Telangana midwifery initiative, a game changer in saving lives of pregnant women and newborns

Lakshmana Venkat Kuchi *

This week I intend to write about a not so often talked about subject–of midwifery–that perhaps India needs the most to help in natural child births and save pregnant women from losing lives during birthing due to complications.

True India has made tremendous progress in terms of medical education, quality and standards of hospitals and health care, but there are areas that still need our focus and immediate attention–as India is only second to Nigeria in terms of numbers of deaths during pregnancy, many of which are preventable if only India once again returned and encouraged midwifery as a profession to raise an army of highly trained midwives, who can offer the healthcare, empathy, sympathy and respect to the pregnant mothers.

Now, if there is any State in India that has recognized the importance of midwifery as an instrument of delivering superior care to the pregnant mothers, it is the newly carved out State of Telangana in South India, where the Government has stepped in to provide global-level training to midwives.

In fact, such has been the success of its pilot project it carried out with the help of a private hospital run by Fernandez Foundation, that even the Central Government has plans to take it up at the National level. The Telangana experiment and its results, thanks to the few committed doctors, hospital authorities and more importantly to the State administrators, can be replicated in rest of the country.

And fortunately, the State and Central Governments have stepped in, and one hopes that in the overall interests of the mother and child, they step up the training and deployment of midwives as part of a separate cadre in healthcare sector.

What has been already observed in Telangana is that Midwifery has led to improvement in the key health indicators maternal and child health in the State and resulting in decreasing the dependence on unnecessary interventions, including cesarean operations.

There is no debate or question about the efficacy and life-saving capabilities of this intervention, but several factors have led to the predominance of C-Section for birthing of a child, which at times can lead to severe complications that could cause deaths of mothers, and child.

In fact, not so long ago, in 2015 it was observed that Telangana had the highest C-section deliveries at a stunningly high 60.7 percent of all deliveries in the State. Of these, 41 percent are in Government run hospitals and a whopping 75 percent in the private sector hospitals.

Another worrying statistic is that Maternal Mortality Ratio (MMR) remains 63 for one lakh births and an infant mortality rate of 26.4 per 100 live births.

These figures are also reflective of the situation in the country with the phenomenon of unnecessary C sector interventions being the rule rather than the exception–for a variety of reasons. The preference and even craze for a good Muhurtham (auspicious time) for the childbirth so that the newborn has a good future is one of the reasons why young couples insist on C-section delivery even though the pregnant mother is healthy, able, and even willing to undergo the natural delivery process. But this urge for medical intervention in childbirth poses a health risk both to the mother and the child.

About 60 percent of deliveries in India are in the private sector. The midwives there can play an important role in such hospitals and the doctors can concentrate on high-risk and complicated cases, as against the present heavy workload in the absence of such a cadre in health services.

Telangana Government recognized the need for improving pregnancy care and the impact of unnecessary C-sections on maternal and infant deaths and decided to step up midwifery care as the potential solution for the State. And it has partnered with Fernandez Foundation and UNICEF to propagate the idea of midwifery – and has come out with a concrete plan to train and employ midwives at Government hospitals across the State. The Foundation ran an exclusive two-year in-house course on Professional Midwifery Education and Training Programme, which began in 2011.

Meital Rusdia, Chief Field Office, UNICEF field office for Andhra Pradesh Karnataka and Telangana believes that this initiative can be the game changer and a sustainable solution to the health personnel gap in the country. She says, “Midwifery is a proven, globally acclaimed intervention that can prevent as many as 83 percent of all maternal and newborn deaths.

With this in view, UNICEF has partnered with the Government of Telangana and Fernandez Foundation to launch the Midwifery Initiative in the State. The initiative has promoted respectful maternal care and ‘natural births’, thereby also bringing down the C-sections. Telangana has been a pioneer on this front and learnings from the State initiative have fed into the National Midwifery initiative.”

It was in the year 2017 that the Fernandez Foundation, which is also one of the Nationally recognized Midwives Training Institutes, undertook a pilot project in association with the Telangana Government by training 30 midwives. These thirty students were shortlisted by the State Government from the nursing staff of the different Government hospitals.

It is an 18-month certificate training programme in midwifery and the first cohort were trained in 2017 and since then two more cohorts have taken place and eventually the Government has plans to increase the number of trained midwives and post them at district level hospitals and even down the ladder in the Government run hospitals, and most importantly, at primary health centres that are the most easily accessible to the women in rural and remote areas.

The midwives play a crucial role in ensuring that pregnant women undergo safe and healthy pregnancy with dignity and care. Midwives not just help in natural birthing process but also help in providing mental support that a mother requires during pregnancy and delivery. These are trained to identify low-risk pregnant women and to take a call when any complication develops.

