While countries that have a strong midwifery workforce have already recognised the perks of collaborative care, clinicians like Dr Triveni have now begun to acknowledge and appreciate midwives in India. On the institutional front, Dr Triveni Jennu, MS in Obstetrics Surgery and Gynaecology says that midwifery is meant to support doctors. She insists that it is a relief to gynaecologists and obstetricians as it helps them concentrate on complicated pregnancies.

Dr Triveni first heard about the concept of midwifery in 2020 when the midwifery-led unit was started at the Area Hospital in Gajwel. Two clinically trained midwives were posted at the hospital to train other nurses.

She works closely with midwives on high-risk pregnancies that need collaborative care. For the rest of uncomplicated cases, midwives work closely with the mothers to help them have a positive birthing experience. She observes the excellent work that midwives are doing and how this is making mothers happy and empowered. She is convinced that midwives are best placed to work with mothers with low risks in their pregnancies. Women are finally getting the respectable care that they deserve. She says, “I wish I had birthed my children with the support of a midwife.”

She believes that midwives are extremely essential to India’s healthcare system and appeals to the government to train midwives and post them at all hospitals across the country. She specifically wants all the periphery centers to have a robust midwifery workforce so that all low-risk pregnant women living in rural areas can have access to a midwife.

Dr Triveni recounts a case where a normal pregnancy led to the mother needing a cesarean. In the remote area of Gajwel, early in the morning, she was the only one on duty and the midwife present at that time helped her take the stress and burden off by working in perfect harmony with her. A healthy baby was born, and the mother was happy that she had a good birth experience despite the last-minute, unexpected change.

If there is a high-risk case and a normal case of pregnancy at the same time, the obstetrician can devote time to the high-risk mother. In doing so, midwives and doctors share the responsibility, and the mother is benefitted. Not just Dr Triveni but also the institution she works with is very supportive of the idea of collaborative care. There is cooperation and obedience from both sides. Obstetricians and gynaecologists at the Area Hospital in Gajwel recognise midwives as equals.

Collaborative care is of utmost importance because some women face medical difficulties related to their health or the health of their baby. Obstetricians are overworked and need to focus on high-risk pregnancies while low-risk mothers are handled by clinically trained, competent midwives. World over, obstetricians have vouched for midwives as their trusted colleagues. In India, too, this is beginning to happen. Obstetricians have started to understand the benefits of midwifery and the value of collaborative care. There is a growing realization that India needs more midwives to meet the healthcare needs of its growing population.
Dr Haripriya Rayapudi is one among many clinicians who is an advocate of midwife-led care for pregnant women. She is a compassionate clinician who works as a civil surgeon and medical superintendent at Vanasthalipuram’s Area Hospital in Hyderabad. During her tenure as a gynecologist, she had very few interactions or associations with midwives. Ever since she began working closely with midwives, she has experienced positive impacts of collaborative care. She is starting to have great admiration for the efforts that the midwives put in.

She credits them for being a pillar of support to the mothers and the babies. In her opinion, midwives are a blessing to government hospitals that are usually understaffed. Midwives share the workload and give humanized care to mothers who are often ignored by busy nurses and doctors. She says, “Midwives handle things as good as an obstetrician would. They bring in the human touch!”

She emphasizes on how the midwives are there with the mother through all the stages of pregnancy and birth. They counsel the mother and stand by her throughout the birthing journey. This makes it easy for obstetricians to concentrate on high-risk pregnancies while midwives take care of low-risk mothers. She says that midwives are an indispensable part of the workforce as they assist the mother and respect her choices and preferences. Collaborative care allows enough time for the obstetricians to attend to other important clinical and non-clinical tasks.

She hopes that the government recognizes this on a large scale and wishes for more midwives to be inducted into medical institutions all over India.