"We still provide care, even if it's by torchlight": A qualitative study exploring the lived experiences of midwives in rural Bangladesh

Midwifery is a relatively new profession in Bangladesh, formally established in 2013. While emerging research has begun to document the advancements and the challenges midwives face, there remains limited understanding of the experiences of those practising in rural settings in rural Bangladesh.

This study aimed to explore the lived experiences of midwives working in rural Bangladesh.

A qualitative descriptive study was used. Seventeen midwives with at least six months of rural experience participated in semi-structured interviews conducted Zoom or WhatsApp with an interpreter present when required to facilitate communication. Data was analysed inductively using Braun and Clarke's six phase process of thematic analysis, supported by Atlas.ti software. Trustworthiness was established through member checking, reflexivity, and use of Lincoln and Guba's criteria for rigour.

Five overarching themes were identified including Community Perceptions and Trust in Midwifery, Climate and Environmental Pressures on Rural Midwifery Care, Infrastructure, System and Resource Constraints, Professional Identity, Motivation and Scope of Practice and Supports Needed to Strengthen the Rural Midwifery Workforce. Midwives demonstrated resilience and professional pride despite facing resource shortages, limited recognition, and cultural and structural barriers.

The importance of community awareness, continued education, government investment, and system level support to enhance midwifery care in rural areas were highlighted in this study. Addressing these needs could improve both workforce strength and sustainability and health outcomes.

Midwives in rural Bangladesh demonstrate strong commitment to woman-centred care despite systemic barriers. Strengthening support, education, and policy investment is essential to sustain this vital workforce.