Bangladesh government has taken many initiatives to reduce maternal and child mortality, and unsafe birth at home.
Though the government has already taken several steps to stop unsafe birth at home across the country; still, unsafe childbirth happens in rural area.
Concerned people say that, maternal death at childbirth is caused by bleeding, and seizure. Yet, these two reasons are completely preventable.
The tendency to have babies by a Caesarian-section is a large threat to maternal health. Normal birth is safe for mothers. About 14 pregnant mothers die every day while giving birth to children in Bangladesh due to different complications. This number stood at 5,473.
According to the latest report from the Demographic and Health Survey, 5,270 mothers die in the country every year while giving birth to 31 lakh children. That is, one mother dies per 600 child. Only 42% of these births are in the hands of a trained nurse.
The remaining 58% of pregnant women give birth with untrained midwives, and relatives. Among them, 63% give birth at home. Only 37% women deliver babies at clinics, and hospitals.
Doctors say that postpartum complications, and more than half of the deaths, happen due to delivery at home.
Salma Akter (not real name) is the mother of a fourteen-year-old girl of Bakshiganj upazila of Jamalpur.
While studying in class five, her parents got her married. At the age of 16, Salma gave birth to her first child. At the age of 19, she was pregnant again. She became pregnant for the third time at the age of 25. But during her third pregnancy, some complications arose. During all her deliveries, her husband called a local untrained midwife.
Salma did not reveal her problems to family members. She went to a village doctor because she suffered a lot of problems before 38 weeks of pregnancy. During her third delivery in the hands an untrained midwife, the baby was not delivered properly and her condition worsened.
Then, the untrained midwife recommended taking her to a doctor. After taking her to a rural doctor she was given an injection but her physical condition did not change.
Then her husband was asked to transfer her to the Upazila Health Complex. But she died on the road while going to the health complex.
Her husband said “During pregnancy, my wife did not have any check-up with a doctor. I did not make any arrangements for her delivery, rather called a local midwife. I lost my wife due to lack of awareness.”
'Save the Children' reported that 20% of married girls under the age of 15 years are already mothers of two or more children before the age of 24, which is causing the high death rate of mothers, and causing nutritional problems in the child.
Experts say that normal birth rather than cesarean-section, by a trained midwife, can reduce maternal and child mortality.
This correspondent talked to some trained midwives.
Rukia Malek is one of them, and she is also a member of Young Midwife Leadership (YML) program which is now working for Banaripara upazila Shastho complex, Barisal.
Earlier, most mothers and children died, but when some trained midwives joined here, this percentage had been reduced.
Midwives can provide counselling. Some NGOs including 'Save the Children' work in this regard. But they do not go door-to-door in the rural areas.
"Since people of rural areas are yet to be aware of pregnancy health, they do not even want to come to Upazila Shastho Complexes, so it is important to take steps to counsel them by going door-to-door," she said.
Midwife Momotaj Begum, President of national Executive Members of BMS said, one midwife should stay next to each mother for the safety of mother and child's health in Bangladesh.
"The Bangladesh Midwifery Society (BMS) has been working since the beginning of the Bangladesh Midwifery Service to make midwives more empowered, and more acceptable in the society," Momotaj Begum said.
This program had started fully from January 2013, even though the government had taken the initiative in 2010.
From 2013 to 2018 four batches of students had passed, and 1,148 midwives had been posted in different Upazila Shastho Complexes, and union sub-centers through PSC exam.
There are 55 government and non-governmental institutions across the country where three years midwifery diploma programs are offered.
