Midwives of India: missing in action.

Area of Science:

• Maternal Health
• Public Health Policy
• Healthcare Profession Studies

Background:

• Historically, India possessed a robust midwifery profession with European and indigenous practitioners during British rule.
• Post-independence, the midwifery profession significantly declined due to various factors, contributing to persistently high maternal mortality rates in India.
• The decline impacts the quality and accessibility of maternal healthcare services.

Purpose of the Study:

• To analyze the reasons behind the diminished status of the midwifery profession in India.
• To propose a framework for effective midwifery-based maternal health services.
• To identify current efforts aimed at revitalizing midwifery in India.

Main Methods:

• Qualitative analysis of historical and policy documents.
• Review of health program directions and regulatory changes.
• Examination of socio-political factors influencing the midwifery profession.

Main Results:

• Key factors contributing to the dilution of midwifery include regulatory amendments, a lack of social and political prioritization, and shifts in health program focus.
• A framework for midwifery-led maternal health services has been developed.
• Both local and international initiatives are underway to strengthen midwifery in India.

Conclusions:

• The decline of the midwifery profession is a significant factor in India's high maternal mortality.
• Policy and programmatic changes are crucial for reinstating midwifery's importance.
• There is a growing recognition and support for rebuilding the midwifery profession to improve maternal outcomes.