Tips for Prevention and Early Diagnosis of Breast Cancer

Among Indian women, breast cancer ranks high in prevalence. An alarming number of young women are being diagnosed with it, and India is predicted to soon have the world’s highest annual incidence rate.

Diagnosis of Breast Cancer

What can you do to protect yourself from this disease?

  • Exercise: Women who exercise for 30 minutes, three to four times a week, lessen their chance of developing breast cancer.
  • Breastfeeding: Reduced risk of breast cancer is associated with breastfeeding.
  • Maintaining a Healthy Weight: Women with a weight gain of more than 25 kg from their weight at age 18 have a higher chance of developing breast cancer than women who have kept a stable weight.
  • Weight Loss after Menopause: Women who lost 10 pounds or more after menopause compared to their weight before menopause had a lower chance of getting breast cancer.
  • Refrain from drinking alcohol: Studies have shown that women who have even one or two drinks per day significantly increase their chance of developing breast cancer. Drinking any amount of alcohol raises endogenous oestrogen levels, which may contribute to the onset of breast cancer.
  • Eat Right: Antioxidants are helpful, therefore eating lots of different fruits and vegetables (at least two cups worth) is recommended. Plant meals are rich in minerals, vitamins, and phytochemicals, and there is evidence that these compounds work together to increase an individual’s natural resistance against cancer. Whole grains, beans, berries, papaya, carrots, melons, cruciferous vegetables (broccoli, cauliflower, cabbage, brussels sprouts), dark leafy green vegetables (spinach, mustard greens etc.), peppers, flaxseed, garlic, grapes/grape juice, green tea, soy products, and tomatoes are all excellent choices for lowering one’s risk of developing cancer.

Brest Cancer Screening

Screen Regularly

If detected early, breast cancer may be treated successfully in 100% of cases. Early detection of breast cancer can be achieved by self-examinations once a month, annual medical exams, and mammograms. A monthly self-breast exam is recommended beginning as early as age 20. If there is a history of breast cancer in the family, screenings should begin early.

Understanding how to screen for breast cancer is important. Changes in breast size or shape, the appearance of lumps in the breasts or underarms, or unusual changes to the skin or nipple should prompt a trip to the doctor.

 

10 Ways to Prepare for a VBAC

If you had a previous C-section birth, it is natural to assume that all subsequent pregnancies will also end up in a C-section. You may be oblivious to the possibility of experiencing a natural birth the next time. You might be afraid of uterus rupture and further harm to yourself. The scars from your surgery may have been more emotional than physical. But what if we tell you that you can put all these apprehensions at rest? You don’t have to undergo a C-section every time you give birth. Any kind of harm to your uterus is rare, traceable, and preventable. You can hope, plan, and work towards experiencing – a normal, physiological birth.

‘Vaginal Birth After Cesarean Section’, also known as VBAC, brings much hope for mothers. Simply put, it means giving birth through your vagina after previously having undergone a cesarean section.

Ten aspects of a successful VBAC

A successful VBAC is usually associated with fewer complications than a repeat C-section. Doctors and midwives will help you prepare and opt for it based on your health and pregnancy. While you can’t control every element of it, here are ten aspects you can focus on to increase your chances of having a successful VBAC:

  1. Work towards a healthy lifestyle even before you plan your pregnancy.
  2. Attend a pre-pregnancy counselling session with your doctor and midwife.
  3. Make sure you do not have any nutritional deficiencies or severe medical issues when planning a pregnancy.
  4. Eat right and stay active throughout the pregnancy.
  5. If you are anaemic, diabetic, or if you develop hypertension, work with your doctor and midwife collaboratively on resolving these health issues during pregnancy.
  6. Talk to your doctor or midwife and provide details about your previous birth.
  7. Identify your VBAC eligibility and seek the best possible support from your doctor or midwife.
  8. Stay in regular touch with your care provider once you prepare for a VBAC.
  9. Choose a facility that is well equipped to run a dedicated clinic for women considering a VBAC.
  10. Ensure your doctor or midwife continuously monitors your baby’s heart rate.

Benefits of a VBAC

Studies show that vaginal births after Caesarean sections have a success rate of 60 to 80 per cent. VBAC helps you avoid risks associated with multiple C-Sections. The benefits of VBAC also include:

  • Less blood loss and a reduced chance of infection.
  • Shorter hospital stay.
  • Quicker return to daily activities.

