'Obstetricians' perceptions of midwifery-led care in Bangladesh - A qualitative study

The midwife as a separate and autonomous profession is a relatively new concept in Bangladesh; as a result, its integration into the maternal healthcare system is yet to be determined. Obstetricians are key stakeholders in maternal health, and understanding how they perceive midwifery-led care can provide valuable insight into the acceptance of the model, and the profession itself. Data was collected from 13 semi-structured interviews conducted with obstetricians working in the Dhaka division, Bangladesh, in July 2023. Thematic analysis was then carried out on the transcripts. Four main themes were identified. 1. Diverse understanding of the role of a midwife; There was a general lack of understanding of the role of a midwife, and confusion surrounding their scope of practice. 2. Perceived benefits of midwifery; Obstetricians felt as though midwives can help decrease their workload, and that they are specialised practitioners who can help improve access and equity of healthcare. 3. Factors restricting midwives' professional autonomy; There was an evident lack of trust from obstetricians of midwives' competency and their education, and their acceptance and integration into the healthcare system are weak. 4. Strengthening future midwifery; Obstetricians suggested a need for improvements in midwifery education, as well as government promotion of midwives. The lack of awareness of the role and potential of midwives limits their professional autonomy. There is a need to increase awareness of other healthcare professionals, as well as the public, of the benefits of midwives and the midwifery-led model of care. Improved regulation is also needed, particularly in the private health sector and in the implementation of midwifery education.