THE ROLE OF THE REGISTERED MIDWIFE

C F VAN NIEKERK

Senior Lecturer, Department of Nursing, MEDUNSA

OPSOMMING
Die vroedvrou lewer deur die eeue been haar diens aan die gemeenskap en haar rol het saam met die mediese wetenskap
ontwikkel.
Navorsing is gedoen oor die hedendaagse rol van die vroedvrou in Suid-Afrika. Daar is bevind dat sy in die lewering
van omvattende gesondheidsorg die geneesheer aanvul. Sy het voorkomende, koordinerende, terapeutiese, versorgings,
opvoedings, besluitnemings en locum tenens rolle waarin sy tradisionele en nie-tradisionefc funksies verrig. Omstandig-
hede bepaal of hierdie funksies afhanklik of onafhanklik uitgevoer word, en dikwels het die vroedvrou nie wetlike dek-
king vir dit wat sy in belang van haar pasicnt moet doen nie. Weens die omvattendhekl van die vroedvrou se take is
daar ’n behoefte aan voortgesette onderwys ten opsigte van baie van haar funksies.

INTRODUCTION
SOCIAL ROLES:
may be defined as prescriptions
f o r in te r p e r s o n a l b e h a v io u r .
Persons who share common at­
titudes and beliefs and assume
responsibilities f o r certain tasks
are perform ing a social role2
W h at is specific a b o u t th e ro le o f
th e reg iste re d m idw ife, is th a t it is
not specific.
H ow could it be specific w hen
• every m o th e r is u n iq u e
• every la b o u r is u n p a ra lle le d
• every b aby is d ifferen t
• every situ a tio n is singular?
R ole d escrip tio n s d iffer becau se
• p ra c titio n e r view s d o n o t co­
incide
• a u th o rs d isag ree
• tim e m oves on
• n ee d s, statistics an d values
change.
R o les are d ynam ic becau se
• techno lo g y d e m a n d s in creased
in tellectu al a n d p sy ch o m o to r d e ­
velo p m en t
• h u m an en ess d e m a n d s affective
and effective c o -o rd in a tio n of
care
• m o rtality an d m o rb id ity rates
d em a n d re d u c tio n
• m o n ey , sta tu s an d p o w er d e m a n d
quality.
A nd yet th e m idw ife has alw ays
played a ro le d eliv erin g a 24-hour
service ev ery d ay o f every y e a r for
as long as m an h as re c o rd e d o c c u r­
rences. She still serves every class of
m o th e r in every c o rn e r o f th e R e ­
public o f S outh A frica an d th e
w orld. H e r services a re norm ally
re n d e re d in ho sp itals, clinics and
h om es b u t she fu n ctio n s as effec­
tively in a caravan!
W h en a d o c to r is available she a t­
ten d s b o th to him and th e p a tie n t.
W hen he is n o t available she m a n ­
ages w ell in th e in te re sts o f the
m o th e r an d th e in fan t and acco rd ­
ing to h e r ex p erien ce an d k n o w ­
ledge she d o es n o t only an ticip ate
p ro b lem s b u t recognises th e n eed to
o b ta in m edical aid. She a d h e re s to
th e re g u la tio n s o f th e S outh A fri­
can N ursing C ouncil w hich e n ab le
h e r to d eliv er a c o m p reh en siv e se r­
vice by in d e p e n d e n tly executing
th o se diagn ostic an d th e ra p e u tic
activities th e pro fessio n p erm its o r
b y p e r f o r m in g d ia g n o s tic a n d
DEPENDENT FUNCTIONS:
those functions carried out as a
result o f the diagnostic or thera­
peutic prescriptions o f a doctor
(or dentist, in the case o f dental
care only).
In the case o f dependent fu n c ­
tions the doctor accepts fu ll re­
sponsibility fo r prescribing or
assigning any diagnostic or the­
rapeutic acts the nurse may be
requested to carry out.4
th e ra p e u tic activities u n d e r the
d irect o r in d irect supervision o f a
m edical p ra c titio n e r o r on his d irec ­
tion o r w ritten o r v erbal p re sc rip ­
tion.
ROLE DEVELOPMENT
Since th e beginning o f tim e the
m idw ife has b e e n c o n c ern e d w ith
w om en ’s business: p reg n an cy ,
la b o u r, m o th e rh o o d , ch ild care. T his
basic m idw ifery ro le , acknow ledged
in an cien t religious d o cu m en ts, r e ­
m ains to this day. A ro le is, h o w ­
ev er, flexible. T h e flexibility is evi­
den t from a d a p ta tio n s, m od ifica­
tions and changes occu rrin g in the
role o f th e m idw ife fro m th e tim e
o f physicians an d b a rb er-su rg eo n s
onw ards. A d v an ces in th e o b ste tri­
cal and e d u ca tio n a l fields, th e cog­
nisance ta k e n o f h u m an rights and
increased legal p ro se cu tio n s for
negligence are b u t som e factors
w hich in fluenced and still influence
th e role o f th e m idw ife.
ROLE:
. . . a position in a social struc­
ture, a set o f expectations asso­
ciated with a position in a social
structure, or a set o f behaviours
associated with a p osition .1
T h e p re se n t ro le o f th e m idw ife
also b ea rs w itness o f role a d ju st­
m ents re la te d to c u rre n t h um an
philosophy an d n eed s, techno scien-
tific d ev elo p m en t and ex panding
know ledge an d skills. T h e m id ­
w ife’s resp o n sib ility , fo r in stan ce,
has beco m e m o re th a n a rro ra i issue
— it is now also a legal issue. T hus
h e r p re p a ra tio n m u st be m o re th an

