Development of midwifery Development of midwifery in Estoniain Estonia

Maret Voites, RM

West Tallinn Central HospitalWomens Clinic(Pelgulinna Sünnitusmaja)

First written notes

First notes about midwifery in Estonia are

from 1330 by Baltic historian Fr. G. Bunge

Midwife named Jossyne appearsrepeatedly in Tallinn City Hall’saccounting books at 1545

Midwife’s duties at 1630

She had to...

... be Lutheran

... participate in a specific study program and after that give an oath to the church

... be “on-call” for 24-hours and obey to the town doctor

Midwife’s duties at 1695

She was...

... not allowed to cure internal diseases

... not allowed to use strong drugs

... to report about complicated birth

... to call the doctor for a difficult birth

... to consult the doctor about a sick newborn

Midwife's values from 1812 to…1. Fair mind, good reputation2. Will to learn3. Youth and health4. Working also as a volunteer5. Soberness and ability to draw the line6. Following the midwifery studies also in

her own life7. Clean and tidy8. Merciful, compassionate, patient9. Attentionate10. Tolerance about colleagues11. Ability to read and write

Education1. 1797 first info about education where the

Governor's letter orders all certified midwives to help other colleagues with knowledge

2. In Tallinn different schools 1809-1811. Midwifery Institute was reopened in Tallinn at 19.08.1901 together with a birth clinic.In Tartu - School for Midwives from 1811-1930, after that merged with Nurses Scool. From 1944 worked as Tartu Medical High-school which was later changed to Tartu Medical School. In Paide -1862-1867

3. Consistent educational program started in Tallinn at 1940 – School for Nurses. Medical School in Kohtla-Järve from 1940

Handbooks

1. “Lühhikene õppetus Eestimaa tallorahwa ämmadele” Dr.J.Walther, 1812.

2. “Ämmamoori raamat” Dr.J.T (Mats Tõnisson), 1896; Prof. B.G. Schulze, 1904.

3. “Sünnitusabi” A.L. Kaplan, 1957.

Home to Hospital1. Most babies were worn at home until 1930-40-s2. Estonian obstetrics was reorganized in the Soviet-time - every woman had to come and register in the antenatal clinic and then give birth in the hospital. In 1950 many small hospitals where built and there was a small maternity ward.3. Big maternity hospitals were were built in 1960s 4. All bigger centers had a maternity hospital in 1970-19805. By that time giving birth in a hospital was the only chance and homebirths were almost extinct6. During Socialism the order in the Maternity Hospitals was very strict, dicipline and attitude was inhumane and impersonal. The bigger the hospital the less was thought of the woman in labor and the midwife.7. During last decade our obstetrics and antenatal care has gone through a big change and is still changing (for the best?)

What has changed?