Table of Contents
ToggleMidwifery Terminologies
1. General & Professional Concepts
Core definitions shaping the practice of maternal and child healthcare.
- Midwifery: The profession of providing assistance and medical care to women undergoing labor and childbirth during the antenatal, prenatal, and postnatal periods.
- Obstetrics: A branch of medicine dealing with pregnancy, labor, and the postpartum period.
- Antenatal care: Medical care and monitoring provided to pregnant women before childbirth.
- Midwifery-led care: A model of care in which midwives are the primary providers for pregnant women, providing continuity of care throughout pregnancy, labor, and postpartum.
- Birth plan: A written document created by the pregnant woman outlining her preferences and expectations for labor, delivery, and postpartum care.
- Neonatal intensive care unit (NICU): A specialized medical unit providing care for newborns with serious health conditions or premature babies.
2. Maternal History: Gravidity & Parity
Understanding a woman's obstetric history is a critical daily skill on the maternity ward.
| Term | Clinical Definition |
|---|---|
| Gestation / Pregnancy | The period from conception to the delivery of the baby, or the maternal condition of having a developing fetus. |
| Gravida | A woman who is or has been pregnant, regardless of pregnancy outcome. |
| Primigravida | A woman pregnant for the very first time. |
| Multigravida | A woman who has been pregnant more than once. |
| Nullipara | A woman who is not currently pregnant and has never been pregnant. |
| Parity (PARA) | The number of pregnancies resulting in a viable birth (≥28 weeks gestation), regardless of whether the baby was born alive or stillborn. |
| Primipara | A woman who has given birth to one child. |
| Multipara | A woman who has given birth to two or more children. |
| Grand Multipara | A woman who has given birth to five or more children. |
🧠 Memory Trick: Gravida vs. Para
To avoid confusing the two, remember:
- Gravida = Going to have a baby (Total Conceptions).
- Para = Parted with the baby (Deliveries past 28 weeks).
3. Fetal & Neonatal Terminology
- Fetus: Refers to the human conceptus from the 9th week of gestation up to delivery.
- Viability: The capability of the fetus to live outside the womb (usually accepted between 24 and 28 weeks, although survival is rare at the lower limit).
- Neonate: A newborn infant up to 28 days old.
- Infant: A child from birth to one year of age.
- Toddler: A child between one and two years of age.
- Preterm birth: Delivery of a baby before completing 37 weeks of gestation.
- Intrauterine growth restriction (IUGR): A condition in which the fetus fails to grow at the expected rate inside the uterus.
- Vernix caseosa: A greasy, cheese-like white substance that covers and protects the baby’s skin at birth.
- Meconium: The very first stool of the neonate. It is present in the lower bowel at 16 weeks of gestation, passed within 3 days following birth, and is greenish-black in color.
- Amniotic fluid: The fluid surrounding the fetus within the amniotic sac, providing protection, temperature regulation, and cushioning.
- Placenta: A temporary organ that develops during pregnancy, providing oxygen and nutrients to the fetus and removing waste products.
- Umbilical cord: The flexible cord connecting the fetus to the placenta, through which nutrients and oxygen are transferred.
4. Labor, Delivery, & Fetal Mechanics
Terms defining the physical and physiological processes of childbirth.
The Process of Labor
- Antepartum: The period before birth.
- Intrapartum: The period during labor and delivery.
- Parturition: The process of giving birth.
- Labour: The physiological process of expelling the products of conception from the uterus after 28 weeks of gestation.
- Lightening: The descent of the baby into the pelvis, resulting in a noticeable drop in maternal fundal height.
- Show: The blood-stained mucoid discharge seen at the onset of labor (loss of the cervical mucus plug).
- Crowning: When the largest transverse diameter of the fetal skull emerges under the subpubic arch and does not recede back between contractions.
Fetal Mechanics in the Pelvis
- Lie: The relationship between the long axis of the fetus and the long axis of the uterus. (Can be longitudinal, transverse, or oblique).
- Attitude: The relationship of the fetal head and limbs to its trunk. (Can be complete flexion, flexion, partial extension, or extension).
- Presentation: The fetal part that enters the maternal pelvis first. (Common presentations include cephalic/head, breech/buttocks, face, brow, and shoulder).