JUNE 1982 CURATIONIS 23

TABLE 1 THE PREVENTIVE ROLE OF THE T h e services re p re se n te d
— all p o p u la tio n gro u p s
REGISTERED MIDWIFE. — w e s te rn , s o u th -e a s te rn an d
e a ste rn C a p e , N a ta l, T ran sv aal
Activities Number of % Of % and O ra n g e F ree S tate
respondents 294 re- respondents
— v arious services at s ta te , p ro v in ­
undertaking spondents determining
the activity function
cial an d local a u th o rity level
independent com prising a co m p reh en siv e a p ­
p ro a ch to h e a lth care.
Health Surveillance activities
T h e u n stru c tu re d in terview s and
79,8
g ro u p discussions p ro v id e d in fo r­
Abdominal palpation 128 44
Auscultation of fetal m atio n reg ard in g
heart 128 44 80,3
— th e ro le , resp o n sib ilities and
Determining blood
pressure 143 49 80,6 p re p a ra tio n o f th e re g istered
Assessing involution of
uterus 81,2
nurse/m idw ife
102 35
Inspecting for healing of — p ro b le m s re la te d to th e p ro ­
episiotomy 112 38 81,2
Inspecting the condition
vision o f co m p re h en siv e h ealth
of lactating breasts 120 41 82,2 services
Inspecting the general
— possible so lu tio n s to th e above-
physical condition of
the baby 130 44 81,8 m e n tio n e d p ro b le m s including
th e in crea se d utilisatio n o f the
Health maintenance activities reg iste red m idw ife
— o v e r la p in m e d ic a l/n u r s in g
Prescribing a diet in fun ctio n s an d view s o n th e co n ­
antenatal period 109 37 81,9 cep t expanded o r extended role.
Immunising (for example
against polio) 69 24 71,6 D u rin g interview s a n u m b e r of
Swabbing 107 36 81,0 d o cto rs an d m a tro n s sta te d th a t,
Avoiding overdistension.
retention-bladder 97 33 79,1 due to existing sh o rtag es o f d o cto rs
Diagnosing progress in w hich th e y e x p ecte d to co n tin u e for
labour 105 36 75.4
Administering B.C.G . m any y e ars, th e re g iste re d m idw ife
vaccination — baby 84 29 68.6 is cu rren tly th e o b vious ca teg o ry of
Ensuring rest and sleep 109 37 83,3
w o rk e r to c o m p le m e n t th e available
m edical m a n p o w e r in o rd e r to p ro ­
Early detection activities
vide co m p re h en siv e care.
A ctivities such as ta k in g a full
Drawing blood:
Rh-grouping, haemoglobin. h isto ry , p e rfo rm in g a co m p lete
W R, etc 133 45 70,7 physical a ssessm en t, m an ag in g u n ­
Examination of urine 127 43 77,9
