Midwifery in District of Columbia, Washington

Midwifery as a clinical discipline consists of the following sections:
- physiology and pathology of pregnancy, childbirth and the postpartum period;
- physiology and pathology of the newborn;
- operative midwifery.

 The most important and common clinical forms of obstetric pathology:

•  Diseases of the ovum

                - Vesical drift

                - Chorionepithelioma

                - Not developing pregnancy (frustrated miscarriage and lingering birth)

• Ectopic pregnancy

                - An intact (progressive) tubal pregnancy

                - Interrupted tubal pregnancy

                - Ectopic pregnancy of late terms

• Anomalies location placental in the uterus

                - Premature detachment of normally located placenta

                - Abaissement of placenta

• Shell attachment of the umbilical cord                 
• Spontaneous rupture of the uterus during pregnancy and childbirth
• The separation of the uterus from the vaginal vault       
• Eclampsia

•  Miscarriage (abortion)
             -  Spontaneous miscarriage
             -  Artificial community-acquired miscarriage
             -  Traumatic injuries to genitalia associated with abortion

Acute forms of surgical diseases of the abdominal cavity at pregnancy

• Appendicitis
• Bbowel obstruction
• Twisted ovarian tumor (cyst, cystoma)
• The pathology of childbirth

Preparing the organism of a pregnant woman for the upcoming birth

1. Patrimonial forces and their anomalies

• Kinematics of the fetus through the birth canal (birth biomechanism)
• Childbirth at malpresentation fetal head

2. Direct standing of the sagittal suture at the cephalic presentation

• Breech presentation of the fetus
• Cross birth
• Births of large and giant fruit

3. Praevia or prolapse of fetal limb

• Praevia and prolapse of legs
• Praevia and prolapse handle
• Praevia and cord prolapse

4. Births with a narrow pelvis

5. Complications in the postpartum period

6. Delay afterbirth and its parts

7. Placenta accreta

8. Hypotonic and atonic bleeding

9. Bleeding from the external genital parts of the vagina and cervix

10. Inversion of the uterus

11.  Hematoma of the birth canal

12. Later postpartum hemorrhage            

13. Measures for the prevention of fetal asphyxia

14. Measures to revive the children born in a state of asphyxia

Directivity of Midwifery mainly Preventive. This means that already during pregnancy is necessary to identify and eliminate factors that may negatively affect its development and future childbirth.

This problem becomes even more complicated, and in some cases - absolutely insurmountable when those or other pathological factors are already beginning to affect the condition of women and the fetus  during delivery, and often reflected on the course of childbirth itself.