and family members to encourage mothers checkups early
and regularly .
2. Mother , husband , community members aware of the benefits of prenatal care early and
regularly , as well as knowing where pregnancy checks .
3. Increased coverage of pregnant women who present before 16 weeks of pregnancy
4. Midwife work with community leaders and volunteers to find pregnant women and ensure that
all pregnant women have checked the content of early and regular
5. Conduct home visits and community outreach on a regular basis to explain the purpose of
prenatal care to pregnant women , husbands , families and communities .
STANDARD 4 : DIAGNOSIS AND MONITORING ANTENATAL
The goal :
1. Provide quality antenatal care and early detection of pregnancy complications
2. Midwife provide antenatal care at least four times . Examination includes the history and
maternal and fetal monitoring carefully to assess whether development proceeds normally
3. Midwife also have to recognize gestation resti / disorders especially anemia , malnutrition ,
hypertension , STDs / HIV infection ; provide immunization services , advice , and health
education as well as other related tasks given by the clinic .
4. Pregnant women receive antenatal care at least four times during pregnancy .
5. Increased utilization of services by the community midwife . Early detection and pregnancy
complications
6. Pregnant mothers , husbands , families and communities to the danger signs of pregnancy and
know what to do
7. Referral arrangements for transportation if at any time of the emergency
8. Midwife to provide quality antenatal care , including maternal use of KMS and recording the
results of antenatal card ( card mother )
9. Midwife are friendly , polite and friendly at every visit

SERVICE STANDARDS 5 : Abdominal palpation

1. The goal :
Estimating gestational age , fetal growth monitoring , determination of the location , fetal position and
bottom
1. Standard statement :
Midwives perform abdominal examination carefully and do participate to estimate gestational age .
When gestational age increases , check the position , the lowest part , the inclusion of the fetal head
into the pelvic cavity , to look for abnormalities as well as timely referral .
1. The result :
Estimated gestational age better.
Early diagnosis of pregnancy lies , and refer as needed
Early diagnosis of multiple pregnancy and other abnormalities and refer as needed
 1. Requirements :
1. Midwife have on learners about the correct procedure abdominal palpation
2. Tool , such as a cloth tape measure , fetal stethoscope , available in good condition
3. There are checkpoints closed and socially acceptable
4. Using KMS maternal / KIA book , recording cards for mom
5. A referral system that applies to pregnant women who require referral
6. Midwife should perform abdominal palpation at each antenatal visit

STANDARD 6 : MANAGEMENT OF ANEMIA IN PREGNANCY

1. Goals :
Find anemia in early pregnancy , and do adequate follow-up to address anemia before delivery takes
place
1. Standard statement :
There are guidelines for the management of anemia in pregnancy

1. Midwife are able to:

1 . Recognize and manage anemia in pregnancy
2 . Provide nutrition counseling to prevent anemia
3 . Tool for measuring levels of well-functioning HB
4 . Available iron tablets and folic acid
5 . Anti-malarial drugs ( in malaria -endemic areas )
6 . helminthic
7 . Using KMS maternal / books KIA , mom cards
8 . Process that must be done midwife :

Examine the levels of HB all pregnant women at the first visit and at week 28 . HB below 11 g% in
pregnancy include anemia , 8 % are under severe anemia . And if severe anemia occurs , for example,
face pale , tired , pale bluish fingernails , eyelids very pale , immediately refer pregnant women for
further examination and treatment . Pregnant women with anemia suggest to keep taking iron tablets
until 4-6 months after birth .
STANDARD 7 : MANAGEMENT OF HYPERTENSION IN EARLY PREGNANCY
1. Goals :
Recognize and locate early hypertension in pregnancy and take the necessary action

1. Standard statement :
Midwife found early every increase in blood pressure in pregnancy and recognize signs and symptoms
of pre - eclampsia other , and to take appropriate action and refer

1. The result :
Pregnant women with pre-eclampsia signs and getting adequate treatment on time , decrease morbidity
and mortality due to eclampsia

1. Requirements :
Midwife perform regular pregnancy checks , blood pressure measurement

1. Midwives are able to:

Measure blood pressure correctly , recognize the signs of preeclampsia , detecting hypertension in
pregnancy , and follow-up in accordance with the provisions of

8 PREPARATION OF LABOR STANDARDS

1. Standard statement :
Midwife provide appropriate advice to pregnant women , the husband and his family in the third
trimester , to ensure that the preparation of a clean and safe delivery and pleasant atmosphere will be
well planned .

1. Prerequisites :
1. All mothers should do 2 antenatal visits in last trimester of pregnancy
2. The existence of national policies and protocols / local delivery of indications that should be
referred and be in hospitals
3. Midwives trained and skilled delivery assistance in conducting a safe and clean
4. Essential equipment for antenatal checks available
 5. Critical equipment that need to help clean and safe deliveries are available in the state of
DTT / sterile
6. Any transportation arrangements for referring pregnant mothers quickly in case of
emergencies mother and fetus
7. Using KMS pregnant women / mothers cards and books KIA phatograf
8. Effective referral system for pregnant women who experience complications during
pregnancy .

LABOR STANDARDS HELP

STANDARD 9 : KALA CARE OF LABOR

1. Goals :
Midwifery to provide adequate services in support of aid deliveries clean and safe for mother and baby.
1. Standard statement :
Midwife assess precisely that labor has begun , then give adequate care and monitoring , with attention
to the needs of the client , during labor .

1. The result :
1. Maternal emergency treatment is adequate and timely when needed
2. Increase the coverage of labor and other complications that helped skilled health personnel
3. Reduced mortality / morbidity due to maternal or infant prolonged labor .