Obtaining cervical smear 80 27 68.8 ex p e cted com p licatio n s such as tw in
Undertaking vaginal and b ree ch d eliv eries, tra n sv erse
examination 107 36 80,0
Assessing haemoglobin 75 26 74.7 lie, resu scitatin g th e in fan t (utilising
Undertaking ultrasonic v a r io u s t e c h n i q u e s ) , c o n tr o llin g
screening tests 2 1 50.0
Obtaining high vaginal h a e m o rrh a g e , tre a tin g co n d itio n s
swab for bacteriology 29 10 58,8 such as v e n e re a l d isease, a n a em ia,
Screening for carcinoma
cervix, breasts 30 10 71,4 k w ash io rk o r, tu b e rcu lo sis, th ru sh ,
o b tain in g sp ecim en s, in te rp re tin g
la b o ra to ry findings, checking d e ­
train in g — it d e m a n d s e d u c a tio n as v elo p m e n tal stag es, p rescrib in g and
tions on a resp o n sib ility c o n ­
well as tra in in g . T o d e te rm in e th e tin u u m dispensing m edicines up to sch ed ­
p re se n t ro le , th a t is th e p o sitio n of ules III, IV a n d ev en V , a re alread y
— th e e x te n t and n a tu re o f the
p re p a ra tio n receiv ed fo r each u n d e rta k e n by m any reg istered
th e re g iste re d m idw ife an d regis­
m idw ives.
te re d n u rse in a p a rtic u la r social fu n ction
stru c tu re an d h e r utilisatio n in p ro ­ — th e n ee d fo r fu rth e r e d u c atio n Som e in terv iew ees believe th at
viding c o m p re h e n siv e h e a lth s e r­ fu n ctions such as v acuum ex trac tio n
w ith re g a rd to each fu n ctio n .
vices th e a u th o r a n d a co lleag u e in ­ and low fo rceps deliv eries are but
tw o o f a n u m b e r o f th e ra p e u tic ac­
v estig a te d th e situ a tio n . Interviews
tivities w hich th e m idw ife sh o u ld be
THE RESEARCH able to u n d e rta k e if an d w hen
P erso n al in terview s an d g ro u p dis­
necessary.
T h e o b je c tiv e s o f th e in v estig atio n cussions w ith d o c to rs an d m atro n s
A n u m b e r o f d o cto rs exp ressed
w ere to d e te rm in e o f tw e n ty -th re e g o v ern m en t se r­
co n cern a b o u t activities in w hich
— w h at fu n ctio n s th e reg istered vices w ere co n d u cte d . P urposive
circu m stan ces fo rc ed th e m idw ife
m idw ife p re se n tly u n d e rta k e s sam pling using fo u r c rite ria , was
to act in d e p e n d e n tly w ith o u t legal
— th e p o sitio n o f th e v ario u s func- u sed to select th e services.
coverage.

