The training programme for obtaining evidence of formal qualifications in midwifery consists of the following two parts:

1. A.

   Theoretical and technical instruction

   1. a.

      General subjects

      • Basic anatomy and physiology

      • Basic pathology

      • Basic bacteriology, virology and parasitology

      • Basic biophysics, biochemistry and radiology

      • Paediatrics, with particular reference to new-born infants

      • Hygiene, health education, preventive medicine, early diagnosis of diseases

      • Nutrition and dietetics, with particular reference to women, new-born and young babies

      • Basic sociology and socio-medical questions

      • Basic pharmacology

      • Psychology

      • Principles and methods of teaching

      • Health and social legislation and health organisation

      • Professional ethics and professional legislation

      • Sex education and family planning

      • Legal protection of mother and infant

   2. b.

      Subjects specific to the activities of midwives

      • Anatomy and physiology

      • Embryology and development of the fœtus

      • Pregnancy, childbirth and puerperium

      • Gynaecological and obstetrical pathology

      • Preparation for childbirth and parenthood, including psychological aspects

      • Preparation for delivery (including knowledge and use of technical equipment in obstetrics)

      • Analgesia, anaesthesia and resuscitation

      • Physiology and pathology of the new-born infant

      • Care and supervision of the new-born infant

      • Psychological and social factors

2. B.

   Practical and clinical training

   This training is to be dispensed under appropriate supervision:

   • Advising of pregnant women, involving at least 100 pre-natal examinations.

   • Supervision and care of at least 40 pregnant women.

   • Conduct by the student of at least 40 deliveries; where this number cannot be reached owing to the lack of available women in labour, it may be reduced to a minimum of 30, provided that the student assists with 20 further deliveries.

   • Active participation with breech deliveries. Where this is not possible because of lack of breech deliveries, practice may be in a simulated situation.

   • Performance of episiotomy and initiation into suturing. Initiation shall include theoretical instruction and clinical practice. The practice of suturing includes suturing of the wound following an episiotomy and a simple perineal laceration. This may be in a simulated situation if absolutely necessary.

   • Supervision and care of 40 women at risk in pregnancy, or labour or post-natal period.

   • Supervision and care (including examination) of at least 100 post-natal women and healthy new-born infants.

   • Observation and care of the new-born requiring special care, including those born pre-term, post-term, underweight or ill.

   • Care of women with pathological conditions in the fields of gynaecology and obstetrics.

   • Initiation into care in the field of medicine and surgery. Initiation shall include theoretical instruction and clinical practice.

   The theoretical and technical training (Part A of the training programme) shall be balanced and coordinated with the clinical training (Part B of the same programme) in such a way that the knowledge and experience listed in this Annex may be acquired in an adequate manner.

   Clinical instruction shall take the form of supervised in-service training in hospital departments or other health services approved by the competent authorities or bodies. As part of this training, student midwives shall participate in the activities of the departments concerned in so far as those activities contribute to their training. They shall be taught the responsibilities involved in the activities of midwives.