STANDARD 10 : LABOR STAGE TWO ARE SAFE

1. goals :
ensure a clean and safe delivery for mother and baby

1. Standard statement :
use reduces the incidence of post- persalinan1 bleeding. Destination Ensure a clean and safe delivery
for mother and baby

1. requirements
1. Midwife called if the mother has begun to heartburn / rupture
2. Midwives are skilled in helping terlalih and delivery in a clean and safe
3. Available tools to aid delivery including sterile gloves
4. Supplies adequate tools

STANDARD 11 : MANAGEMENT OF LABOR ON STAGE III

 1. goals :
Actively assist expulsion of the placenta and membranes are complete to reduce the incidence of
postpartum hemorhage , shortening the third stage , preventing retained placenta and uterine Atoni

1. standard statement
Midwives perform properly handling the umbilical cord to help expulsion of the placenta and
membranes are complete

STANDARD 12 : TREATMENT WITH STAGE II THROUGH episiotomy fetal distress

1. goals :
Expedite delivery with episiotomy done if there are signs of fetal distress during the fetal head
perineum .

1. standard statement
Midwife precisely recognize the signs of distress in the second stage jani old , and immediately
perform an episiotomy to induce labor safely , followed by suturing the perineum

THE SERVICE STANDARDS POSTPARTUM

STANDARD 13 : NEWBORN CARE

1. destination
Assess the condition of the newborn and help start breathing and prevent hypothermia , and infection
hipoglikemia

1. standard statement
Midwifes examine and assess the newborn to ensure breathing prevent spontaneous secondary hypoxia
, find abnormalities , and take action or refer as needed . Midwife also have to prevent and deal with
hypothermia

STANDARD 14 : HANDLING THE FIRST 2 HOURS AFTER LABOR

1. destination
Promote maternal and infant care is clean and safe for when the baby is 4 to restore health , improve
care dear mother and darling baby , began administering IMD

1. Standard statement :
Midwife to monitor the mother and baby to the occurrence of complications within two hours after
delivery , and perform actions that need

STANDARD 15 : SERVICE FOR MOTHERS AND BABIES IN THE POSTPARTUM

1. goals :
Providing services to mothers and infants up to 42 days after birth and exclusive breastfeeding
counseling

1. Standard statement :
Midwives provide care during childbirth through home visits on the third day , and a week to two to
six weeks after childbirth , to assist in the recovery of the mother and baby through the umbilical cord
right treatment , early detection of treatment or referral of complications that may occur during
childbirth , as well as provide an explanation of the general health , personal hygiene , nutritious food ,
newborn care , breastfeeding , immunization and family planning

STANDARD HANDLING emergency obstetric and neonatal

STANDARD 16 : TREATMENT OF BLEEDING IN PREGNANCY TRIMESTER III

1. Destination
Recognize and prompt action 3 trimester bleeding in pregnancy

1. Standard statement :
Midwife precisely recognize the signs and symptoms of bleeding in pregnancy , as well as first aid and
refer

STANDARD 17 : HANDLING AND ECLAMPSIA GRAVITY

1. goals :
Understand early signs and symptoms of severe preeclampsia and provide proper and immediate care
in the handling of emergency occurs when eclampsia

1. standard statement
Midwife precisely recognize the signs and symptoms of threatening eclampsia , as well as referring
and or providing first aid .

STANDARD 18 : HANDLING ON EMERGENCY PROLONGED LABOR

1. Objective:
to know the immediate and proper handling of the state of emergency in prolonged labor / jammed

1. Standard statement :
Midwife precisely recognize the signs and symptoms of prolonged labor and perform an adequate and
appropriate treatment or refer to future

STANDARD 19 : LABOUR USING vacuum extractors

1. Purpose :
to accelerate delivery in certain circumstances by using the vacuum extractor

1. Standard statement :
Midwife recognize when in need of vacuum extraction , do it right in giving aid delivery to ensure
safety for both mother and fetus / baby .

STANDARD 20 : HANDLING retained placenta

1. Purpose:
to recognize and take appropriate action in the event of retained placenta total / partial
 1. Standard statement :
Midwife are able to recognize retained placenta , and provide first aid and manual handling including
placental bleeding , according to the needs

STANDARD 21 : PRIMARY TREATMENT postpartum hemorrhage

1. Purpose:
to recognize and take appropriate action in emergency aid to mothers with primary PPH / uterine Atoni

1. Standard statement :
Midwife to recognize excessive bleeding in the first 24 hours after childbirth ( postpartum hemorrhage
primer ) and immediate first aid to control bleeding

STANDARD 22 : SECONDARY TREATMENT postpartum hemorrhage

1. Purpose:
to recognize the symptoms and signs of secondary postpartum hemorrhage and perform proper
treatment to save the mother's life

1. Standard statement :
Midwife are able to recognize the early signs and appropriate and symptoms of secondary postpartum
hemorrhage , and perform life-saving first aid to the mother , or refer

STANDARD 23 : HANDLING puerperal sepsis

1. Aim to recognize the signs of puerperal sepsis and take appropriate action

1. Standard statement :
Midwife were able to observe precisely puerperal sepsis signs and symptoms , as well as first aid or
refer

STANDARD 24 : HANDLING asphyxia NEONATURUM

1. Objective:
to know the exact newborns with neonatal asphyxia , take appropriate action and conduct emergency
relief newborns who suffered asphyxia neonatorum

1. Standard statement :
Midwife are able to recognize the right of newborns with asphyxia , and resuscitation immediately ,
seek medical assistance as needed and provide follow-up care .