Introduction
The terms “higher education” or “classical education” that we use today, were to some extent meaningless within the scope of midwifery in a century ago in Iran. Self-taught midwives were responsible for women`s health and the health of infants solely based on their personality traits and experience with the help of women in labor. It was a pity that in many cases the unknowingness of these self-taught midwives and their lack of update knowledge were leading to sad real stories. This article aims to examine the history of midwifery education that led to a reduction in maternal and neonatal mortality. Failure to explore the history of midwifery education in Iran and lack of knowledge of its process are among the shortcomings of Iranian medical history.
Before us, Dr. Elham Melkzadeh wrote and published an article titled "Midwifery in the health system during Reza Shah Period”, and she has provided some information form the written references, including books, journals, and periodicals. However, through the archival documents we have received so far, we provide a more precise history of midwifery education in this article. In order to obtain this evidence from the history of midwifery in Iran, the documents related to formal midwifery education were reviewed at the National Library and Archives of Iran. The first is in the level of school and in form of midwifery school in 1919. Then, in order to compile this article, all documents up to 1928 related to the subject were retrieved and presented. After 1928, this education, under the supervision of the Ministry of Education, had different framework which we postpone it for another occasion and we just mention to it very briefly here.
After constitution and the early entry of Iran into modernity, many schools called “Female High Schools”, “Male High Schools”, and “Supreme Schools” were established, and the number of these schools was increased year by year, so that it could not be compared with past. New equipment was bought every year for schools. New buildings and monuments were built around the country and the wise and insightful teachers were recruited. Supreme schools for medicine, law, teachers` education, senior servants, agriculture, dentistry, midwifery, fine art and music were established. These schools became more and more and the number of teachers and students was increased. The Trade Branch was established at the Supreme Law Schools. The Agricultural Supreme School was opened by European teachers, and European teachers were recruited for high schools and supreme schools [1]. It has been written in one of the documents relating to October 24, 1917 that:
“An amount of 3375 Tomans was considered as a salary of a physician teacher in the budget of this year in the Ministry of Education. According to the proposal from the respectful ministry and approval of the High Council of Minister, it was decided that the half of the amount equal to 1375 tomans would be allocated for one midwifery and four nurses. On August 2, the request was issued and sent to the commission for transmission. The commission acknowledged 843 Tomans and 7500 Dinars which was for the first six month of the year according to the request, and it will acknowledge the remaining 843 Tomans and 7500 Dinar at the end of the year since two months have been remained until the end of the year, and as the commission has stated, they will acknowledge it at the end of the year. Please confirm the transmission so that at the end of the year the paper of request will be sent to the commission for the approval. 

