‘Midwives to lead maternal healthcare in Bangladesh’

Midwives will lead maternal healthcare in Bangladesh, a Member of Parliament has said, as the government works on plans to develop this new profession to provide “high-quality” maternal and newborn care.

“We want doctors to see only the complicated cases. Midwives will be the leader of maternal healthcare,” Prof Md Habibe Millat while representing Bangladesh at a global symposium on midwifery in Copenhagen on Sunday said.

The meet, highlighting the role of midwives in achieving the new SDGs, was organised a day before the opening of the biggest meeting of the ‘Women Deliver’.

Millat’s comment bears significance, as doctors traditionally dominate when it comes to childbirths.

But he regretted that the caesarian section rate was so high in Bangladesh that “we cannot accept this by any standards”.

Midwives work at facilities and they are to conduct all the normal deliveries, but would refer the would-be-mothers to doctors if complications arise.

The medical journal ‘The Lancet’ defines them as providers of “skilled, knowledgeable and compassionate care” for childbearing women, newborn infants and families through the period of pregnancy in the early weeks of a child’s life.

They are also capable of taking care of many aspects of women and girls’ lives ranging from sexual and reproductive health to family planning.

Millat said midwives can make a “significant contribution” to the maternal, newborn, sexual and reproductive health in Bangladesh that cut more than half of the maternal deaths during the MDGs that ended last year.

For even better results, Prime Minister Sheikh Hasina had announced in the 2010 UN General Assembly that she would create professional midwives.

About 1,400 nurses were given six months’ midwifery training after her announcement to post them in facilities before the International Confederation of Midwives (ICM) approved curriculum was devised.

In 2013, a direct-entry three-year midwifery diploma degree was introduced and midwifery was recently recognised as a separate profession, steps that earned kudos at the symposium.

ICM Vice-President Address Malata said: “What Bangladesh has done, we need to do in many countries. We need to invest in midwifery”.

WHO’s technical advisor in midwifery Fran McConville said: “I was so impressed to see the progress. The difference is incredible”.

One of the participants requested the Bangladesh Prime Minister to organise a midwifery summit with the SAARC heads of states so that the region could learn from Bangladesh.

Bangladesh can serve as a “role model”, she suggested.

“We conducted a workshop in early 2010 and found a lot of enthusiasm, and a midwifery association was formed within six months of the workshop,” Geeta Lal, senior technical adviser Midwifery, UNFPA, said, while lauding Bangladesh’s progress within a “short time”.

The UNFPA and the ICM had teamed up in 2008 and launched the global midwifery programme.

The programme has four pillars -- education, association, regulation, and advocacy to make the authorities recognise the need to treat midwifery as a separate profession.

According to the UNFPA, which organised the symposium with the WHO and the ICM, professionally trained midwives can provide 87 percent of essential maternal and newborn care.

“We have estimated that at least 20,000 professional midwives will be required for Bangladesh. We have begun the recruitment, and will complete recruiting the required number in the near future,” Millat said.

But he acknowledged the challenge to retain them in their posts.

“Fifty percent of the certified midwives who were posted in 2016 did not report to their posts. They do not want to relocate (from their earlier positions),” he said.