International midwifery educators training midwives at Fernandez Foundation. ©Fernandez Foundation

India records 25 million births each year, out of which 2.7 million babies are stillborn, and 0.56 million babies die during the first month of their life. Thirty-five thousand women die of pregnancy-related complications. Most of these deaths occur during childbirth and are preventable with the presence of a skilled midwife. The Lancet series on Midwifery (2014) revealed, midwives trained to international standards can avert 83 per cent of all maternal deaths, stillbirths, and newborn deaths. However, India needs to train and deploy thousands of new midwives to meet its needs. This is a question of training capacity, public expenditure, and a race against time. There is an opportunity here for experienced midwives from across the world to come and help us establish this professional cadre in India.

India’s maternal mortality ratio remains high even though institutional births have increased. Today, nearly 90% of all births take place in health care institutions. An unfortunate outcome of institutional births is the strong medicalized birthing environment. This has led to an unacceptably high caesarean birth rate (21.5% of total institutional births) both in private (47.4%) and public facilities (14.3%) (NFHS 5, 2019-21). WHO considers the ideal rate for caesarean sections to be 10-15%.

Professional midwifery is a multi-pronged approach to address the range of issues plaguing childbirth and maternal health in India. However there is an acute shortage of trained midwives—and just as importantly, there is a shortage of skilled and experienced trainers. This is a chicken and egg issue: unless a critical mass of clinically experienced midwives becomes available, it will be hard to find good trainers.

The PROMISE campaign

The Professional Midwifery Services (PROMISE) campaign strives to make birthing safe for Indian mothers. It embodies the promise of humanized, evidence-based, and respectful care for childbearing mothers irrespective of caste, creed, or religion. The campaign has four clear objectives:

• make pregnancy safe
• humanize births
• train a midwifery workforce
• promote midwifery

India needs midwifery trainers. ©Fernandez Foundation 

The PROMISE campaign delivers on these objectives by focusing on training and capacity building of nurses as professional midwives.

The campaign aims to train midwives and also build up a national cohort of midwifery educators. PROMISE runs the Nurse Practitioner in Midwifery (NPM) course for nurses in the public sector. The NPM course is designed to train registered general nurses with global standards of knowledge, skills, in providing highly quality midwifery led care to mothers and neonates. It also runs a Midwifery  educator’s programme to help build a national cohort of midwifery educators and trainers An excellent example of PROMISE’s outreach is its support to the 18-month Midwifery training programme run by the Indian state of Telangana. The PROMISE campaign aims to train for India, 10,000 midwives by 2032.

The Fernandez Foundation spearheads the PROMISE campaign. The Foundation runs a tertiary referral perinatal centre, the Fernandez Hospital, with 320 beds and an annual birth rate of 10,000. Based out of Hyderabad in the southern Indian state of Telangana, the Foundation is a crucial player in promoting midwifery services across India.

Work with us

There is an urgent need for midwives in India to provide women-centred, respectful, kind, and compassionate maternity care. The Foundation is looking for experienced midwives who can work with us to train and establish this new cadre of professional midwives across India.

If you are interested, do get in touch.

Write to us with a short letter of intent and a brief resume at midwifery@fernandez.foundation or WhatsApp us on +91 7995566001