When you undergo a C-section, it’s not just a cut through your belly. There’s a surgical cut going through your uterus as well. The obstetrician will lift your baby out of these deep incisions. Unlike this elaborate clinical process, a natural, vaginal birth involves no surgery. Therefore, you avoid the possible complications of surgery.

The best part about a VBAC is that it’s also great for your baby. Birthing through the birth canal results in your baby receiving natural microbiomes; your baby also benefits in other ways such as:

  • Immediate skin-to-skin contact.
  • Better maternal-infant bonding and early initiation of breastfeeding.
  • Successful lactation influencing cognitive development.
  • Better immunity against diseases.

Stay flexible and continue discussing the risks and benefits of VBAC throughout your pregnancy. Your actual birth experience will never be entirely in sync with what you planned or expected. But prepare for what you desire and let your doctor or midwife hold your hand through it all.

Call our dedicated VBAC Clinic numbers to book an appointment

  • Hyderguda: 79956 66 114
  • Bogulkunta: 79956 66 003
  • Banjara Hills (Stork Home): 83740 06 868

 

5 Tips to Stay Healthy during a Monsoon Pregnancy

Monsoon is perhaps one of the most awaited seasons as it brings relief from the scorching summer heat. However, for pregnant women, monsoon may not be as relieving as is assumed to be. The high humidity and the chances of certain infections may bring in discomfort.

But pregnant women can make the best of monsoon by taking some special care and making some changes in their lifestyle.

Here are five tips to make your monsoon pregnancy a comfortable one:

  1. Clothes
    As the humidity increases during monsoon, people tend to sweat more than summer. Moreover, pregnancy leads to fluctuation in body temperature. So, to stay comfortable, wear cotton clothes that are a size bigger. Cotton will absorb the sweat easily and keep you dry.
  2. Personal Hygiene
    Hygiene is one of the most important factors to remain free from infectious diseases. As monsoon brings rain and the water gets dirty due to sewage, mud etc., it may lead to variety of infections. So, don’t go outside barefoot during pregnancy. Stay indoors as much as possible and if you have to go out, make sure to wash your hands and feet with mild disinfectant soap immediately after returning home.Take bath with Neem water at least once every day during your monsoon pregnancy. It will help prevent various skin problems.
  3. Keep your Home Clean
    It is important to keep your home free from infection. Use good quality mild disinfectants to clean the floors and bathroom. You can even burn dried Neem leaves to keep away flies and mosquitoes.
  4. Stay Hydrated
    During pregnancy, it is very necessary to stay hydrated. Drink plenty of water and make sure to have filtered water only. Unfiltered water carries lots of germs causing varied health problems.
  1. Eat Healthy Food
    Stay away from street foods during monsoon. In fact, avoid having street in general as it may carry different types of germs. As your baby in the womb will receive nutrients from the food you eat, have a healthy and balanced diet.

Follow these to avoid unwanted health concerns during the monsoon season. If you feel severe discomfort, do consult your obstetrician. Have an enjoyable pregnancy journey!

Fernandez – Built for Birthing

Dr Pramod, CEO and Dr Evita Fernandez, Chairperson, Fernandez Foundation with the new brand identity

“Nothing is more powerful than an idea whose time has come.”

– Victor Hugo

 

In 1948, Lourdes and Leslie—our founders—stepped into the unknown when they set up a two-bed maternity practice in a bustling corner of Hyderabad. That practice took shape with values that have stood the test of time. Life comes from God; respect life. Service, always, before self. Do what is right, and never let the lack of money turn a patient away. Stay honest: with finances, patient care, and with employees. These values coalesced into the Fernandez Foundation’s abiding principle: compassionate, respectful care. While we celebrate all that is new and necessary, we must remind ourselves of timeless values and our commitment to the mother and her newborn.

The mother-baby dyad

By 1985, the founders had handed over the reins of a hospital that had grown to 40 beds. The facility provided a range of care: ENT, orthopaedics, general surgery, medical and maternity services. However, the hospital’s calling was in maternity and newborn care. The hospital rebuilt its services around the mother-baby dyad with a renewed sense of purpose. It began its transformation into a one-stop centre for meeting every pregnant woman’s and newborn’s needs. The Fernandez Hospital built its first level 3 Neonatal Intensive Care Unit (NICU)in 1996. It was the first for any private maternity hospital— a practice now taken for granted in all maternity hospitals. By 1996, the Hospital serviced 100 beds. In another four years, we had grown to become a tertiary, perinatal referral centre.