24 CURATIONIS VOL. 5 NO. 2

 TABLE 2 THE CO-ORDINATING ROLE OF
INDEPENDENT
THE REGISTERED MIDWIFE
FUNCTIONS:

are those fo r which . . . the Activities Number of % of %

nurse takes fu ll legal responsi­ respondents 294 re- respondents
bility.4 undertaking the determining
activity spondents function
Independent fuctions involve independent
actions which the nurse initi­
ate h erse lf3
Health assessment activities

Such activities include inter alia,

Determining previous
p rescrib in g an d ad m in isterin g a n a l­ 208 71 80,3
health status
gesics in outlying clinics. C ircu m ­ Determining present
health status 210 71 81,7
stances o fte n p laced th e m idw ife in
Determining general
th e u n en v iab le p o sitio n o f deciding physical condition 214 73 79,8
Determining cognitive
b etw een w ith h o ld in g an analgesic 206 70 81,2
status
(w ith im plications fo r th e m o th e r Determining psychological
status 203 69 79,5
an d th e bab y ) o r giving it (w ith im ­
Determining economic
plications fo r h erself). T h e p ro b lem status 210 71 81,5
Determining occupational
is fu rth e r co m p o u n d e d by th e fact 195 66 83,9
background
th a t stan d in g o rd e rs a re n o t valid
w ith re g a rd to sch ed u le V I drugs.
C o m m u n icatio n w ith th e d o c to r is Referral Activities
also difficult d u e to a n u m b e r of
reaso n s such as th e m idw ife being
th e only p e rso n in th e clinic and Referring mother to
having to cope w ith m o re th a n o n e support services such as 123 42 83,4
d elivery at th e sam e tim e , as well as clinics, social welfare
Referring selected 93 32 76,0
w ith u n re lia b le te le p h o n e services. patients to doctor
F u rth e r activities th e y a re c o n ­ Referring to medical or
supplementary health 94 32 66,7
cern ed a b o u t include tre a tm e n t for service personnel
exam ple o f co n v u lsio n s, eclam p sia, Referral to clinic 110 48 78,9
(229 respondents)
o e d e m a a n d h y p e rte n sio n . T h e Referral to hospital 115 50 83,0
(229 respondents)
d o ctors p re p a re w ritte n in stru ctio n s
Referral to dentist 120 52 82,9
to guide th e m idw ife w h en p re ­ (229 respondents)
Referral to child guidance
scribing b u t som e d o cto rs felt th a t
(229 respondents) 77 34 75,9
the m idw ife n e e d s legal p ro te c tio n Referral to social worker
o n a n a tio n a l level. T his is e sp eci­ (229 respondents) 132 58 76,5
Referral to physiotherapist
ally tru e fo r cases w h e re in tra m u s­ (229 respondents) 80 35 69,2
cu lar an d in h a la tio n a l analgesics are
ad m in iste re d in g o o d faith b ased on
a p ro to c o l m u tu ally accep ted for
th e b en e fit o f th e p a tie n t.
A n o th e r im p o rta n t issue, w hich selected th e re sp o n d e n ts in h e r p a r­ w ere u n d e rta k e n by o n e o r m o re
becam e e v id e n t d u rin g th e in te r­ ticu lar service according to th e cri­ re g iste re d m idw ives. T h e n u m b e r
view s, w as th e lack o f k now ledge te ria o f reg istratio n as a nurse o f activities u n d e rta k e n illu stra te d
am ong st d o c to rs a b o u t th e d e p th an d /o r m idw ife an d em p lo y m en t in th e scope o f th e m idw ifery role.
and e x te n t o f th e m idw ife’s p re p ­ a situ atio n in w hich a w ide ran g e of T he n u m b e r o f resp o n d e n ts u n d e r­
a ra tio n as w ell as a b o u t h e r ro le, n ursing fu nctions w ere u n d e rta k e n . tak in g a specific activity (ranging
legal ob lig atio n s an d resp o n sib ili­ T h e d a ta , re tu rn e d by 294 re ­ b etw een o n e an d 233 p e r activity),
ties. T his m ight be a co n trib u to ry sp o n d e n ts, w as pro cessed in to fre ­ su p p o rts th e assu m p tio n th a t the
fa cto r to b o th ro le o v e rlo a d and quency tab les an d in te rre la te d p e r­ role o f th e m idw ife is flexible and
cen tag es. T h ese p ro v id e d th e basis c o m p r is e s t r a d i t i o n a l f u n c tio n s
u n d e ru tilisa tio n — tw o factors
fo r analysis an d su b se q u e n t fin d ­ (u n d e rta k e n by m o st m idw ives),
closely re la te d to m o tiv atio n and
ings. n o n -tra d itio n a l fu n ctio n s (u n d e r­
jo b satisfaction an d th u s p e rso n n e l
Findings based on data ob­ ta k e n by th e select few only) and
tu rn o v e r.
tained from questionnaires non -n u rsin g fun ctio n s (in th e a b ­
Questionnaires sence o f th e a p p ro p ria te category
Findings about role o f h ea lth w o rk e r).
Q u e stio n n a re s w ere d istrib u te d to
400 p erso n s in th e tw e n ty -th re e s e r­ T h e d a ta in d ic ate d th a t 469 o f 474 V ario u s ro les com prising th e
vices. A m a tro n o f each service activities listed in th e q u e stio n n a ire c o m p r e h e n s iv e m id w if e r y r o le ,