[Signature]: August 22, 1917.
The salary of a midwife and four nurses requested by Ministry of Education is 1687.5 Toman for this year. Since the payment for the first six months has been approved, would you please transfer the amount and we will wait for the permission of the payment for the second six months.
The payment of the first six months can be transmitted.
To Ministry of Education and Donation, Department of Computing, Correspondence Office, No. 6734, Date July 30, 1917.
To: Ministry of Finance. According to the budget approved in the Ministry of education, the salary of one foreigner physician teacher which is 3375 Toman, has been allocated for two midwives. According to the proposal from Mr. Amir Alam, the Ministry of Education has been approved half this amount for a midwife and four nurses and the paper for this request has been sent under number 65 on date March 5, 1917. Unfortunately this amount has not been transmitted yet. Now that a briefing has been sent to this ministry from the head of High Council of Ministers, I would like to ask you to transfer this amount as soon as possible, so that the hospital continues working.
[Signiture]: Morteza Gholi Momtaz Almolk [Stamp]: Ministry of Education, Donation and Fine Arts
Head of Ministers, No. 3733, Date March 7, 1917.
To Ministry of Finance:  please approve and transfer the salary of the midwife and nurses in the Nesvan Hospital and provide facilities for them.
[Stamp]: Head of Minister [Signature]: Hassan Vosoogh aldoleh
{Note] To Department of Computing, please present related information.  Date: July 21, 1917 [2]. “ 
Testing self-taught midwives
On February 12, 1921, following the establishment of human resource training centers, laws were adopted for various professions and occupations which were working in the traditional way, including the practice acts for medical, dentistry, and midwifery.
“On February 12, 1921, the Medical Practice Act was approved and according to:
Article 1: No one at any point in Iran has the right to engage in any of techniques of medicine and dentistry unless he has obtained permission from the Ministry of Education and this permission must be registered in the Ministry of the Interior.
Article 2: In the future, the documents which are officially recognized and authorized by the Ministry of Education are: First, the certificates issued by the national medical schools in Iran, Secondly, the state medical certificates of the foreign countries, etc.
Article 8: From the date of approval of this law, for a period of three years, a commission will be established in the Ministry of Education two times a year, once in spring and once in autumn. In accordance with article 5 of this law, persons who have been working in Tehran for more than five years and less than ten years as physicians and have no qualification need to introduce themselves to the mentioned commission in the previous article and take an exam for qualification. The commission will be composed of:
Firstly, the formal medical teachers from the Dar ul-Funun (First modern university in Iran), Secondly, four well-known physicians, thirdly, one representative of the Ministry of Education who will be the head of the commission. Determination of the persons will be on behalf of the Ministry of Education [3]”.
After what have come up with here, we must add that, in addition to all physicians, all health personal and workers were required to provide valid credentials in accordance with the law or required to be tested. It is natural that the midwives were not excluded from this law, and therefore, on November 9, 1921, The Head of Ministers, forced those who have been midwifes for many years to attend exam (Table 1).

Table 1) Names of the self-taught midwives who were ready for exam on July 15, 1923.

 

Among the documents that have survived in this event is the request of Ms. Khadijeh Hafez alseheh which was sent to Ministry of Education on October 23, 1922:
“ To Ministry of Education, Donnation, and Fine Arts, Hamedan Education Department, Request letter from Khadijeh Hafez-al-Sehe, No. 403, Date October 23, 1922.
To Head of Ministry of Education, Donation and Fine art. With politeness and respect, I would like to inform you that I have been engaged in curing women`s illnesses in Hamedan City for almost twenty years.  During this time, I have done different sorts of treatment with the utmost care according to the regulations. Most doctors have observed and investigated my treatments. For your attention, there is affidavit in attachment that I received from honorable doctors regarding my treatments. Now, according to the rules and regulations of Ministry of Education, each medical practitioners or midwife must have state approval. Therefore, I would like to ask the honorable minister to issue a state approval for my service, so that I can continue my work with official approval.
Excessive dignity.
Khadijeh Hafez al-Sehe [5]”.
After examining the experienced midwives and obtaining the necessary requirements, a certificate was given to self-taught midwives without which they were not allowed to work (Figure 1).

Figure 1) Sample of a certificate

After this period, the municipality was preventing the activities of unconfirmed midwives. In this regard, in one document is has written that:
“Ministry of Education, Donation, and Fine Arts, Department of Supreme Education, No 672. 25. Date: July 17, 1922.
Report to the Respectful Authority of the Ministry
Recently, the municipality has taken some steps to prevent the activities of the midwives without certificates. Since most of the midwives have the request for the certificate, the Ministry of Education has invited a representative from the municipality and Director of the Ministry of Health made a commission on July 17, 1922. The commission voted that:
1. An announcement is issued from the Ministry of Education according to which midwives need to register their names in an office determined by Ministry of Education from the June to the end of July provided that they are aged more than 35 and less than 65.
2. In order to teach midwifery, two sessions per week are hold in the Dar ul-Funun. The course will be from the first to the end of the December (if the Maternity Hospital be opened, the course will be given at the hospital).
3. Dr. S. Froskina will be in charge of teaching and the all midwives are required to take the instruction written by Dr. Ehya-al-Malek.
4. After the expiry of the period specified in article 2. The midwives need to participate in the exam and receive the certificate.
5. There is no right for a midwife to give prescription and to do operation (washing is not part of the operation).
6. Until the exam, the current situation will not be violated.
7. After a month for registering the name, the registration will be expired, and no other midwife will be accepted for the course and will be deprived from midwifery. Ali Akbar Davar [6]” (Figure 2).