This growth and transformation were also visible in our brand and colours: From Stork Home in the 40s, we became Fernandez Dawakhana. In the 1990s, Fernandez Hospital Pvt Ltd was set up but ploughed back all profits. In 2018 all activities were brought under the canopy of Fernandez Foundation, a not-for-profit company. The hospital’s external transformation reflected our evolving sense of the allied services that a mother and her newborn need. The deep trust mothers place in our practices has remained unshaken—and has only grown over all these years. Our clinical approach is rooted in respectful, equitable and high-quality care. It does not discriminate on any basis. The Fernandez Hospital focuses on facilitating a joyous, blissful moment that mothers can cherish for the rest of their lives.

A new dawn

Childbirth the world over is facing a crisis. It has become overly medicalised. Caesarean sections and birth inducement is coercing mothers into options that remove their agency and comfort. For a while, it seemed as if the medical practice had forgotten that childbirth was a natural event and that mothers were the primary drivers of this blissful journey. The Fernandez Hospital had an informed position, rooting firmly for the mother and her freedom. We began building a unique cadre of professionals—midwives—to help prevent avoidable maternal and newborn deaths. Midwifery, in turn, brought us back to woman-centred respectful care. A midwife offers a mother the highest quality of care in an environment where compassion, respect, dignity, and privacy are central. This transformed us again and put us on a fresh, new path.

So, in our 75th year, we have donned a new set of colours, typefaces and designs that radiates this refreshed, renewed commitment to care. It took us many months of internal discussion and dialogue with our several well-wishers and supporters. The incredibly creative team at Cracker & Rush, led by Ashutosh, Ruhi, and Richa, helped us break out of our chrysalis. This trio brought into focus our 75-year journey in the new, simple but vibrant logo. We share our joy with the world—and with all mothers and their newborns who bustle through our many doors.

 

Our new tagline refers to our founding principle: “Make birthing a blissful experience for every mother.” One where the mother feels the joy of the life she ushers into this world. The new logo reflects the hospital’s compassionate care to the mother and the newborn under our watch. The Yellow is the yellow of sunshine, joy, and our service’s warmth. This new look is a fresh and contemporary encoding of the values of our founding and daily practice. As you walk into our doors, we hope you will look up, look around, and break into a smile.   

 

Water Birth Wonders

4 blissful benefits of Water Births.

“Water Birth is the best option for a normal delivery. Giving birth to the baby becomes easy. Labour pains become bearable and manageable. I was comfortable throughout the whole process.” – Mrs Sowjanya

“If it was not a water birth, I don’t know how I would have handled the pain. Warm water helped me feel relaxed and in control.” – Mrs Asisha

“Being in water was really calming. The whole birthing experience was smooth and peaceful. I don’t think I could have gone any other way.” – Mrs Stuti

It is no surprise that pregnant women are drawn to the idea of giving birth in water. Water Birth is exactly what it sounds like. Birthing. Your Baby. In Water!

Wondering why Water Births are that good? Here’s listing out the four blissful benefits of Water Births.

  • Serene and Relaxing

Warm water has always been a source of serenity and relaxation. When used for birthing, it presents an entirely different world of benefits for pregnant women.

The warm water in the birthing pool not only “feels nice” during labour, but also leaves a calming impression on your mind. A mind that’s free from worry, anxiety and fear has more room for positive birth affirmations.

Going by the testimonials of mothers who’ve opted for Water Births at Fernandez Hospital, we can vouch for the fact that:

– You feel a sense of serenity and calmness inside the birthing pool

– Warm water in the pool makes labour pain bearable

  • Flexible and Liberating

When you are about to birth your baby, your body is under extreme strain. What is usually a strenuous phase, turns into a calming experience. It is almost therapeutic – all thanks to the warm water in the birthing pool.

Floating in water helps you move around easily. You experience flexibility that cannot be achieved on ground. The liberty of movement is quite unmatched to any other birthing method.

Being in a pool filled with warm water is an option that you can use in entirety or in parts – throughout the course of your labour. You can, at any point in time, get out of the birthing pool if you don’t like it in there. Having said that, there’s a great chance of you loving your Water Birth experience and never wanting to get out.