- Denominator: The specific part of the fetal presenting part used to describe fetal position (e.g., occiput in a cephalic presentation, sacrum in a breech presentation).
- Position: The relationship of the denominator to the maternal pelvis (e.g., ROA – right occiput anterior).
- Presenting Part: The portion of the fetal presentation that lies over the internal os of the cervix.
- Cephalic: A term directly referring to the head.
5. Obstetrical Complications & Interventions
- Abortion: Termination of pregnancy before 28 weeks of gestation (Note: Week limits vary by country, 28 weeks is standard in the UNMEB curriculum).
- Ectopic pregnancy: A pregnancy that occurs outside the uterus, most commonly in the fallopian tube.
- Preeclampsia: A pregnancy complication characterized by high blood pressure and organ damage, usually occurring after 20 weeks of gestation.
- Fetal distress: A condition in which the fetus is not receiving adequate oxygen, typically detected through abnormal heart rate patterns.
- Episiotomy: A surgical incision made in the perineum during childbirth to enlarge the vaginal opening and facilitate delivery.
- Caesarian section: An incision made on the uterus through the anterior abdominal wall to remove products of gestation after 28 weeks of gestation.
Haemorrhage Classifications
- Antepartum Haemorrhage (APH): Bleeding from the genital tract between 28 weeks of gestation and the end of the second stage of labor.
- Intrapartum Haemorrhage: Bleeding occurring during labor and delivery (e.g., bleeding that occurs after the delivery of a first twin).
- Postpartum Haemorrhage (PPH): Significant blood loss from the genital tract after delivery of the baby and placenta.
⚠️ Clinical Alert: Postpartum Haemorrhage (PPH)
PPH is generally defined as a blood loss of ≥500mL, or any amount of bleeding that leads to maternal hemodynamic instability. It can occur up to 8 weeks postpartum and requires immediate emergency management to prevent shock.
6. The Postpartum Period (Puerperium)
- Postpartum: After birth.
- Puerperium: The period after childbirth or abortion, lasting approximately 6-8 weeks, during which the mother’s body undergoes physical and hormonal changes.
- Lying-In Period: The period immediately following delivery, typically 14 days, during which the mother receives close postpartum care from a midwife.
- Involution: The natural physiological process by which the uterus returns to its pre-pregnancy size and state.
- Lochia: The vaginal discharge that occurs after childbirth or abortion, consisting of blood, mucus, and uterine tissue.
- Colostrum: The first fluid found in the breasts, present from the 16th week of pregnancy up to the 2nd and 3rd day after delivery. Rich in antibodies.
- Lactation: The production and secretion of breast milk.
- Postpartum depression: A mood disorder characterized by feelings of sadness, anxiety, and exhaustion experienced by some women after giving birth.
7. Anatomical Terms & Vital Statistics
Anatomy Highlights
- Cervix: The neck of the uterus.
- Perineum: The area between the vagina and anus in females, which may stretch or tear during childbirth.
Maternal and Infant Mortality Rates
| Statistical Term | Definition |
|---|---|
| Perinatal Period | Relating to the period around birth (typically from 28 weeks gestation to 7 days postpartum). |
| Mortality Rate | The number of deaths per 1,000 individuals in a specified population. |
| Maternal Mortality Rate | The number of maternal deaths attributed to pregnancy, childbirth, or the puerperium per 1,000 women of childbearing age. |
| Perinatal Mortality Rate | The number of stillbirths and neonatal deaths (within the first week of life) per 1,000 total births. |
| Neonatal Mortality Rate | The number of deaths of neonates within the first 28 days of life per 1,000 live births. |
| Infant Mortality Rate | The number of infant deaths within the first year of life per 1,000 live births. |
❓ Quick Review Question
Scenario: A woman arrives at the antenatal clinic. She is currently pregnant. Her first pregnancy resulted in a healthy baby born at 39 weeks. Her second pregnancy ended in a spontaneous abortion at 12 weeks. What is her Gravida and Para status?
- Answer: She is Gravida 3, Para 1. (She has had 3 conceptions/pregnancies in total, but only 1 viable birth past 28 weeks).
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