Role of Midwives in Maternity Care: Functions, Importance and Benefits

Context: India has made notable strides in maternal health, with the Maternal Mortality Ratio declining from 130 per lakh live births (2014–16) to 93 (2019–21). However, a contrasting trend has emerged in the rising number of caesarean deliveries from 6.4% in 2008–09 to over 27% in 2024–25. This is significantly above the 10–15% range suggested by the World Health Organisation, pointing to an over-medicalisation of childbirth.

Role of Midwives in Healthcare

Midwives play a crucial role in ensuring safe and respectful maternal and newborn care, acting as primary healthcare providers during pregnancy, childbirth, and the postnatal period. They are trained to support normal deliveries, identify complications, and provide essential guidance on nutrition, breastfeeding, and infant care. In countries like India, strengthening midwifery services is key to reducing maternal and infant mortality rates and improving overall public health outcomes, especially in rural and underserved areas.

Also Read: Maternal Care in India

Factors Driving the Rise in Caesarean Deliveries

• High prevalence in private healthcare: Caesarean rates in private hospitals have climbed to nearly 47.4%, indicating excessive reliance on surgical methods.
• Regional disparities: States like Telangana report rates exceeding 60%, reflecting uneven practices across regions.
• Economic motivations: Surgical deliveries are more expensive, creating financial incentives for private healthcare providers.
• Revenue dependence: A substantial portion (70–80%) of private gynaecologists’ income comes from deliveries, which may indirectly promote caesareans.
• Cultural influences: Some families opt for planned births on astrologically favourable dates, increasing elective surgeries.

Also Read: Maternity Benefits Act 1961

Health Risks Linked to Unnecessary Caesareans

• Maternal complications: Greater chances of infections, excessive bleeding, and post-surgical adhesions.
• Future pregnancy risks: Increased likelihood of complications in subsequent pregnancies.
• Long-term conditions: Possibility of issues such as scar endometriosis.
• Child health concerns: Higher risk of respiratory problems, asthma, and obesity in children.
• Impact on gut health: Disruption of the newborn’s microbiota, though breastfeeding may partly restore it.

Also Read: Maternal Mortality Rate

Significance of Professional Midwives

• Promoting natural childbirth: Midwives treat labour as a natural physiological process rather than a medical condition.
• Continuous care: They provide close monitoring during labour, reducing unnecessary interventions.
• Early risk detection: Timely identification of complications ensures prompt referral to specialists.
• Reducing surgical dependency: Their presence encourages safe, normal deliveries.
• Wider outreach: They improve maternal care access in both rural and urban healthcare settings.

Also Read: Denial of Maternity Benefits to Adoptive Mothers

Challenges in Expanding Midwifery Services

• Workforce shortage: There is a significant gap between demand and the availability of trained midwives.
• Doctor-centric system: Healthcare remains heavily dependent on physicians, limiting midwives’ roles.
• Private sector bias: Financial incentives favour surgical procedures over natural births.
• Social attitudes: Many families perceive caesarean delivery as safer or more convenient.
• Weak integration: Midwives are not sufficiently embedded within public health systems, especially in rural and tribal areas.

Way Forward

• Scale up midwifery education and training programmes nationwide.
• Integrate midwives into primary healthcare and maternity services.
• Promote awareness about the benefits of natural childbirth.
• Strengthen regulations to curb unnecessary caesarean procedures in private hospitals.
• Establish robust referral systems linking midwives with obstetricians.

Sharing is caring!