  • Ease and Comfort

In a birthing pool, you enjoy the much-needed sense of weightlessness. It is extremely relieving after having gone through the 9 months of your-baby-in-your-belly. And guess what ensures more ease and comfort? – According to studies, being in warm water shortens the duration of your labour! Incredible, isn’t it?

Midwives who assist you through your Water Birth are clinically trained and competent. You’d be amazed, they can even check the baby’s heartbeat while you’re inside the pool. Yes, they have their ways. And you have to worry about nothing.

  • Warmth and wonder

We’ve established how the temperature of the water lessens labour pain and makes you feel calm. What’s remarkable is that your body produces less adrenaline because of that.

Low levels of adrenaline make way for oxytocin and endorphins – the “feel-good” hormones. Bubbling in good hormones, you’re sure to feel happiness, warmth, and wonder.

Water Birth is equally good for your baby who will love the transition “from the warmth of your womb – into a pool of warm water”.

You can opt for a Water Birth if….

-You are a low-risk mother

-Your baby is positioned head down

-You’ve had no complications during your pregnancy

At Fernandez Hospital we welcome and encourage your partner to be by the birthing pool, holding your hand fondly. The midwives help you explore all birth positions. Once your baby is born, he or she is gently lifted, brought close to you. You seal the moment in a loving embrace. We let you take your time bonding. Once you both are ready, the midwives help you out of the pool. You are dried off and taken over to a clean, cosy bed.

 

5 Steps to Better Sleep During Pregnancy

It is natural for mothers to expect sleepless nights after the baby arrives, but there is often little preparation for the sleeplessness that comes with pregnancy. Pregnant mothers frequently find themselves incapable of getting quality sleep, which leaves them feeling fatigued and frustrated. Lack of sleep can have adverse effects on the body and mind and in some cases, cause complications. Sleep disorders like obstructive sleep apnea, restless legs syndrome, and gastroesophageal reflux disorder during pregnancy can be managed with the guidance of your doctor. It may also be helpful to try these 5 tips to improve your quality of sleep:

  1. Find A Comfortable Sleeping Position 

Finding a comfortable position to sleep in can be challenging as you adjust to your growing bump. You can opt for a pillow between your knees and try out a few recommended positions to see what is comfortable for you. Make sure to keep your hands above the belly to avoid cramping.

  1. Maintain Good Sleep Hygiene 

Sleep hygiene refers to building habits that ensure you have good quality sleep.

  • Go to bed at the same time each night and schedule naps earlier in the day so they don’t interfere with nighttime sleep.
  • Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature.
  • Remove electronic devices, such as TVs, computers, and smartphones, from the bedroom and try to read a book, take a bath, or indulge in other calming activities.
  • Avoid large meals before bedtime.
  • Get some exercise. Being physically active during the day can help you fall asleep more easily at night.
  1. Good Nutrition Goes a Long Way

During gestation, your digestive system slows down. You might have to deal with issues such as heartburn, constipation, or indigestion. Healthy digestion can help get a good night’s sleep.

Keep in mind the following things…

  • Cut down on caffeine; not only is it a stimulant that disrupts sleep but is also harmful to your baby.
  • Avoid spicy foods, carbonated drinks, citrus fruits that can cause acid reflux.
  • Have small meals throughout the day to avoid feeling bloated.
  • Do not eat three to four hours before bedtime.
  • Take plenty of fluids throughout the day but reduce intake before bedtime.
  1. Breathe 

Breathing exercises will help you sleep through the night.

  • Use humidifiers; they help ease nasal congestion.
  • If you suffer from sleep apnea, consider using a CPAP machine, if your physician prescribes it.
  • Sleep in an inclined position by raising the height of the pillow.
  1. Keep Cramps at Bay

Though leg cramps or restless leg syndrome is hard to prevent, there are ways to soothe cramps

  • Exercise during the daytime.
  • Include calcium-rich foods.
  • Indulge in soothing massage and leg stretches before hitting the bed.

Continued or chronic loss of sleep can lead to gestational diabetes, stress, and depression. If the sleep disorders are difficult to manage, check in with your doctor or childbirth educator at your next prenatal appointment. Have a positive mindset and try meditation and calming activities to keep stress at bay.

