Get men in the delivery room, say Bangladesh's first midwives

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One-in-500 women die in childbirth in Bangladesh – with cultural factors as much to blame as a lack of medical care.

There's hardly a man to be seen in the maternity ward of the Maternal and Child Health Training Institute in Dhaka, the capital of Bangladesh.

Despite the lack of any law forbidding men to enter the delivery room, fathers are normally not present during the birth of their own child – an attitude that needs to change ...

"Men need to be involved in the labour process if we are to reduce maternal mortality," says Mala Reberio, one of the 20 midwives being trained to international standards in Bangladesh, which is still heavily reliant on community skilled birth attendants, who lack the skill and the authority to perform more complicated deliveries. Currently, one in 500 women in Bangladesh dies during childbirth.

"If [men] could see firsthand the complications of childbirth, they would be more likely to send their pregnant wives to proper medical facilities and less likely to insist on early childbirth after marriage," ... More than 75% of deliveries take place at home, and the average age of women having their first child is just 16 years ...

... Bangladesh is on target to ... reducing maternal mortality ... the maternal mortality ratio in Bangladesh has declined from 322 per 100,000 in 2001 to 194 in 2010 ...

The Bangladesh government aims to have 3,000 fully qualified midwives who can provide round-the-clock assistance in all 427 sub-districts by 2015 ...

The programme still faces a number of major obstacles, despite being well received by the general public. First, doctors who can earn large sums of money by delivering a baby through a caesarean-section may be unwilling to lose that income if midwives are available to do the surgery for free. Second, the potential fallout from introducing a new cadre of midwives or professionals into an already hierarchical sector could prove difficult.

The government's biggest challenge, though, remains getting women into the healthcare facilities and continuing to bring about behavioural changes in men and women ...

Learn more about private midwifery care and antenatal shared care