In Pakistan, for every 100,000 babies born, some 260 women die during childbirth. The country is one of 11 countries that comprised 65 per cent of global maternal deaths in 2008. Yet most maternal deaths could be prevented if a skilled practitioner attended the birth. Even now, the journey to motherhood remains a dangerous one in Pakistan.

In 2008, Pakistan introduced an 18-month training programme for community midwives. But lack of clinical experience limited the midwives’ ability to practice after graduation. In 2014, UNFPA – together with the Department of Health and Sindh Province’s Maternal, Newborn and Child Health programme launched a pilot effort to supplement the midwifery courses with hands-on training. Midwifery coaches visited the midwives’ clinics, offering guidance and mentorship.

Maternal Health care

Midwives ‘who are educated and regulated to international standards’, according to the World Health Organization, can provide 87% of the essential care for women and newborns. And many countries across the world slowly understand this; along with the realisation that midwifery also helps bring down total healthcare costs. The services of a midwife depend on the certification and licensing credentials obtained and the practice restrictions of each state. These services include annual gynaecological exams, family planning and preconception care, prenatal care, labour and delivery support, newborn care, and menopausal management. Midwives generally provide reproductive education in fertility, nutrition, exercise, contraception, pregnancy health, breastfeeding, and quality infant care.

Midwives often function as both a quality and economical option for birthing care. In rural Pakistan, many people consider it shameful or unorthodox for women to work outside the home. According to a 2012 survey in Pakistan, 70 per cent of respondents said that when women work, their children suffer. Many of the midwives faced these attitudes, as well.

“My in-laws and other relatives were against me,” said Shabana Jabir Ansari, 27, from Mushtrika Colony. “Sometime due to my duties – morning and evening shifts – people said negative comments. That hurt me.”

The BBC reported a Himalayan woman, Sherbano who decided to train to become the first midwife in her area after going through her own experience of giving birth without any assistance. She is been termed as the ‘superwoman’ midwife of the mountains. She is now been recognized as a paid government practitioner. Sherbano is one among many midwifes who are the life-savers today.

So far, in Pakistan over 300 midwives have benefitted from the coaching and mentorship programme. Plans are now underway to scale up midwifery training efforts. The 18-month midwifery training programme was expanded to 24 months, with help from UNFPA. And the midwifery coaching programme was rolled out to all the districts in Sindh through 2018.

These programmes will empower more women to save lives.