No matter how far one looks back in the history of mankind: As long as humans are born by women there were midwives and there will be midwives.
The knowledge of “wise women” led already in the Middle Ages to uncertainty - particularly among the physicians and church princes. Midwives were strongly affected by witch-hunt. Many were burnt at the stake, because people did not trust their knowledge and their art – because of ignorance or eagerness for power. At that time midwives were considered to work in the function of a gynaecologist or as a person with healing skills which got their knowledge as a gift. They acquired their knowledge through the knowledge of older women and own practical experience. The current and historical literature about the midwife art gives an idea of this traditional occupation of woman (Skolik 2001). This knowledge developed more and more and passed on since generations. But nowadays the situation has changed: Many midwives are working on their own with their own experiences and their own unverified methods of practice. This already begins in the time of the midwifery training without standards in many working areas. The care of the umbilical cord of the baby is in the homely care of the midwife again and again in discussion. The unverified methods of practice in midwifery tasks are widespread in different working fields and should initiate a development of caring with evidence-based background. Dannenfeld stated in their work about the significance of the salutogenetic concept of the midwifery work that in this work it is important to deal with scientific topics for achieving a more effective and more professional work. This statement is emphasised by the Schweizer Hebammenverband. They mentioned that the midwifery work is including the task of assuring and further development of their quality of work.
In 2002 the World Health Organisation (WHO) mentioned in their training modules about Essential Antenatal, Perinatal and Postpartum Care that throughout the world there are numerous methods of caring for the cord, but the most effective is to use NO application to the cord but to keep it clean and allow it to dry over the first two days. In context to this statement this essay works out the different actually used methods of umbilical cord care and their advantages and disadvantages in comparison to the recommendations of the WHO.
Table of Contents
1. Introduction
2. The History of Umbilical Cord Care
3. Present Practice of Cord Care
4. German methods for cleaning or treating the umbilical cord
5. Traditional cord care practices worldwide
6. Medical practices of cord care worldwide
7. Evaluation of studies about cord care
8. Conclusion and recommendations for future practice
Research Goal and Topics
The primary goal of this paper is to explore the effectiveness of various umbilical cord care practices by evaluating available scientific literature and comparing subjective traditional methods with evidence-based recommendations, specifically those provided by the World Health Organization (WHO).
- Historical evolution of cord care and infection control
- Diversity of current cord care practices in Germany and globally
- Evaluation of clinical evidence regarding antimicrobial applications versus dry cord care
- The impact of hygiene standards on neonatal outcomes
- Recommendations for standardized, evidence-based midwifery practice
Excerpt from the Book
Present Practice of Cord Care:
Mändle et al. (1997) mentioned in their book (often used for the midwifery education) that in the last years the care of the umbilical cord became worldwide a less important part. The midwife or nurses of the hospital have to show to the parents that the cleansing of the cord stump has to be done carefully with good hygiene. The cord care should bring forward the drying (mummification) of the stump with avoiding an infection of the cord wound.
During more than seven years of work experiences I changed my own method several times. But with own insufficient case numbers of patients and the lack of evidence-based literature it is difficult to work out the best own way of caring. At the time when I was an entrant in the midwifery profession I started working in a birthing centre where three experienced colleagues were giving me their support. Through and with the different methods of umbilical cord care of these three midwives I learned a lot and developed my own method. At that time I or rather we always used the Calendula-Oil for cleaning the umbilical cord. We left the oil at the parents house and told them to clean with the oil whenever the cord is stinking or seems to be moist. This caring for the cord when the midwife is not available occupied the parents and
Summary of Chapters
Introduction: Provides the historical context of midwifery and highlights the current lack of standardized, evidence-based practices in umbilical cord care.
The History of Umbilical Cord Care: Outlines historical challenges, such as staphylococcal outbreaks, which led to the adoption of various topical cleansing agents.
Present Practice of Cord Care: Reflects on personal professional experiences and the evolution of methods used by midwives in daily practice.
German methods for cleaning or treating the umbilical cord: Enumerates various common cleansing methods currently employed in Germany, ranging from water to herbal essences.
Traditional cord care practices worldwide: Discusses global cultural practices and the risks associated with applying non-sterile substances to the umbilical stump.
Medical practices of cord care worldwide: Examines routine hospital practices and evaluates clinical studies regarding the use of human milk and other topical agents.
Evaluation of studies about cord care: Critically analyzes existing clinical trials, noting the difficulties in finding high-level evidence and the impact of regional hygiene standards.
Conclusion and recommendations for future practice: Summarizes that keeping the cord clean and dry is the most effective approach and calls for more standardized research in midwifery.
Keywords
Umbilical cord care, Midwifery, Neonatal hygiene, Cord separation, Evidence-based practice, Omphalitis, Dry cord care, Topical antimicrobial, Calendula-oil, Staphylococcus, Neonatal mortality, Clinical guidelines, Sterility, Cord stump, Infection prevention.
Frequently Asked Questions
What is the core subject of this paper?
The paper examines the various methods used for umbilical cord care in newborns and questions whether a scientifically "perfect" or standardized way of care exists in modern midwifery.
What are the central themes discussed?
Key themes include the historical development of cord care, the transition from traditional to evidence-based practices, the impact of hygiene on cord healing, and the role of the midwife in ensuring safety.
What is the primary objective of this study?
The primary objective is to evaluate different cord care practices—comparing traditional subjective methods with medical evidence—to provide a clear recommendation for future practice.
What scientific methods were utilized for this investigation?
The author conducted a literature review of existing clinical studies, meta-analyses, and organizational guidelines to synthesize the current state of knowledge on cord care.
What topics are covered in the main section of the paper?
The main section covers the history of cord care, specific cleansing techniques used in Germany, traditional global practices, an evaluation of clinical studies, and evidence-based recommendations.
Which keywords best characterize this work?
The work is characterized by terms such as umbilical cord care, evidence-based practice, neonatal hygiene, cord separation, and infection prevention.
Why does the author emphasize that dry cord care is often recommended?
The author cites WHO recommendations and clinical studies suggesting that simple, clean, and dry care is frequently more effective and less prone to risks than the application of unnecessary topical substances.
How does the author evaluate the use of alternative substances like breast milk?
The author notes that while some studies suggest human milk is safer than harsh chemicals and potentially effective for cord separation, more multicenter research is needed to make it a standard recommendation.
- Arbeit zitieren
- BSc of Midwifery Stefanie Nunes-Laibold (Autor:in), 2006, Independent exploration of practice - Is there a perfect way of cord care?, München, GRIN Verlag, https://www.grin.com/document/85909
