International Midwives Day 2018: Midwives leading the way with quality care

Growing up, Saima Begum did not wonder what career she would pursue. Her father wanted her to be a health professional, and she followed his wish. She thought she would be a paramedic like her aunt, but upon learning of BRAC University’s midwifery course, she chose that instead.

Two years ago, Saima was a fresh graduate, aged 23, working her first job as a midwife at her local upazila (sub-district) hospital in Sylhet. Although her internship had proved she was competent, she still lacked experience.

One night, at 2am, she was thrust into a life and death situation. A woman in labour arrived in distress, crying she had not felt the baby move for two days. Saima felt for a heartbeat. The baby was alive, but barely. The foetal heart rate was low, and Saima worried she would not be able to deliver the baby. She was alone on duty, with no medical officer or other nurses present.

“I told the mother it was best to refer her to the main district hospital, but she refused to go”, recollects Saima. “She told me ‘No, I will either give birth here, or I’ll die here, but I won’t go anywhere else.”

Saima Begum checks a young mother’s blood pressure.

The grandmother then told her, “If you are forced to choose, save my daughter’s life over the baby’s.” Saima was determined they both would live. She called the medical officer, who said it would take him a while to arrive, and then did what she was trained to do.

Shortly after, a baby boy was born. Alive. But he did not cry, or move. Saima thinks back, “I quickly began massaging him, but while doing so, the mother went into post-partum haemorrhage.”

Rushing to the mother, Saima removed her placenta, after which she stabilised. When she turned back to the baby, he had died.

Later that morning, the mother haemorrhaged again. Once again, Saima was able to save her life.

“That day, I knew that God had guided me to be a midwife.”

Now based in Dhaka, she occasionally sees the mother when she visits Sylhet. “To this day, every time she sees me, she thanks me for saving her life. If she didn’t come to the hospital, she would have died at home.”

Saima is one of BRAC University’s 400 midwife graduates. Bangladesh is on a drive to train more midwives, a step seen as critical to reducing the maternal mortality rate. The country’s ratio of home deliveries vastly outnumber births at health facilities. In rural areas, it is estimated only 20% of women give birth with a skilled birth attendant present. On International Day Of The Midwife, we honour women who are saving lives.

Bibi-Aisha Wadvalla is a communications manager of BRAC’s health, nutrition and population programme.