Role of Midwife in Developing Countries of Asia

Dr. Saria Tasnim, Associate Professor, Faculty of Obstetrics and Gynaecology, Institute of Child & Mother Health, Dhaka, Bangladesh

Abstract
Introduction: Literally midwife means a person ‘with woman’ to assist during childbirth. Midwifery is one of the oldest professions for women in the world.
Objective: To reappraise the evolution of the midwives and their role in current obstetric practice in developing countries of Asia.
Methods: Review of relevant studies and documents with some predetermined eligible criteria.
Results: With advancement of medical science in developed countries midwifery became professional and skills required of midwife defined. The evolution from traditional birth attendant to skilled birth attendant has been gradual in developing countries of Asia as well. The experience of global Safe Motherhood Initiative since 1987 have identified that skilled birth attendant with appropriate referral is the most critical intervention for reduction of maternal mortality, yet, in developing countries only 53% births receive such care. Some countries of Asia like Malaysia and Srilanka attained success in reduction of maternal mortality through implementation of midwifery service in the community and increasing
institutional deliveries. In Bangladesh, India, Pakistan and Nepal most of the people still depends on traditional birth attendants for delivery and the coverage of skilled birth attendant is much below the expected level. To achieve millennium development goal the countries are currently implementing programs to ensure skilled birth attendants in their own context like auxiliary nurse midwife in India, community SBA in Bangladesh, village midwife in Indonesia.
Conclusions: It is acknowledged that the midwives are the key personnel for care during pregnancy and childbirth and maintenance of proper skill, quality and supervision according to individual country needs is necessary. In currentpractice their role has been redefined and entrusted with the care for women’s whole reproductive health care needs.
Keywords: Traditional birth attendant, Midwife, Skilled birth attendant,
maternal mortality.