STRENGTHENING MIDWIFERY EDUCATION: CHANGE STRATEGIES IN CURRICULA

Background:
The midwife is recognized as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant (ICM, 2011).
The philosophy of the midwifery education programme are essential to strengthen midwifery worldwide by preparing fully qualified midwives to provide high quality, evidence-based health services for women, newborns, and childbearing families.
In Portugal the midwives’ training is guided by legislation to the European Community. However, the difficulties related to implementation the Bologna process and the philosophy of health system may limit the development of the midwives’ professional profile and interfere with the caring and women/families’ supervision. Several studies appointed the model of the midwives’ training implemented in clinical practice are crucial to the development in midwifery education. So, the philosophy in the health’ care services influenced the surveillance of women during the prenatal and childbirth.
The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care (ICM, 2011).

Methodology:
During four years we developed with students’ midwives a strategy to promote the women/families’ monitoring and surveillance the antenatal and postnatal care in health centers and maternity hospital. Fifty five students followed up three thousand eighty five pregnant women since the first prenatal visit until twenty eight days after childbirth, including labor and conducting normal delivery- each student attended at least seven pregnant. We realized quantitative, non-experimental, descriptive and explanatory study, being a non-probabilistic and convenience sample. Data collection was done by questionnaire at 30th day and one year postpartum to evaluate satisfaction of women and students / professionals.
Results: There was a high satisfaction for women and students, in both evaluations. The students, who accompanied women all the time, reported that the practice increased its share in the birth and parents recognize the quality of their work and intervention. Women expressed a desire to be followed by a midwife in the next pregnancy. We identified several constraints in implementing this strategy by institutions and other health professionals.

Conclusion:
To promote autonomous midwives is necessary developing different strategies in midwifery curricula for develop professionalism and preparing fully qualified midwives. It’s important to create in the students essential pillars to strengthen midwifery worldwide by to provide high quality, evidence-based health services for women, newborns, and childbearing families, while institutions should actively collaborate in the training process facilitating learning conditions.