In the UK, when a woman first discovers that she is pregnant, she is referred to a midwife, not a doctor.
There’s a saying in the UK – ‘Every pregnant woman needs a midwife, only some need a doctor’. It is the midwife that assesses the pregnant woman and is responsible for pregnancy care, birth, and postnatal care.
On the other hand, deliveries in Indian hospitals are primarily carried out by doctors from the beginning.
“In hospitals where I have worked before, providing epidurals or cesareans was the norm. At Sitaram Bhartia, we have been working towards keeping medical interventions to the minimum and adopting the midwifery model of care,” says Sister Anju, Senior Nurse, Labour Room.
Listed below are key points of difference between the system of midwifery led care in the UK and India.
Midwifery as a Tradition of Practice
For a country with a rich history of midwives, or daimas, India lacks the strong tradition of practicing midwifery that the UK has established over centuries.
Pregnant women in the UK would not expect to see a doctor. The only women who expect to see a doctor are those who are unfamiliar with the midwifery model of care in UK hospitals.
Midwifery as a Preferred Choice
Most women in the UK prefer care from a midwife, as their model of care has lesser interventions in low-risk mothers. The midwives are highly trained to detect problems and refer them to a doctor if needed.
In UK, women develop a strong connection with their midwife through pregnancy. Instead of a clinical relationship they want a friendship – someone they can trust and rely on during their pregnancy journey.
Indian midwifery hasn’t evolved and developed enough for pregnant women to have much faith in the concept here.
Midwives and doctors work in tandem
After the initial risk assessment, midwives in the UK refer high-risk pregnant women (with pre-existing medical conditions, or risks from a previous labour or birth) to an obstetrician.
In high-risk cases, the doctors and midwife work together, and together participate in pregnancy care and checkups.
“At Sitaram Bhartia, the nurses and consultants work together towards the shared goal of helping expecting women deliver vaginally. Doctors are on stand-by, hands-off positions during deliveries as we assess and monitor labour to deliver the baby naturally,” says Nurse Anju.
Patience is key
Gill Perks and countless other midwives in the UK, strongly believe “If the mother and baby are well, then patience is all that is needed as labour takes time.”
“Patience is very important for natural birth, but many Indian hospitals use hormones or other medical interventions to speed up the process. This is one area Sitaram Bhartia strives to be different – they recreate an environment that is private, quiet, and provides one-to-one care in active labour.”
Emphasis on Midwifery Training
Unfortunately, India lacks the training and investment towards midwifery that one finds in Europe. In our setting, nurses receive limited training in midwifery which leaves them without the skill or confidence to deliver women independently.
Nurses in India have a few months of midwifery training included in their nursing curriculum, which limits the learning opportunities and content.
In the UK, midwifery is a commonly accepted practice by professionals and the public alike. Obstetricians and midwives work together towards the common goal of reducing caesarean rates and promoting natural birth.
The story has been authored by Gill Perks, consultant mid-wife and Rinku Sengupta, Head of Maternity Program at Sitaram Bhartia.