Figure 2) Report from Ministry of Education to prevent the activities of midwives without certificate in 1922

On August 5, 1925, a government letter was issued to prevent the activities of physicians without certificate [7]. On August 29^th of the same year, the Ministry of Education, sent a same letter to the public departments and educational departments of different province and prohibited the use of term “doctor” except for those having diploma of medicine and other persons, both authorized and unauthorized did not have the right to use the word “Doctor” on the office board and papers, and the offenders were persecuted [7].
Teacher Training Center, establishment of Midwifery School 
In 1919, Mirza Ahmad Khan Nasi-al-Doleh, the Minister of Education, turned the French Female High school, named “Franco Pearson “, which had been established in 1905 into a teacher training center [8]. Ten students of this school were required to go to the maternity hospital to study maternity diseases and midwifery. After completing the 6-year elementary school, the teaching training course was 4 years that in the first 3 years, the high school lessons were taught and the students learned the principles of education in the fourth year [9].

Place of Midwifery School
The primary site of the teacher training center was at Shah (Naderi) street at the beginning of Nobahar alley. The school had only 2 classes, one for elementary school and another for high school. In the elementary class, the courses for teaching elementary schools were taught, and in the high school class, the courses for teaching high school were taught. After this place, the school was transferred to the Farhang building, located on Takhte Zomord, Sahm al-malek Alley. The head of the academy was with Abolhassan Foroughi and the principal was Esmail Marat. Foroughi managed the school for 10 years from 1919 to 1927 [8]. Nasir-al-Doleh, The minister of education in that time, ordered two students to attend a 3-day weekly course on female illnesses and midwifery train in the Maternity Hospital [10]. According to Klooney, Chief National Health Office, a special section was considered at the Maternity Hospital in order to expand the practical knowledge of midwifery students. He writes: “Midwifery students receive great academic education, but their practice work is not enough because in the two maternity hospitals, the rate of birth is very low. The maternity department which has been considered for the new hospital, will remove this problem [11].”
Teachers of Midwifery School
Initially, the school teacher was Madame S. Fraskina, the physician in the Nasavan Hospital [12]. At that time, there were very few pregnant women who were referred to the Nasavan Hospital for labor, and only occasionally in the cases of abnormal delivery, the pregnant woman was brought to the hospital, and in this condition, every 15 to 20 days, only one delivery was done. After Madame Fraskina, three European midwives named Dr. Dormpes, Dr. Pen, and Dr. Sarkisian, were working in the Maternity Hospital and they were teaching midwifery [13].
Dr. Matilde Dormpes, was a doctor and former student of the Eastern Language School. She writes about her work in Iran: “When I arrived in Iran, Vosoogh-al-Doleh government was authority, and expressed more interest in hiring foreign staffs until the nationalist government took power [14]”. In another part of her report which should be related to the years following the transfer of monarchy from Qajar to Pahlavi, she writes: “I should tell you that I will be in this country for another year, and Iranians intends to keep me because they are talking about the transfer of the school of midwifery to the school of medicine [14]”.
To hire Ms. Dormaps, the Supereme Council of Education sent a request to the Minister of Education with the following text:
“To Mr. Moshar-al-Doleh, the Minister of Education, Donation;
As you know, Dr. Dormpas was recruited five years ago and the Maternity Hospital was established. From that honorable ministry, the following signers who have completed their primary and secondary education were introduced to the hospital, to study medicine and become specialized in women`s diseases. Particularly, the honorable authority of the Ministry of Education, ensured us that they would provide us all the assistance to complete our education. We are studying for sure that will be doctors and we can serve after our graduation. Up to now, we have been studying for four and a half years with the attention of Dr. Dormpas and we have practiced in the hospital and it`s only one and a half years left for us to become graduated.
Now that we will graduate one and half a year later, instead of encouraging us, we have been told to get our midwifery diploma and we are convinced that we have wasted 14 years of our life and today we are midwives while the education period for midwifery is only two years and we did not attend this school to study for midwifery. So we would like to ask you to let us study for a year and a half. We would like Dr. Dormpas to teach us who has been taught us with attention for a long time, so that we can become specialized in female illnesses, as we had been promised before. In this way we can serve our nations. In the end, we appreciate your interest in education and we expect you to encourage us by let us to continue our education for one and half year later and let us to achieve our goals and do not despair.
[Signitures]: Najmabadi, Ozra Safavi, Heshmat Mokhtarian, Nosrat Golsorkhi, Batool Fili, Khatoon Haji Moosa, and Nayereh Hakim Maroof
[Note] Education Department, please pay attention and do any action that is required by the Ministry of Education [15].”
In 1932, the school teachers were: Azim al-malek Frahmandi, head of the school and Teacher of health preservation; Dr. Amir Alam, teacher of anatomy; Dr. Alam-al-Molk, general diseases; Dr. Hakim-al-molk, physiology, deputy of the head of the female department; finally, Malek Hessabi, the school master [16]. Altogether, the teachers of midwifery school form the establishment until 1936 that the school was renamed to the Supreme School of Midwifery were: Dr. Saeed Malek, Dr. Younes Afrookhteh, Dr. Ali Khan Alim-al-Molk Farahmandi, Dr. Amir Alam, Dr. Hakim Azam, Dr. Alam-al-Molk, Dr. Moaven, Dr. Abolghasem Bakhtiar, Dr. Jahanshah Saleh and Madams: Fraskina, Dr. Matild Dormpas, Dr. Pen, Dr. Sarkisian [13]. Also, in the practical courses taught at the School of Midwifery, in addition to the doctors mentioned above, Eyni Najm abadi and Ozra Safavi who were the first graduated doctors from the Maternity Hospital, cooperated [16].

