THIRD EDITION
Annamma Jacob MSc (N)
Formerly Professor, St Philomina's College of Nursing,
Mother Theresa Road Bengaluru, Karnataka, India
Principal, Graduate School for Nurses BNE, SIB, CMAI Nurse Supervisor, Suburban Medical Center,
Paramount, Southern California, USA
Assistant Director of Nursing, Al-Sabah Hospital, Ministry of Public Health,
Kuwait
Sister Tutor, LT College of Nursing, SNDT Womens’ University,
Mumbai, Maharashtra, India
Junior Tutor, College of Nursing, CMC Hospital,
Vellore, Tamil Nadu, India
Principal Bhagwan Mahaveer Jain College of Nursing
Millers Road, Vasanthanagar Bengaluru, Karnataka, India
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This book has been published in good faith that the contents provided by the author contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the author specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the author. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
A Comprehensive Textbook of Midwifery and Gynecological Nursing
First Edition: 2005
Second Edition: 2008
Third Edition: 2012
9789350255575
Printed at
5Editor's Remarks
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 and 71 chapters with an Appendix and exhaustive Glossary at the end. Each chapter is ending with a list of bibliography which are 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 midwifery teachers, for study as well as for ready-reference.
With best wishes,
TM Krishnaveni PHN
Former Assistant Director
Directorate of Health and Family Welfare Services
Government of Karnataka
Bengaluru, Karnataka, India
6Preface to the Third Edition
The goal of nursing education in general and midwifery education in particular is to prepare nurses/midwives who combine the highest level of scientific knowledge and technological skills with responsible caring practice. To that end we need to challenge students to identify and master the cognitive and technical skills as well as the interpersonal and ethical skills they will need to effectively nurse the mothers and newborns in their care.
The author has identified that addition of more information in certain topics and more chapters on Obstetric and Gynecological Nursing would further assist nursing students to expand their knowledge of maternal-newborn nursing and make the textbook more student and teacher friendly. Three more chapters are added in the midwifery section and eleven chapters in gynecological nursing section.
I am grateful to all the midwifery teachers who have given feedback on earlier editions of the book, which helped me to incorporate their suggestions in this third edition of the A Comprehensive Textbook of Midwifery and Gynecological Nursing.
I sincerely thank Mrs N Christina Jonathan, Lecturer of Nursing for her suggestions and assistance in preparing the matter and getting the photographs done.
I express my appreciation of the patient forbearance of Mr A J Jacob my husband who helped me to complete the work.
I am grateful to the team of M/s Jaypee Brothers Medical Publishers (P) Ltd. at Bengaluru branch and New Delhi for their prompt and high-level performance in getting this and other titles printed and published.
Annamma Jacob
7Preface 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 the 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 indepth 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 six 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. These tells the reader specifically what she or 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. 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
8Acknowledgments
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 TM Krishnaveni, Consultant to the Government of Karnataka Institute of Health and Family Welfare Services, for the patient and wholehearted efforts in editing the book.
Special acknowledgment and thanks to Mr Joji George RN and Miss Aswathy Alexander BSc(N) who drew a 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, CMC Hospital, Vellore, 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 students at LT College of Nursing, SNDT Women's University, St Philomina's College of Nursing and Graduate School for Nurses, BNE, SIB, CMAI.
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.
Finally, not least but most, I acknowledge my husband A J Jacob who encouraged me and worked with me tirelessly to complete this book and in whose honor I have decided to publish this book.