JUNIE 1982 CURATIONIS 25

TABLE 3 THE THERAPEUTIC ROLE OF THE em erg e fro m a classification o f the
REGISTERED MIDWIFE 469 activities in to re la te d groups.
T h e roles a re as follow s
Preventive ro le re fle c te d by h e a lth
Activities Number of % Of %
surveillance, h e a lth m ain ten an ce
respondents 294 re­ respondents
an d screening activities
undertaking the spondents determining
activity function Co-ordinating role refle cted by
independent
h ealth assessm ent activities on a
biopsycho-social level, reco rd in g
and re p o rtin g a n d re fe rra l activities
Therapeutic activities
Therapeutic role re flec ted by p re ­
Infusing fluids and scription an d a d m in istra tio n of
electrolytes 89 30 56,4
Doing episiotomy 89 30 69,7 m e d ica tio n , p rescrib in g an d altering
Infiltrating local tre a tm e n t, e m erg en cy tre a tm e n t
anaesthesia 75 26 60,5
Removing placenta: and fam ily p la n n in g activities
Brandt Andrews method 88 30 82,4
Suturing episiotomy 71 24 67,1 Nurturative ro le re fle c te d by h e lp ­
External bimanual
ing an d su p p o rtiv e activities
compression of uterus 37 13 57,9
Intubation (endotracheal) 35 12 63,6
Performing circumcision 42,9
Education ro le re flec ted by te a c h ­
5 2
ing nu rsin g p e rso n n e l a n d o th e r
Medicine related activities categ o ries o f h e a lth w o rk e rs and
teach in g h ea lth ca re co n su m ers
Administering pethilorfan 32 11 34,2
Administering potassium Decision M aking ro le including d e ­
bromide l,20g 33 11 48,5 cision m aking a b o u t a p p ro p ria te
Administering chloral
hydrate 2 g 33 11 48,7 nursing c are a n d decision m aking
Administering nitrous ab o u t th e n e e d fo r m edical in te r­
oxide and oxygen
analgesia 29 10 60,0 v en tio n
Administering general
aneasthetic 2 1 50,0 Locum Tenens o r Deputising Role.
Administering oygen
per mask 90 31 64,5
T h e ab ove ro le s a re su b sta n tia te d
Administering oxytotic in T ab le s 1 to 7 in w hich selected
medications (intra­
venous) 58 20 36,8
activities p e rta in in g to each role are
Prescribing sedatives 37 13 59,4 listed. T h e n u m b e r an d p e rce n tag e
Prescribing diuretics 20 7 54,2
Prescribing vasodilators 12 4 47,1
of 294 re sp o n d e n ts w ho u n d e rto o k
Prescribing vitamins 86 29 68,0 each activity as w ell as th e p e rc e n t­
age resp o n ses b ro u g h t o u t in fav o u r
Treatment activities of th e actio n b ein g an in d e p e n d e n t
fu n ctio n a re ind icated .
Treating sore buttocks 129 44 71,4
Treating skin rashes 122 41 60.3 U n fo rtu n a te ly th e d a ta n o t only
Treating kwashiorkor, reflec ted th e tru e ro le o f th e reg is­
marasmus 108 38 57,5
Treating conditions such as te re d m idw ife b u t also th e m alutili-
colds, influenza 76 26 58,5 sation o f h e r services in n o n -n u rs-
Suppressing lactation 74 25 70.3
ing activities w hich o u g h t to be p e r­
fo rm e d by a n o th e r c ate g o ry of
Emergency treatm ent activities
w o rk er. T h e m alu tilisatio n is clearly
Treating shock 99 34 72,1 illu stra te d in tab le 8.
Resuscitation with
positive pressure 42 14 73,3
Performing external
Findings about responsibility
rotation: shoulder
presentation 14 5 86.0
Commencing artificial A n in te re stin g finding w ith reg a rd
respiration (interm it­ to th e resp o nsibility fo r v ario u s ac­
tent positive pressure
respirator) 46 16 43,8 tivities is th a t no activity is totally
Infusing blood 50 17 32.1 (100% ) d e p e n d e n t o r in d e p e n d e n t.
R esp onsibility fo r specific activities
Family planning activities
ran g es b e tw e e n 85% d e p e n d e n t and
Administering oral 85% in d e p e n d e n t. T h e v a ria tio n in
contraceptives 101 34 73,6
32 72,2
th e p e rc e n ta g e resp o n se s w ith
Issuing oral contraceptives 95
Placing intra-uterine re g a rd to th e d e p e n d e n t/in d e p e n ­
device in situ 30 10 63,8
d e n t n a tu re o f an activity is to som e
Administering intramuscu­
lar contraceptives 91 31 58,2 ex te n t re flected in th e last colum n
Examining for presence of o f T ab les 1 to 7 w hich co ntain
intra-uterine device 65 22 70,3
selected ex am p les o f activities in-