Prerequisites for studying at Midwifery School
In 1923, according to the decision of Supreme Council of Education, students and volunteers of midwifery had to complete the first three years of secondary education, and for this purpose they had to either present a 3-year secondary school diploma or participate in entry exam. In any case, the volunteer were required to pass the chemistry, physics and French exams [17].
On January 19, 1925, according to the request of Dr. Amir Alam, Director of the Maternity Hospital, and the request of Dr. Matlid Dormpas, academic secondary Medal was considered for Ms. Zinat Daneshvar, intern of the state hospital and Ms. Rana intern of Maternity Hospital who was one the most distinguished students of the midwifery school respectively [18].
In the academic year of 1927, according to the order of Dr. Azim al-Malek, deputy of medical school, the announcement of the opening of midwifery school was published in the media. The terms of the entry were as follows:
“Ministry of Interior, National Health Organization, No. 3873, Year 1927
Announcement for School of Midwifery: The school lessons of the Midwifery School will begin from September 24, 1926. The volunteer should have the following requirements:
1. Age: over 18
2. Acknowledgement of the ethics from the school which they left.
3. Certificate of high school and passing the three year school exams.
4. Passing the physics, and chemistry in French according to school program
Those who do not have a three-year high school certificate will be required to take the three-year exams and they must be present at Midwifery School on 5^th of September at three o’clock. The school office of the Maternity Hospital will be open for registration from September 17^th to September 23^rd and from morning till noon, except for holidays [19]”.
The examination board were: Marat (Head of the Center of Education), Fahimi (Head of Supreme Education), Mirza Gholam Hossein Rahnam and Mirza Mohammad Vahid, Teacher of Dar-al-Funun [19]. For re-examination of dismissed students, Dr. Azim-al-Molk from the Medical School and Dr. Loghman al-Doleh were invited to administer the test 2 hours before the noon, on Sunday, September 26^th, in the Maternity Hospital, and the classes of the new academic year began on the same day (Figure 3) [19].