Central Government noted that 85 percent of pregnancies and births do not require specialized obstetric intervention. Midwifery led care can play a crucial role in promoting physiological births and reducing over medicalization. Which is why, the Centre has stepped in with support to the midwifery and has come out with guidelines for starting midwifery services, as a separate cadre, across India.

Convinced at the conceptual level, one hopes that the midwifery services as a separate cadre gets implemented at the earliest. The Telangana Government has, at its level, already put in place a midwives training programme and has even appointed those who completed training in Government jobs.

While this presents a job and livelihood option for girls across India, the response of different states to the programme and the Union Government has encouraged all those committed to and engaged in propagating midwifery. They are happy that more States – Andhra Pradesh, Uttar Pradesh, Odisha, Karnataka, and Maharashtra have evinced keen interest in taking up the project and have also sent trainees for the midwives training programme.

It sure is a long journey, but one on which India has only embarked recently. But one is happy that it is in the right direction.

The WHO is of the opinion that 70-80 percent of all births could potentially be normal births, but in India and many countries, the C section rates increased that pose a health risk also in few cases as unwanted interventions can pose risk to the lives of mother and child.

The WHO has noted with concern that maternal and perinatal deaths following C-sections are disproportionately high in low-income and middle-income countries.

* Lakshmana Venkat Kuchi wrote this article for The Sangai Express
The writer is a senior journalist tracking social, economic, and political changes across the country.
He was associated with the Press Trust of India, The Hindu, Sunday Observer and Hindustan Times.
He can be reached on kvlakshman(AT)gmail(DOT)com
This article was webcasted on April 25 2022.

* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.