26 CURATIONIS VOL. 5 NO. 2

eluded in th e co m p lete research TABLE 4 THE N U R T U R A T IV E ROLE OF THE
p ro je c t.

T his leads to th e co nclusion th a t REGISTERED MIDWIFE

m idw ifery activities a re in te rd e p e n ­
d en t ra th e r th a n d e p e n d e n t o r in d e ­
p e n d e n t. T h e d e p e n d e n t/in d e p e n ­
Activities Number of % of %
d en t classification varies according
respondents 294 re­ respondents
to d ifferen t situ atio n s an d a ttitu d e s, undertaking the spondents determining
th e n u m b e r o f d o c to rs availab le and activity function
th e p ro to c o l a c c e p ted w ith re g a rd independent
to medical an d nursing activities in a
p a rtic u la r situ a tio n . F o r p ro fe ss­ Supportive activities
ional practice it is co n ducive to
Arranging financial
realise th a t th e re g iste re d m idw ife benefits for mother 73 25 80
is ac co u n tab le fo r h e r ev ery actio n ,
Supporting unmarried
w h e th e r self-assigned o r ac c e p ted mothers 73 25 81,6
by p re sc rip tio n , as well as fo r o m is­ Accompany patient to
sion to act. hospital 81 28 79,8

Supporting m other in
puerperium 106 36 87

Findings about preparation Providing psychological

support in the
antenatal period 101 34 85,4
Findings re g a rd in g th e p re p a ra tio n
Assisting mother with
o f th e re g iste re d m idw ife ind icate care of baby 127 43 86,9
th a t th e m idw ifery co u rse is th e Encouraging mother to
m ain p re p a ra tio n fo r th e m idw ife’s cope with new situation 123 42 85,7

role. P ost-basic (fo r reg istratio n ) Promoting relationships:

mother-baby-father 90 31 87,7
ed u ca tio n a n d in service train in g for
specific activities w ere h o w ev er r e ­
ceived by as m an y as 40% o f r e ­
sp o n d en ts.