Figure 3) Entry criteria for midwifery school in the academic year 1926

Midwifery School Lessons
According to the available documents, at the beginning, Madame S. Fraskina, doctor of the Maternity Hospital, was in charge of teaching in midwifery school. She was teaching the printed instruction written by Dr. Ehya al-Molk [6]. Subsequently, Dr. Matild dormpas was recruited. Dr. Dormpas was the first female doctor in the Maternity Hospital in the years 1920 and 1921, and she wrote a book titled “New Maternity Protection Principles”, in French, based on what she was teaching to the midwives of the Tehran. After her, Dr. Mohazeb al-Saltaneh, Head of State Maternal Hospital, translated this work from French into Persian and it was published in the same years at the Fars News Office in Tehran. Since then, this book became the basis of midwifery lessons. The headings of this book have been arranged according to the text that was supposed to be presented in 17 sessions with the date of the session. After that, the school curriculum found its own discipline. The description of the “program” of the midwifery class is as follows:
“1- Techniques of labor, natural labor
2- Female genital organ
3. Menstruation and post-menstruation
4. Ovule and Sperm
5. Fetal fertilization
6. Membrane, Amniotic fluid, and cord
7. Definition of pregnancy and duration of pregnancy
8. The changes in mother`s organs during pregnancy, changes in digestion, blood circulation system, nerve system, skin, skeleton, cartilages, general conditions and nutrition
9. Pregnancy status, changes in the reproductive system, uterus, gametes, thickness, weight, tissue, shape, position, erectile dysfunction, rectal tissue, uterine tissue, peritoneal muscle layer, mucosal mucosa
10. Cervical changes: Gassaamt, Shape, position, strength, nozzle, cervical tissue, muscle layer, mucous
11. Endometriosis of the uterus: Sensitivity, delay, Toto, Shrinkage
12. Changes in the uterus extension, ligaments, fallopian tube, vaginal orifice, , Belly skin, Chest change
13. Signs and symptoms of pregnancy: Diagnosis of pregnancy before four and half months, after four and half months, diagnosis of the time of delivery,
14. Maintaining the health during delivery
15. Delivery: Fetal head, fetal rotation, fetal neck, fetal trunk, fetal organs
16. Embryo problems, causes and birth
17. Birthmarks
18. Upper limbs problems: causes, upper limb diagnosis, abnormal coronary, diagnosis of abnormal coronary artery, chronic obstructive pulmonary diseases, abnormal conditions of the fetus, birth defects
19. Face Problmens: Adverse affliction of adenopathy, morphological changes in embryo head at the end of the face, methods of diagnosis of adenocytosis, adenocarcinoma, adenovirus, adenomycosis, adenomyosynopathy, adenomycosis
20. Aortic aneurysm, Diagnosis of forehead aorta, different conditions, forehead appearance, diagnosis of frontal collapse, uterine appearance, embryo appearance, embryo deformation
21. Full abdominal diagnosis, full erection disorder, the effect of erection disorder throughout the body
22. Anal disorder
 23. Problems of arm bones: causes and diagnosis, congenital problems of the bones
24. Vertebral column
25. Changes in reproductive organs after childbirth
26. Nursing the women who had the delivery
27. Nursing the infant
28. Conditions of woman after the delivery
29. Death of fetus
30. Neonatal physiology
31. Preserving the baby`s health
32. Preserving the baby`s health
33. Condition of Birth
34. Pregnancy, multiple pregnancy, causes, diagnosis
35. Asepsis and antisepsis
36. Midwifery cleanliness and equipment
37. Using drugs
38. Special tools and gadgets for the midwives
39. Cleanliness in delivery
[Test terms]:
1. Basic anatomy (20 questions)
2. Reproductive organs of women (9 questions)
3. Basic physiology (16 questions)
4. Physiology of women`s genital organs (5 questions)
5. Basic Bacteriology (14 questions)
6. Basic general diseases (17 questions)
7. Genitalia diseases (18 questions)
8. Nursing the patient (79 questions)
9. Techniques of delivery (1. Natural delivery, 39 questions, 2. Hard conditions of delivery, 26 questions)
10. Maintaining the health of mother and neonatal (12 questions)
[Notes:]
A: the duration of education is two years.
B: Courses should be taught in Persian.
C: Birth operation are practiced in private maternal hospital.
D: The entry requirement is having certificate of high school [20]”.
 
