Can Midwifery Pave the Way for Safer Maternity Care in India? Find Out

In a world where more than 130 million babies are born every year, it would be indispensable to spotlight the role of the midwife in maternal and newborn care. Skilled midwives would play a massive role in reducing those deaths resulting from maternal mortality, neonatal deaths, and stillbirths, especially in low- and middle-income countries. It is estimated through research that with proper midwifery care over 80% of these deaths could be avoided.  

Midwifery as a profession is a relatively new phenomenon in India with a definition from the International Confederation of Midwives. Midwives not only assist women through childbirth but also provide full care through the whole period of pregnancy, birth, and postpartum periods, supporting family planning and early child health interventions.

Approximately 74 women still die every day in India due to pregnancy and other complications" is typically derived from government health reports and international health organizations, such as the National Health Mission (NHM) of India, World Health Organization (WHO), and UNICEF.

Why Is The Concept Of Midwifery Important?

In a country where 25 million babies are born yearly, high-quality maternal and newborn care is a critical priority. A professional cadre of midwives is necessary to ensure it. Midwives are considered to play a very important role in making childbirth facilities more accessible to women, providing them and their babies with empathetic, skilled, and respectful care. Midwives are also credited globally with the potential to greatly reduce maternal and neonatal mortality rates, particularly in low- and middle-income countries.

According to the World Health Organisation forecasts, by 2030, the shortage of midwives will be 0.31 million worldwide. This represents a threat to the goal of quality care for every woman during childbirth. Addressing such gaps proactively was the case in India when it introduced 2018 the Midwifery Initiative.

India's Midwifery Initiative

The Government of India recently introduced the ‘Guidelines on Midwifery Services’ in December 2018, to establish a new set of Nurse Practitioners in Midwifery (NPMs), who will be heads of midwife-led care units in public health facilities and strive to achieve physiological birth and reduction in over-medicalization; such a professional will also provide respectful maternity care. This decongests the more advanced health facilities as routine births are attended to in the midwife-led centres.

A salient thrust of the initiative is training. India has established seven National Training Institutes of Excellence to train midwifery educators. To date in 2019, national midwifery training institutes are in place in Maharashtra, Uttar Pradesh, Madhya Pradesh, and Bihar, where NPMs practice clinically and care for healthy pregnant women and their newborns antenatally, in labour, at birth and postnatally.

How It Can Empower Mothers and Healthcare Workers?

Aastrika Foundation, a nonprofit with five years under its belt that has been working toward healthier mothers in India. To celebrate its victory, Aastrika held the ‘Transforming Birthing’ conference in New Delhi, which saw experts, policymakers, and other health professionals from organizations such as the Bill and Melinda Gates Foundation, WHO and many others attend, discussing capacity building and professional midwifery in India.

"At Aastrika Foundation, we believe that every woman deserves respectful, timely, and high-quality maternity care, and every child deserves a healthy start to life in a supportive environment." highlighted by Dr Janhavi Nilekani, Founder and Chairperson, of Aastrika Foundation,  

The heart of Aastrika's work is in its ‘Aastrika Sphere’ programme on training healthcare workers via digital platforms and evidence-based practice, currently extended to 100,000 learners, with 200 courses and 11,000 hours of learning. It had already been able to train more than 1,500 healthcare workers through in-person programs.

Aastrika Foundation aims to reach 25 million women annually by 2030. Its vision is that every woman, through capacity-building, advocacy for respectful birthing practices, and the use of enlightened healthcare providers, receives the dignity, care, and respect she deserves at one of life's most critical moments: childbirth.

As India progresses toward better maternal health, the concept of midwives will ensure the safe delivery of every mother and her newborn in an environment that does not infringe on her dignity.