A n ee d fo r fu rth e r e d u c a tio n of TABLE 5 THE EDUCATIONAL ROLE OF

m o re th a n o n e ty p e w as in d icated
by th e re sp o n d e n ts fo r 98% o f th e
item s. M idw ives in d ica te d a n eed THE REGISTERED MIDWIFE
for post-basic courses fo r re g istra ­
tion in o rd e r to p e rfo rm p la c e n ­
to g rap h y , to su tu re th e cervix, tre a t Activities Number of % Of %
m issed a b o rtio n , d e te rm in e m a te r­ respondents 294 re­ respondents
nal card iac fu n c tio n , apply forceps undertaking the spondent' determining
an d vacu u m e x tra c to r, d o an episi- activity function
independent
oto m y , a n a e sth e tise an d su tu re th e
p e rin e u m , d iag n o se ab n o rm a litie s
in la b o u r, re su sc ita te , exp el th e p la ­
c e n ta u s in g B r a n d t A n d re w s Educational and
m e th o d , in c re a s e fle x io n a n d counselling activities
m anual ro ta tio n in o ccip ito p o s te ­
rio r p o sitio n s, p e rfo rm versio n s, Instructing patient regarding 128 44 84,2
ta k e high vaginal sw abs, m anually diet, clothes, lesser complica­
tions in antenatal period, etc.
rem ov e p la c e n ta , c o n tro l h a e m o r­ Instructing parents regarding 93 32 92,8
rh ag e, tre a t infectio ns an d h a e m o r­ management of siblings
Instructing husband regarding 63 21 91,1
rh oids an d u n d e rta k e b lo o d analysis support of wife
w ith A stru p m ic ro -a p p a ratu s. Health education: mother
and baby, during postnatal 128 44 85,6
T he to ta l n e e d fo r fu rth e r e d u c a ­ visit
Inservice education: all cate­
tion o f m idw ives w as ex p ressed as gories personnel 86 29 84,8
follow s: p o st-b asic (fo r re g istra ­ Instructing mother: own care.
care of family and neonate
tio n ) cou rses w ere re q u ire d fo r 8% during puerperium 119 40 86,4
o f th e activ ities, post-b asic (n o n ­ Providing genetic advice 52 18 69,1
Informing m other/parents of
re g istra tio n ) co u rses fo r 45% an d abnormalities or other condi­
inservice tra in in g fo r 34% o f th e tions of neonate 97 33 82,5

activities.

JUNE 1982 CURATIONIS 27

TABLE 6 THE DECISION MAKING ROLE OF A logical d e d u c tio n fro m th ese
THE REGISTERED MIDWIFE findings seem s to be th a t co n tin u in g
ed u c a tio n o f a n o n -reg iste rab le
n a tu re , o ffere d by th e e m p lo y er
Activities Number of % Of %
an d /o r on p riv ate in itia tiv e, is
respondents 294 re­ respondents
spondents determining n e e d e d by re g iste re d m idw ives in
undertaking the
activity function o rd e r to u n d e rta k e th e ir p resen t
independent activities.

