Photo Gallery Turning to Midwives to Reduce Maternal Mortality
Giving birth in a state hospital in Hyderabad, India. It is rare in the country that a trained midwife is there to attend births, but the Indian government would like to change that.
The child finally arrives at 1:10 a.m. It's a boy. Rekha Marandi, a 25-year-old midwife, places the newborn under a warming lamp.
Rekha and her colleagues are among the very few trained midwives in India. They received their training in a private clinic. On the weekends, they do night shifts here at a state hospital.
The maternal mortality rate in India is high, with 32,000 women dying each year as a result of pregnancy or childbirth, with most of those deaths occurring as a result of blood loss or infections.
According to the World Health Organization (WHO), it would be possible to cut the maternal mortality rate by more than 80 percent if comprehensive care from midwives were available.
Rekha on her way to her night shift at the state hospital. Thus far, there has been a lack of awareness in India for what exactly trained midwives do.
Family members are not allowed into the maternity ward of the state hospital in Hyderabad. Many of them sleep on the steps outside.
Outdated rules and convictions still shape the approach to giving birth in many Indian hospitals: A woman shouldn't walk during labor; she shouldn't drink any water; and she should deliver while lying on her back.
There are numerous reports of doctors and nurses insulting mothers during birth, or even pinching them and hitting them on the legs with forceps.
A mother with her newborn. In the Indian tech capital of Hyderabad, politicians, gynecologists and midwives have been fighting to improve maternal care.
In 2011, Evita Fernandez began training nurses in her clinic to become midwives. Now, every third birth in the clinics she runs is attended by a midwife. The number of Cesarean sections has halved since then, Fernandez says.
The trend back toward natural births has also been evident among more affluent couples, with a growing number of young, educated parents opting for alternatives like birth centers, which have thus far been in short supply in the country.
Ravali (left) and Phani Garimella are also planning to have their second child in the Sanctum birth center in Hyderabad.
Ravali Garimella at a pre-birth checkup with a midwife.
