Caring for Two Lives: Q & A with a Midwife
“It is not an easy task to perform. I have [responsibility for] two lives at a time -- the mother and the baby,” says Aklima Begum, 48. Aklima lives in Bangladesh and is highly respected in her community.
Thanks to World Vision, Aklima was able to be educated and certified as a midwife. Midwifery is an extremely important skill for her community, since many families can't afford to see a doctor or stay in a hospital. The lives of mothers and infants are put at risk when they don't have access to proper prenatal care or a safe birthing environment.
Through her education in midwifery, Aklima is able to provide skilled care to mothers who would otherwise have to go without it.
As a midwife, can you explain the current or traditional birthing practices in your community?
In our community, women normally give birth in their house. Sometimes they are kept in a separate room that is especially prepared for the delivery. Other times, a woman arranges to give birth in their bedroom. In such cases, a local midwife plays the role of doctor.
If a mother’s condition becomes critical, we suggest sending her to the hospital or a nearby clinic. Sometimes, I also accompany the pregnant mother [to the hospital].
What is your role or responsibility to a pregnant mother?
I monitor the mothers whom I assist from the beginning of their pregnancy. I suggest that the woman eats nutritious food, drinks more water, takes extra food in the afternoon, and takes proper rest every day. I suggest that they go for a check-up at the World Vision center and government maternity center regularly when they become five months pregnant.
As they are poor, they cannot eat fish, meat, egg, or milk in their daily diet. I suggest that they add [a substitute food] in their daily diet so that it can meet her protein needs.
Tell us why you chose this job as your profession.
Actually, I was inspired by my mother. She worked in the hospital as an assistant to a nurse. I got a chance to stay there while she was working and observed her work. I realized its value to poor people and liked it so much. That’s why I chose to do the same job.
Does your community respect you?
I am proud to say that there are a few more midwives in this village, but people ask me to help them. They say that I work well and am also friendly. Moreover, they know I have gone to several trainings. That’s why they come to me with their needs.
Can you remember any significant cases?
Yes, I can remember one case where a pregnant mother was taken to the nearby clinic for delivery, but she escaped from there and came to me. The doctor there said that she needed surgery to deliver the child. You know, that baby was delivered normally in her house, and I [had] delivered it successfully without any complications.
Later, the doctor wrote about me in the local newspapers that an untrained village woman was illegally performing deliveries. Anyway, he could not do any harm to my reputation, as I could show them my midwife and traditional birth attendant certificates that I got from World Vision and the hospital.
I also delivered the woman’s second child later on.
Did you observe any changes after getting the traditional birth attendant training from World Vision?
Oh yes, I have made a lot of changes. For example, before getting training, I used to close all the doors and windows of the house during the delivery. Now, I make sure that there is an availability of light and air where delivery will take place.
Before getting the training, midwives like me kept wearing jewelery during the time of delivery. Now, before I enter the room for a delivery, I change my clothes and take off my jewelery. Before, I didn’t wear any hand gloves [and] didn’t cut my nails or wash my hands.
Now, I am serious about maintaining hygiene.
What kind of changes do you observe in mothers and family members?
I have seen a tremendous change in mothers and families, too. Before, family members insisted that mothers give birth in dirty places and on torn cloth…now, they are careful about hygiene. Before, people prevented the newborn from drinking the mother’s raw milk. Now, they have changed.
How much do you get paid for each delivery?
It’s their wish. Sometimes they give me 500 tk (U.S.$7), sometimes 800tk (U.S.$11). Sometimes, they even give me a sari as a gift. You cannot believe it -- in the last few years I didn’t buy any saris. All the saris I have are gifts from my clients.
How do you feel working in the community as a midwife?
I am very much proud and happy to do this work. It’s not only me; my husband is also proud of my service to the community.
He says: “You know, nowadays if you go to doctor for delivery, they will insist you do not do it normally. They suggest you have a surgery. It is quite difficult for the poor people to bear the cost of hospitalization and surgery. They are even afraid of doctors also.
"So they want to deliver with the help of the local midwife. People often need 10,000 to 12,000 tk (U.S.$140 to $168) to deliver in the hospital. Meanwhile, they can deliver with a midwife for 500 to 800 tk. I think villagers are benefiting from midwifes like Aklima.
"We are thankful to World Vision and such humanitarian organizations that are thinking about our children and women’s health by giving training to traditional midwifes."
World Vision is honored to be partnering with the 10X10 campaign, an effort aimed at moving individuals from awareness to action through World Vision's programs on the ground. We share a commitment to the global empowerment of girls through education.
The training that Alkima received is a health benefit to the women she serves. It also helps meet her family's needs and is a fulfilling career for her.