Module 5: Asepsis in Midwifery

Study Notes

Midwives play a crucial role in maintaining a biologically safe environment by controlling the spread of microorganisms.
Microorganisms are everywhere, including on body surfaces, in water, and in soil, but most are harmless and some are even beneficial.

Bacteria are the most common infection-causing microorganisms, with hundreds of species capable of causing disease in humans.
Viruses, including rhinovirus, hepatitis, herpes, and human immunodeficiency virus, rely on living cells to reproduce.
Fungi, such as Candida albicans, are normally found in the human vagina, while parasites, including protozoa, helminths, and arthropods, live on other living organisms.

Asepsis is the freedom from disease-causing microorganisms, achieved through aseptic technique to prevent the transmission of microorganisms.
Medical asepsis involves practices that confine microorganisms to a specific area, limiting their number, growth, and transmission.
Surgical asepsis, or sterile technique, involves practices that keep an area or object free of all microorganisms, including practices that destroy all microorganisms and spores.

The chain of infection consists of six links: the etiologic agent, reservoir, portal of exit, method of transmission, portal of entry, and susceptibility of the host.
The etiologic agent is the microorganism capable of producing an infectious process, depending on factors such as virulence, potency, and ability to enter the body.
Reservoirs of microorganisms include humans, animals, plants, and the environment, with people being the most common source of infection for others and themselves.

Before an infection can establish itself in a host, the microorganism must leave the reservoir through a portal of exit.

There are three mechanisms of transmission: direct, indirect (vehicle-borne or vector-borne), and airborne.
Direct transmission involves immediate and direct transfer of microorganisms from person to person through touching, biting, kissing, or sexual intercourse.
Indirect transmission involves a vehicle (e.g., food, water, fomites) or vector (e.g., insect) to transport the infectious agent.

Nonspecific body defenses include anatomic and physiological barriers and the inflammatory response.
Intact skin and mucous membranes are the body's first line of defense against microorganisms, preventing bacteria and fungi from penetrating.
The immune system uses nonspecific defenses, such as the inflammatory response, to defend against infection.

Inflammation is a local and nonspecific defensive response to an injurious or infectious agent, characterized by pain, swelling, redness, heat, and impaired function.

There are two types of immunity: active and passive.
Active immunity involves the production of antibodies by the body in response to an antigen, either naturally through infection or artificially through vaccination.
Passive immunity involves the transfer of antibodies from another source, providing short-term protection.