T h e role o f th e re g iste re d m idw ife

Basic nursing care activities is b ro a d and dynam ic. C a re should
Providing basic care in the antenatal period 117 82,2
th u s be ta k e n to clarify specific role
40
Providing basic care in the labour period 109 37 83,1 lim itatio n s a n d role e x p ecta tio n s
Providing basic care in the puerperium period 109 37 84,6 w hen new m idw ifery p e rso n n e l are
Providing basic care during postnatal visit 92 31 83,5
Providing basic care to neonate 128 44 89,2 a p p o in te d in specific situ atio n s.
Providing care to prem ature in incubator 79 27 72,2
W ritten p ro to c o l sh o u ld indicate
Providing care to prem ature without incuba­ 88 30 74,5
tor w hich fun ctio n s are c o n sid e re d de­
pendent. T his will m inim ise feelings
Determining need for o f u n c e rta in ty am o n g st new e m ­
medical intervention ployees an d p e rso n s circu latin g b e ­
tw een u nits. P o stb asic m idw ifery
Baseline assessment in e d u c a tio n — w hich is now available
191 65 72
emergencies
Measuring pelvic capacity
— sh o u ld c o n c e n tra te on p rep arin g
55 19 77,2
(pelvimeter) th e p ractisin g re g istere d m idw ife
Diagnosing disproportion
(Chassar Moir method)
30 10 72,4 fo r n o n -tra d itio n a l nu rsin g activi­
Diagnosing abnormalities tie s . T h ro u g h p e r s o n n e l d e ­
such as tum ors, fetal
death, dysmature fetus
103 35 77,9 v elo p m en t p ro g ra m m e s an d p riv ate
Auscultating fetal heart i n itia tiv e c o n tin u in g e d u c a tio n
with ultrasonic aid 56 19 60,7
Auscultating maternal
(n o n -re g istra tio n ) sh o u ld strive to
51 17 77,4
cardiac function p ro m o te e x p ertise in specialised
Diagnosing abnormalities in labour such as
prolongation and haemorrhage 92 31 83,2 are as o f p ractice. M idw ifery e d u c a ­
tio n should aim at in -d e p th k n o w ­
ledge o f resp o n sib ilities, ro le o v e r­
TABLE 7 THE LOCUM TENENS or DEPUTY ROLE OF THE lap an d c o lla b o rativ e activities,
skills in co m m u n ic atio n an d in te r­
REGISTERED MIDWIFE
p erso n a l re latio n sh ip s as w ell as in ­
te rn alised affective skills.
Activities Number of % of %
respondents 294 re­ respondents T h ro u g h quality in e d u c a tio n th e
undertaking the spondents determining m o th e r and child will b eco m e the
activity function focal p o in t, th e te a m sp irit will
independent grow , ro les will b e a d a p te d to n eed s
Locum tenens activities a n d c o llab o ra tiv e co m p reh en siv e
Giving exercises 97 33 86.4 care will b eco m e a reality.
Interpretation of Róntgenograms 15 5 52,4
U ndertaking X-ray pelvimetry 1 0,3 100
Directing breathing and relaxation exercises 90 31 87,8
Undertaking chest radiography 3 1 75,0
Undertaking electrocardiography 4 1 50.0
Taking ultrasonogram 9 3 16,7
Taking X-rays 7 2 50.0
Arranging adoption 33 11 69,1

REFERENCES

TABLE 8 ACTIVITIES ILLUSTRATING THE UTILISATION OF

1. Hardy, M E; Conway. M E. Role Theory — perspectives
THE REGISTERED MIDWIFE FOR NON-NURSING ACTIVITIES fo r health professionals. A ppleton-Century-Crofts. New
York, p l l
AND THE NUMBER AND PERCENTAGE OF 294 RESPON­
DENTS UNDERTAKING THE ACTIVITIES 2. Jensen. R N; Benson. R C; Bobak. I M. Maternity’ care
— the nurse and the fam ily C V Mosby. St. Louis, p ll .
Non-nursing Respondents % of
activities undertaking the 294 re­ 3. M urray, M. Fundamentals o f Nursing Prentice-Hall. New
activity spondents Jersey. 1976. pl9.

Completing admission forms 142 48 4. Searle, C. Guide I. Nursing Education 1. Unisa. Pretoria.
O btaining a deposit for treatm ent 44 15 1980. pl98.
Providing receipts 66 22
Returning items from safe 112 38 5. Van Niekerk, C F Die benutting van die geregistreerde
Dispensing prescribed medicine from unit stock 97 33 vroedvrou in die Republiek van Suid-Afrika Unpublished
M asters dissertation. U.P. 1981.

28 CURATIONIS VOL 5 NO. 2