  • ILP Check point at Jiri : Gallery
  • COVID-19 Status 27 June : Govt of Manipur
  • The untold story, lest it be forgotten
  • Assistance to victims of Assam Flood
  • A glimpse of 'Yangna Paikhredako Punshi'
  • Market innovations in developing country
  • COVID-19 : Impact in Manipur :: News Timeline
  • Anti-drug day expose state pathetic situation
  • The wedge amongst the Nagas
  • Coming of Manipur University in 1980
  • COVID-19 Status 26 June : Govt of Manipur
  • Laitonjam Lanchenba: Best Swimmer
  • Our capital Imphal - the city of sanity
  • Workshop : ND & PS Act, 1985
  • Mara Prabhu - Lord of the trees
  • Essence of international anti-drug day
  • July 1 : Taking the fight to plastic
  • Miss Shirui Lily 2022 #3 : Gallery
  • COVID-19 Status 25 June : Govt of Manipur
  • Flesh Trade : Connection between Goa & NE
  • Importance of Soil Testing & Management
  • ST status Vs Classical language for Meetei
  • Life, faith and belief
  • MANISFA General Secretary appointed
  • Flood Watch : 23rd June #2 : Gallery
  • COVID-19 Status 24 June : Govt of Manipur
  • Community led in ensuring HIV treatment
  • Approach to ideology & development
  • Solar Energy solution for healthcare facility
  • Yoga for health, beauty and immunity
  • Innovation Prize Launched for Designers
  • Knotty higher education sector
  • Classical language status and ST demand
  • Flood Watch : 23rd June #1 : Gallery
  • COVID-19 Status 23 June : Govt of Manipur
  • Birds and Bees Talk launched 3rd phase
  • Luck matters, Rio's first entry into cabinet...
  • Need to deal with dumping of waste materials
  • Training on mushroom at Nagamapal
  • 1961 as base year: Take it or leave it
  • 10 years too late : JCILPS
  • Phamnaiba Jagoi @ Thangjing : Gallery
  • COVID-19 Status 22 June : Govt of Manipur
  • Women's cleanliness enjoys equal rights...
  • Life in some hill villages
  • The MCI Restoration II
  • 'BRO Cafes' on 75 border roads
  • Protest over boundary row headache for Govt
  • Issues on the indigenous question
  • Drug Menace In Manipur : Gallery
  • COVID-19 Status 21 June : Govt of Manipur
  • ST tag for Meiteis - A perspective!
  • Manipur State Welfare : Politics 1-0 Citizens
  • International Yoga Day at Assam Rifles
  • International Yoga Day at IBSD Imphal
  • International Yoga Day at NSU Imphal
  • Manipur Lokyukta: Fighting against corruption
  • Vision to distribute local rice under NFSA...
  • Taking the fight to the drug menace
  • Landslides - Imphal-Jiri [Jun 17] : Gallery
  • COVID-19 Status 20 June : Govt of Manipur
  • Thangjing in folklore of Koireng tribe
  • Health Workshop on Diabetes at Pune
  • Everyone is a thief :: Poem
  • E- barton for CM & Governor
  • Intensive cultivation of vegetables
  • High time to encourage e-vehicle operators
  • Scripting success story with Rs 500
  • Leima Jagoi by Transgender #1 : Gallery
  • COVID-19 Status 19 June : Govt of Manipur
  • June 19 2022 : Father's Day message
  • Nine Hills One Valley : Ottawa Film Fest
  • Shirui Lily Festival or mud festival ?
  • Yoga for Women organised
  • Flight link to Mandalay dream come true
  • Action of Govt needs to be backed
  • 21st Great June Uprising #1 : Gallery
  • COVID-19 Status 18 June : Govt of Manipur
  • The Great June 18 Uprising :: News Timeline
  • Revive environmentalism in Meetei ethos
  • COVID-19 Status 17 June : Govt of Manipur
  • Elephant army of Lord Guruvayurappan
  • Who will be next at Rashtrapati Bhawan
  • Hiyang Tannaba @ Loktak #1 : Gallery
  • Freedom movement against British #2
  • Inequity and health security
  • Donating blood is an act of solidarity
  • Unregulated deposit schemes & BUDS Act
  • Extension of entry age : Agnipath
  • Citizens feeding on adulterated food items
  • Of food safety and street vendors
  • Pooja Elangbam, IAS, 81st ranker in AICS
  • COVID-19 Status 16 June : Govt of Manipur
  • NE Model @Delhi Kids Fest : Gallery
  • Manipur Rajkunja
  • Effective Legal Aid to Women Prisoner
  • How to avoid cracked heel during hot summer
  • Aid to artisan must to promote local product
  • Education for whom ?
  • Kabui Dance @Nongshaba Haraoba : Gallery
  • COVID-19 Status 15 June : Govt of Manipur
  • 'Let's Talk About It' : music album
  • Significance of World Environment Day
  • The MCI Restoration
  • North East CSR Award 2022
  • Prolonged sitting or standing spoils your leg
  • State fast-tracking towards drug making hub
  • 'Progression' from smuggling to manufacturing
  • Bonny Elangbam : Longest distance covered
  • COVID-19 Status 14 June : Govt of Manipur
  • Interaction with Makakmayum Hosni Mubarak
  • India to become $5 trillion economy
  • Exploring traditional medicines of NE
  • Freefall of the kids after COVID-19
  • Honour the tax payers, expose defaulters
  • NE needs more than 'unprecedented'
  • Miss Shirui Lily 2022 #2 : Gallery
  • COVID-19 Status 13 June : Govt of Manipur
  • Water management in paddy cultivation
  • PM Modi hails Nagaland Gaon Burahs
  • Blight of Nature :: Poem
  • Moreh as Las Vegas
  • NHIDCL's reputation at stake
  • Drugs, poppy & 'alternatives'
  • Thaopai Shithaine of Poumai #2 :: Gallery
  • COVID-19 Status 12 June : Govt of Manipur
  • Jadonang Park, Tamenglong :: Gallery
  • Freedom movement against British #1
  • Multi-Tasking Staff at Leima Traders
