Source : INDIA TODAY NEWS
Avni had imagined many things about becoming a mother. But what she did not want was to spend the most intense hours of her life surrounded by people she had never met, under bright hospital lights, with strangers walking in and out of the room while she tried to bring her baby into the world.
She wanted something more familiar. Her husband beside her, a calm environment, someone who knew her pregnancy and understood how she wanted to approach labour. And most importantly, she wanted a trained professional who would not just arrive when the baby was ready to be born, but stay with her through the journey.
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That conversation is becoming increasingly familiar among expecting couples. Childbirth is no longer being discussed only in terms of one question: normal delivery or C-section? Couples are talking about birth plans, pain relief, breastfeeding, postpartum recovery and how involved the husband should be. Some women are also asking whether a midwife could be the person supporting them through pregnancy, labour and the weeks after birth.
For a generation that has grown up associating childbirth with an obstetrician and a hospital delivery room, the idea of a midwife may sound almost old-fashioned. But the modern midwife is a trained healthcare professional who specialises in normal, low-risk pregnancy, labour, birth and postnatal care.
Dr Sarada M, Senior Consultant Obstetrician & Gynaecologist and Midwife at Yashoda Hospitals, Hyderabad, says she has noticed growing interest among women in more natural and personalised approaches to childbirth, including questions around planned home births. Concerns around unnecessary medical procedures, particularly C-sections, hospital costs and increasingly medicalised childbirth are influencing some of these conversations. Social media, online communities and WhatsApp groups are also playing a role.
But wanting a midwife does not automatically mean wanting to give birth at home. That distinction is important. Midwife-led care is primarily a model in which a trained midwife takes the lead in caring for a woman with a low-risk pregnancy, while an obstetrician and emergency facilities remain available if complications develop.
The bigger shift may therefore be less about women moving away from hospitals and more about wanting someone to stay with them while they are there.
THE PERSON WHO STAYS WHEN EVERYONE ELSE IS BUSY
A hospital can provide everything a woman may need if something goes wrong: an obstetrician, anaesthetist, operating theatre, blood bank and newborn care. But having access to medical expertise does not always mean having one familiar caregiver continuously beside the woman throughout labour.
The doctor who sees her during an antenatal appointment may not necessarily be the one present when labour begins. The nurse on duty may change. Another doctor may be called if the situation becomes complicated. For a woman in labour, that can make an already overwhelming experience feel even more unfamiliar.
A midwife-led model tries to offer something different: continuity. A trained midwife can remain involved during pregnancy, help the woman prepare for labour, monitor her and the baby, provide physical and emotional support during contractions, assist with a normal vaginal birth and continue to care for her after delivery.
Dr Sarada describes the role as a continuum that includes antenatal monitoring, tracking the baby’s growth and heartbeat, preparing the woman for labour, supporting her during birth and helping with breastfeeding and maternal recovery afterwards.
That last part may be particularly important because childbirth does not really end when the baby arrives. Once the excitement settles, the mother is often left dealing with pain, bleeding, exhaustion, breastfeeding and sleepless nights while everyone around her focuses on the newborn.
For some women, the appeal of midwifery is therefore not simply the promise of a natural birth. It is the possibility of having someone who knows them stay involved even after the baby has arrived.
IT IS NOT ABOUT REPLACING THE OBSTETRICIAN
The growing interest in midwifery does not mean women are choosing between a midwife and an obstetrician. In a properly organised system, the two roles work together.
Dr Snehal Patil of Tanaya Nursing Home, Bandra, describes a professionally trained midwife as an autonomous care provider for normal pregnancy, labour, birth and the postnatal period. For a low-risk woman, she says, a trained midwife can safely conduct the birth when there is a clear referral pathway and obstetric backup.
That backup becomes crucial when pregnancy or labour moves outside the normal pathway. Conditions such as pre-eclampsia, multiple pregnancy, breech presentation, placenta previa, significant anaemia, foetal growth restriction and major medical illnesses may require obstetric-led care.
Even a pregnancy that begins as low-risk can change during labour. That is why the safest model is not simply about finding a skilled midwife. It is about having a system around her that can respond quickly if something goes wrong.
Dr Raju R. Sahetya, Obstetrician & Gynaecologist and Founder of Pushpaa Hospital, makes the same point: risk can change during pregnancy or labour, which means a midwife-led model needs clear referral pathways and access to specialist care.
The ideal picture is therefore not a midwife replacing a doctor. It is a midwife leading care when everything is progressing normally, with an obstetrician ready to step in when the situation demands it.
WHY THE C-SECTION CONVERSATION MATTERS
The renewed interest in midwives is also arriving at a time when India continues to debate its C-section rates. For expecting parents, the concern is not necessarily about C-sections themselves. A C-section can be lifesaving when medically necessary. The bigger concern is whether any intervention is needed.
