MIDWIVES BEFORE AND TODAY-INDEPENDENCE OF MIDWIVES IN CROATIA

Primaljstvo, najstarija od svih medicinskih struka, razvijalo se kroz povijest usporedno s razvojem civilizacije pojedinih naroda. Cilj primalje nije bio samo pomoć pri porođaju , već su i liječile medikamentima, njegovale ženu i dijete, te nastupale na sudu kao vještaci. Vođenje poroda bilo je u domeni primalja, a liječnici i kirurzi su davali savjete i ordinirali iz daljine. U današnje vrijeme medicina se znatno unaprijedila, a stope smrtnosti majke i djece su na niskoj razini, no porođaj je sve više u domeni liječnika i ginekologa. U Hrvatskoj se nudi isključivo medicinski model vođenja poroda, koji dokazano remeti normalne fiziološke procese rađanja. Naš zdravstveni sustav je organiziran tako da žene ne mogu doći do primalje tijekom trudnoće, već je upoznaju dolaskom u rodilište. No, bez obzira na to što primalje u Hrvatskoj ne donose odluke o tijeku porođaja, one mogu svojim pristupom i znanjem učiniti da se žena u rađaonici osjeća ugodno, sigurno i opušteno. Trend u Europi i svijetu je povratak prirodnom porođaju i odabiru načina i mjesta porođaja. Hrvatske primalje trebaju poticati porođaj s minimalno medicinskih intervencija, sa rodiljom kao aktivnim sudionikom u porodu. Treba shvatiti da je ono što je za zdravstvene djelatnike u rađaonici rutina, za svaku trudnicu koja uđe u rađaonicu to je novo iskustvo i najvažniji događaj u njihovom životu i životu njihovih obitelji. Direktive EU i Zakon RH omogućuju samostalnost prvostupnicama primaljstva koja nažalost još nije zaživjela u praksi naših rodilišta. Liječnici i ginekolozi su i više nego opterećeni poslom i brojem samih pacijentica kao i sustavom. Kada bi primalje mogle utvrđivati i voditi normalnu trudnoću i porod, uvelike bi pao i teret sa ginekologa koji bi bili na raspolaganju u slučaju patologije, malformacija ili nekih drugih hitnih stanja.Midwife, the oldest medical profession, grew throughout the history parallel with civilization growth of nation. Midwifes purpose was not just helping with childbirth, they would also take care ofa a woman and her baby, they would serve as a pharmacist, anda ct as a jurist in court. Midwifes were completely in charge of delivery process, while doctors and surgeons would give advice and observe from distance. Today medical profession improved considerably, and death rate of mothers and their children is extremely low, but delivery is also led mostly by doctors and gynecologists. In Croatia medical model of childbirth is the lone option, which is proven to disrupt natural psychological birth proces. Our health care system is designed so pregnant women cannot get access to midwife during theri pregnancy, but during their arrival at the maternity hospital. Although midwifes in Croatia do not make decisions during childbirth, with their approach and knowledge, they can make woman feel comfortable, safe and relaxed. A trend in Europe, and int he world in general, is going back to natural childbirth experience, and women is choosing of method, an place of childbirth. Croatian midwifes should encourage childbirth with minimal intervention of medical staff, with midwife as an active participant at childbirth. We need to understand that what is for medical staff a routine, for every pregnant woman that enters a delivery room, it is a new experience, and the most important moment in their lives, and in lives if their families. The EU directive, and the laws of Republic of Croatia, empower independence of the bachelors in science of Midwifery, wich unfortunately has not come to life in practice in our maternity hospital. Doctors and gynecologists are not only overwhelmed with the amount of work, and the number of patients, but with the system itself. If midwifes could affirm and monitor normal pregnancy and childbirth, weight of the shoulders would be lifted for many gynecologists who would be accessible to tend to each pathology, malformation or any other emergency cases