  • Toning down rhetoric that hurts religion
  • Shirui Lily fest brings to fore plastic menace
  • Conservation of pony & grazing fields
  • Kakwa Lairembi Haraoba #2 :: Gallery
  • COVID-19 Status 11 June : Govt of Manipur
  • The unheeded cry of children in labour
  • Why present distribution of urea fails?
  • World Day Against Child Labour 2022
  • Sunrise on the Civil Aviation Horizon
  • Arambam Samarendra Ningshingba :: Gallery
  • COVID-19 Status 10 June : Govt of Manipur
  • NE Ex-Super Model at Delhi Kids Fest
  • What Diphu has, Dimapur & Kohima don't
  • Towards Manipur Budget 2022-23 ...
  • NE Social & Behaviour Change inaugurated
  • Fighting corruption remains an uphill task
  • Environment needs more than tree plantation
  • SN Chand: The father of Manipuri cinema #3
  • COVID-19 Status 09 June : Govt of Manipur
  • Degree Certificate for Survival #2
  • Value chain management of Umorok
  • Pulses for Nutrition Security in Manipur
  • Keeping your skin oil free during summer
  • Demand for impartial probe into IMC scam
  • Politics of isolating the NSCN (IM)
  • Raas @Manipur Rajbari, W Bengal :: Gallery
  • COVID-19 Status 08 June : Govt of Manipur
  • A rare book on Birds of Manipur
  • Condemns bomb blast in Manipur
  • Market Innovations made America great #2
  • Jal Jeevan Mission : PHED Manipur
  • Disturbing data on lifestyle diseases in state
  • Tough talk against drug menace
  • Trekking to Shirui Peak, Ukhrul #2 :: Gallery
  • COVID-19 Status 07 June : Govt of Manipur
  • Take a leaf from sunderban if you're serious
  • Testimony of brother Ninghor Mahongnao
  • Local leaders unitedly push for One Health
  • Letters from the Republic of Dust #2
  • Soil testing for better crop production
  • Despicable threat to school
  • Outrage at Little Flower School
  • Ibudhou Thangjing Lam Thokpa #3 :: Gallery
  • COVID-19 Status 06 June : Govt of Manipur
  • India-Taiwan Global Bamboo Tech Forum
  • Condemns bomb attack at LFS
  • RSS chief sounds logical
  • Career options in Environmental Science
  • We reap what we sow
  • NRC in focus as keyboard warriors spar...
  • Coming together of COCOMI, UNC
  • HSE Result 2022 : Statistiscal Abstract
  • HSE Result 2022 : Subject Pass Percentage
  • HSE Result 2022 : District-Wise Pass %
  • HSE Result 2022 :Science Topper
  • HSE Result 2022 : Arts Topper
  • HSE Result 2022 : Commerce Topper
  • HSE Result 2022 : Science Stream Result
  • HSE Result 2022 : Arts Stream Result
  • HSE Result 2022 : Commerce Stream Result
  • COVID-19 Status 05 June : Govt of Manipur
  • Nagaland: Is it fair to blame Indrajit Gupta ?
  • 4th Plenary Session of WMC at Sugnu
  • World Environment Day at Tamenglong
  • World Environment Day at Lilong
  • World Environment Day at Haraorou
  • Musing :: Poem
  • Yet another World Environment Day observed
  • Mounting pressure for solution
  • Padmashree Award Moirangthem Muktamani
  • COVID-19 Status 04 June : Govt of Manipur
  • Congested road at Shirui Village :: Gallery
  • Degree Certificate for Survival #1
  • Admission for National Sports University
  • World Environment Day at Imphal
  • Include Meeteis in the ST list
  • Inhumane act of De-addiction centres
  • UK band Monuments @ShiRock #2 :: Gallery
  • COVID-19 Status 03 June : Govt of Manipur
  • 'Provocation' charges arrests on social media
  • Gerinda Loitongbam: Natl Women Award
  • Timeless Memories :: Poem
  • Ket Meth releases music video Trauma'
  • 8 years of Modi Govt: More hits than misses
  • Bad example commanders
  • Posers parents may raise within
  • Miss Shirui Lily 2022 #1 : Gallery
  • COVID-19 Status 02 June : Govt of Manipur
  • Letters from the Republic of Dust #1
  • Workshop on Food Processing at Lilong
  • 1st June is the Global Day of Parents
  • 'Developing human resource in Manipur'
  • Swachh Bharat Mission (Grameen)
  • 'Yoga for personality development' orgd
  • Row over boundary fencing project
  • Brain storming session of the Congress
  • Lunghar (Imp-Kohima / Jessami) #3 : Gallery
  • COVID-19 Status 01 June : Govt of Manipur
  • Delphi Oinam : Topper at Nagaland HSLC
  • Teaching at Churachandpur Govt College
  • Jadonang Park at Tamenglong renovated
  • Quality seed production of rice (HYV)
  • Audiobook for NEET aspirants launched
  • Naga issue: From bush war to shadow boxing
  • Tenants in Nagaland tag on the NSCN (IM)
  • Wakhom Leikai Lairembi Haraoba #2 : Gallery
  • COVID-19 Status 31 May : Govt of Manipur
  • Pageant winners showcase Robert's collection
  • MIFF to pay homage to Irom Maipak
  • Awareness on Legal rights of women prisoner
  • Election petitions galore in Manipur
  • Training program on mushroom at Nagamapal
  • Must expedite process for border projects
  • Wanted : A far sighted leader
  • Naga Indigenous Wrestling :: Gallery
  • June Calendar for Year 2022 : Tools
  • UK band Monuments @ShiRock #1 :: Gallery
  • Ibudhou Thangjing Lam Thokpa #2 :: Gallery
  • SN Chand: The father of Manipuri cinema #2
  • Licypriya speech at East Timor :: Gallery
  • On 200th Anniversary of MK Binodini Devi
  • Featured Front Page Photo 2022 #2: Gallery
  • Harvesting Fest of Tarao #4 :: Gallery
  • Id-ul-Fitr @Hatta Golapati :: Gallery
  • Rules of English Pronunciation : Download
  • Sub-Syllables in English : Book Download