Dr Sarada says some women seeking more natural approaches are particularly concerned about unnecessary medical procedures and C-sections.
Midwifery cannot and should not promise to eliminate C-sections. Instead, the idea is to allow normal labour to progress physiologically in women who are suitable for that model, while avoiding interventions that may not be necessary.
Dr Sahetya points to evidence from a 2024 Cochrane review involving 17 randomised trials and more than 18,000 women. He says midwife-led continuity of care was associated with fewer C-sections and instrumental deliveries, more spontaneous vaginal births and a more positive experience of pregnancy and birth.
Dr Patil similarly highlights fewer episiotomies and instrumental deliveries, along with greater maternal satisfaction.
The point is not to turn midwife-led care into another side of the C-section versus normal delivery debate. The larger question is whether low-risk women can receive less intervention and more continuous support without losing access to emergency medical care when they need it.
AND THEN THERE ARE THE HUSBANDS
There is another quiet change happening alongside the conversation about midwives: husbands are becoming more involved in childbirth.
For years, childbirth could feel like an experience in which the woman entered the delivery room while everyone else waited outside. Today, many couples are preparing for birth together. Husbands are attending antenatal appointments, reading about labour and pain relief, learning about breastfeeding and thinking about how they can support their partners after delivery.
A continuity-based model can make that involvement feel more natural. The partner is not simply waiting for the doctor to announce that the baby has arrived. He can be involved in preparing for labour, supporting his partner during contractions and helping her navigate the first weeks with the newborn.
That matters because childbirth is not simply the moment a baby is delivered. It is the beginning of a completely different phase of family life, and the mother’s recovery is part of that story too.
POSTPARTUM CARE IS ENTERING THE CONVERSATION
For many women, the first few weeks after childbirth can be physically and emotionally demanding. There is recovery from labour, breastfeeding, sleep deprivation, bleeding, pain and the constant adjustment of caring for a newborn.
Yet postpartum care can sometimes become secondary once the baby arrives. The focus shifts immediately to whether the newborn is feeding, sleeping and gaining weight, while the mother’s recovery gets less attention.
Midwifery places the mother back at the centre of that conversation. Because the same professional may have been involved during pregnancy and labour, she can also help the woman navigate breastfeeding, recovery and the early postnatal period.
This continuity is one of the reasons the model is attracting interest among couples who are thinking about childbirth as a longer journey rather than a single event.
IS THIS BRINGING HOME BIRTH BACK?
The renewed interest in midwives has also revived conversations around planned home births. Dr Sarada says she has noticed women asking about them, particularly in cities and semi-urban areas, but cautions against confusing professionally trained midwifery with the traditional home-birth system associated with dais.
A home birth can offer privacy, familiarity and freedom to move, eat and choose comfortable positions during labour. But the major concern is what happens if an emergency develops suddenly.
Heavy bleeding, fetal distress, prolonged labour, infection, high blood pressure or placental complications may require immediate hospital treatment. Some emergencies can develop with very little warning, making rapid access to specialist care critical.
That is why midwife-led care and home birth should not be treated as the same thing. A woman can choose midwife-led care while giving birth in a hospital or a setting where emergency obstetric support is readily available.
For India, the more interesting question may therefore be whether some of the intimacy and continuity associated with home birth can be brought into a medically equipped maternity setting.
IS THE MIDWIFE THE NEW FACE OF CHILDBIRTH?
Perhaps not. And that is what makes the conversation interesting.
The future of maternity care may not be about replacing one professional with another. It may be about changing who does what, and when. A woman with a low-risk pregnancy may have a midwife who knows her, understands her preferences and stays beside her through labour and recovery.
If something changes, she should not have to choose between personalised care and medical safety. The obstetrician should already be part of the system, ready to step in when needed.
India has already taken steps towards formalising midwifery through specialised training and the Nurse Practitioner in Midwifery cadre. But gaps remain in the number of trained professionals, regulation, career pathways, private-sector adoption and awareness.
Awareness may be the biggest challenge of all. For many Indian families, the word midwife still brings to mind a traditional dai. The modern midwife is something very different: a trained professional whose expertise lies in supporting normal pregnancy and birth while recognising when a woman needs specialist medical care.
She is not the person replacing the doctor. She may be the person making sure the woman does not feel alone when the doctor is not needed.
And perhaps that is why this old profession is finding a new audience.
Not because parents want to reject modern medicine, but because after years of increasingly medicalised childbirth, some are beginning to ask for something that can feel surprisingly simple: more time, more continuity, more trust and someone who remembers the mother even after everyone else starts looking at the baby.
– Ends
SOURCE :- TIMES OF INDIA