Centralization of National Health Institutes into Department of Health
The Cabinet of Ministers, at the meeting of February 6, 1926, in accordance with the proposal of the Ministry of Interior, approved that the Department of Health should be attached to the Ministry of the Interior and become a part of that ministry. According to this act, the credits and budgets of department of Health attached to the credits of the Ministry of the Interior. After this Dr. Hossein Khan Bahrami was appointed by the Ministry of the Interior to be the head of Department of Health [21].
However, apart from what was the responsibility of the Department of Health, The Ministry of Education was legally responsible for certificates and examinations of the students. One of the documents states:
“The Ministry of Education, Donation, and Fine Arts, The Supreme School of Medicine and Pharmacy, No. 41.36, Date January 20, 1927.
To Honorable Minister of Education,
Since the responsibility of authentication and examination of Nasavan Hospital Students is not legally mandated by the Ministry of Education, and Since the ministry has referred this responsibility to the School of Medicine, it is noted that the education program for Nasavan students should be provided promptly to the teachers` council which after approval is intended to be presented to the Ministry of Education in order to decide about the examinations of Nasavan. Otherwise, the School of Medicine cannot sign the certifications of the students whose information is not clear. Of course, a decision will be taken by Ministry of Education to address these problems.
Sincerely yours, [Signature]: Mohammad Hossein Loghman al-Doleh Adham [22]”.
According to this law, the centralization of all national health institutes into the Department of the Health was approved on February, 1927. All the national health institutes, municipality health centers, army health centers and the Pasteur Institute (Office of Health), which was part of Ministry of Interior in that time, was centralized and the head of this office was the technical deputy director of that office as well [23].
On June 30, 1926, Ali Mansour, Minister of Interior wrote a letter to Ministry of Education under no. 2527 about the education and exams of Midwifery School. While determining the organization of the school, he writes:

“The ministry does not object to supervision of medical school over the education and exams of the mentioned school, and in this regard it was requested that the medical school determine the examiners and administrate exams as in the past. Since the deadline for the exams has been delayed, it is requested that as in the past years, examiners be determined as soon as possible, exams be taken, and a copy of the grades and results of the students be sent to the Department of Health [24]”. It seems that this conflict for the head mastering of the midwifery school continued and documents indicate this situation as well.
“The Ministry of Interior, Department of Health, No. 7659.15532 Date: November 27, 1307.
To honorable Ministry of Education, Donation, and Fine Arts,
According to the provision no. 1570. 18586, it is declared that the Nasavan Hospital is a health organization and its budget is financed from the credits of Department of Health. Regarding the midwifery school, it should be noted that since the nation needed educated midwives, the Department of the health, established the course and recruited that female doctor for teaching the students. However, it should be noted that the midwifery school has never been a part of medical school and has received no budget from the medical school, and the department of Health provides the program of school by informing that honorable ministry. If you want, the regulation can be presented to Council of Education as well. However, considering that the midwifery school is part of department of health it cannot be attached to the medical school. Therefore, the Department of Health accepts the curriculum designed by ministry of education and administrating the exam by that ministry, but cannot accept the attachment of the midwifery school to another institute. [Signature: Dr. Saeed Malek] [25]. “

Students of the Midwifery School
According to the available documents, the Gynecology Examination Section was hold in the Nasavan Hospitla under the supervision of Dr. Loghman al-Doleh, Head of Medical and Pharmacy School, Dr. Dormpas, doctor of hospital, and Dr. Youneskhan, midwifery teacher of medical school, Dr. Abolghasem Bahrami, director of Nasavan Hospital, and Dr. Azim al-molk, Deputy of School of Medicine and Pharmacy on November 20, 1923 (Table 2).

Table 2) The first graduates of midwifery school and their grades in the exam in 1923

Deputy of State Medical School: Dr. Azim-al-Molk; Director of Nasavan Hospital: Dr. Abolghasem Bahrami; midwifery teacher of medical school: Dr. Younes; Doctor of Nasavan Hospital: Dr. Matild Dormpas, Head of State Medical School, Dr.Loghman al-Doleh. 29715037

A year later, the exam of the midwifery school was in the same order: The Head of Medical and Pharmacy School, Dr. Loghman-al-Doleh; The Deputy of Medical and Pharmacy School and the Head of Women`s and Children`s Technical Department, Dr. Alim-al-Molk Farahmandi; Teacher of the School of Medicine, Dr. Loghman-al-Doleh; Doctor in the hospital, Dr. Matild Dormpas; and Teacher of Medicine School, Dr. Younsefkhan [26]. The midwifery exam from gynecology examination was hold at the Women`s and Children`s Hospital at 2:00 pm on Saturday and Wednesday of the December, 1924 under the supervision of Dr. Loghman-al-Doleh, Dr. Younes Khan and Dr. Alim-al-Molk (Table 3, Figure 4). 

Figure 4) Document related to the exam from the students of the midwifery school in 1924.

Table 3) Examination for midwives and list of their grades in 1924

Two years later, the midwifery exam was hold on Tuesday and Thursday, July 13 and 15, 1926, from 8 to 12 am under the supervision of Supreme Medical School of Medicine at the Maternal Hospital and headed by Dr. Ali Khan Farahmandi, the Head of Technical Department of the Maternal Hospital, the membership of the Dr. Alam-al-Molk and Dr. Loghman al-Molk, Teachers of the Medical School, Dr. Dormpas, the First Female Teacher and Dr. in the Maternal Hospital. The results of the exam with their names are presented in the tables (Tables 4 and 5) [27].

Table 4) Midwifery School Examination on Tuesday to Thursday, July 13-15, 1926

Teacher of the Supreme School of Medicine, Dr. Saeid Malek; Teacher of Supreme School of Medicine, Dr. Abbas Adham, Female Doctor and Teacher of Midwifery School, Dr. Matild Dormpas; Head of the Technical Department of the Maternal Hospital, Dr. Farahmandi; 36114

Table 5) Midwifery School examination on July 15, 1926; first year

 

Before establishment of the School of Midwifery, to satisfy people`s need for midwives and prevention the activities of inexperienced midwifes, all midwifes were tested and after the test, the midwifes who passed the test, were given certificates. Those who failed were prevented from continuing their work. After that, when the first group of midwifery students graduated from the University of Teachers` Training and the education and employment of the graduates of this school continued, the use of self-taught and primary techniques of midwifery began to diminish. In the following years, a more sophisticated and comprehensive curriculum was conducted and teachers such as Madame Fraskina, Matilde, Dormpas, Pen and Iranian physiciations such as Alim-al-Molk Farahmandi, Amir Alam, Saeid Malek, Hakim-al-Molk, Alam-Al-Molk and Moaven, taught midwifery, and inevitably, a curriculum or program and instruction for designing questions were provided. The graduate students were replaced by the traditional midwives. From 1928, with the implementation of laws and regulations, the educational and administrative process of midwifery entered another stage, which we will discuss in another article.

Conclusion
Before the establishment of the Midwifery School, there was no classical midwifery education, and the midwifery was traditionally transferred to the next generations. The ignorance of these self-taught midwives in medicine led to the deaths of many mothers and infants in the way that according to Dr. Amir Alam, this mortality rate was 30 to 50% of the childbirths. With the establishment of the Teacher Training Center in 1919 by Ahmad Khan Nassir-al-Doleh, the Midwifery School was established and to a significant extent, the death of mothers and infants was reduced.
 

Acknowledgements: The case was not found by the authors.
Ethical permissions: The case was not found by the authors.
Conflict of interests: The case was not found by the authors.
Contribution of authors: Ali Karimian (First author); all sections of the article has been done by him (100%)
Financial support: The case was not found by the authors. 
Contribution of authors: Ali Karimian (First author); all sections of the article has been done by him (100%).