Low Cost and Lifesaving

Kangaroo Mother Care at Fernandez Hospital

A nurse helping a mother with Kangaroo mother care (KMC)

 

Kangaroo mother care (KMC) involves early continuous, and prolonged skin–to–skin contact between a mother and her newborn. The kangaroo pose consists of skin-to-skin contact (SSC) between the mother and the neonate in a vertical position, between the mother’s breasts and under her clothes. It has been proven scientifically that KMC significantly improves the survival in low birth weight (LBW) infants, reduces the risk of severe blood infections, decreases the length of hospital stay, improves breastfeeding, and leads to better physical and brain growth of the baby apart from psychological healing to the mother. Hence, KMC is now considered as the standard of care for low birth weight (LBW) and very low birth weight (VLBW) neonates in all socio-economic settings. 

 

A father giving KMC to a low-birth-weight infant

 

KMC at Fernandez Hospital

In 2004 Fernandez Hospital introduced a KMC ward. It was started initially at the Boggulakunta unit and later initiated in the other units. At Fernandez Hospital, KMC commences for the VLBW neonate as early as possible, right in the NICU, once the babies are clinically stable and the mother is comfortable. In the absence of a mother, foster KMC is encouraged by other family members. Once the babies are stable, they are transferred to a dedicated KMC ward for continuous KMC. KMC wards attached to the NICUs mimic the home-like environment for the mother-infant and are, in general, low on gadgets and technology. 

 

In the KMC ward, mothers are supported by nurses and nursing aides, but primarily the babies are taken care of by their mothers. This facilitates empowering the mother to care for her baby and allows an early discharge from the health facility. KMC also provides the best developmentally supportive care possible to the neonate and alleviates fear and anxiety in the mother and other caregivers in taking care of these tiny infants. The mothers are encouraged to continue KMC at home.

 

In our initial study, we looked at the feasibility of caring for stable VLBW neonates on full oral feeds in the KMC ward instead of conventional NICU. The study found that KMC ward care is safe, and neonates had similar growth patterns. It decreased the length of NICU by two weeks. Another study published by Fernandez Hospital showed that stable VLBW infants can be shifted to the KMC ward even at 1100 grams. They had better weight gain, reduced NICU, and hospital stay, with a significant cost reduction of almost 35000 INR per baby (500 USD). The effect was consistent even in extremely low birth weight babies. Around 2000 VLBW neonates have benefitted from the KMC since its inception at Fernandez Hospital.

 

Biases are Meant to be Broken

3 Historical Women who paved the Way for Women Studying Medicine

History remembers women who reclaim the power of womanhood by breaking biases. They overcome social exclusion and obstacles of family, society, and patriarchy to actualize their potential. They create history and pave way for more such pathbreakers.  On International Women’s Day, we remember three fearless women who became trailblazers for women to study medicine, which predominantly was a male domain.

Dr Kadambini Ganguly (1861-1923)

Well-behaved” women rarely make history. Dr Kadambini Ganguly is fondly remembered, to this day, as a revolutionary rebel. She dedicated her life to fighting for women’s education and rights, at a time when women were not allowed to have any other aspirations except raising a family. Dr Kadambini became the first female physician in India to be trained in western medicine and was one of the first working women. She did not let biases or societal norms prevent her from fulfilling her dreams. With the support of her husband, Dwarkanath Ganguly, who himself was a crusader of women´s emancipation and encouraged them to participate in every walk of life, she secured a seat for herself to study medicine. After obtaining her degree, she openly addressed Calcutta Medical College’s practice of not admitting female candidates, which led the university authorities to open their doors to all female students. She was also part of the first female delegation that helped secure voting rights for women. Although the journey was not easy, Dr Kadambini remained a working professional till her last breath and is still remembered for the incredible contributions she made towards this change.

Anandi Gopal Joshi (1865- 1887)

Driven by passion and purpose, Anandi Gopal Joshi, became the earliest pioneer for women’s healthcare in India. She overcame the barriers of caste and societal stigma to secure an education in medicine overseas at the tender age of 18. She wanted to change the sad truth that women, in most cases, due to the lack of female doctors, would rather die than take medical aid at the hands of a male physician. Her vision was to study medicine and set up a school of medicine in India for Indian women.

Although she actualized her dream of securing a medical degree, Anandi (22) succumbed to tuberculosis on 26th February 1887. She could not open the women’s medical college she’d envisioned or put her hard-earned knowledge into practice for too long. Her legacy, however, lives on. The Maharashtra government offers healthcare fellowships to women in her name to keep the memory of this Braveheart alive.

Dr Mary Poonen Lukose (1886–1976)

Born on 2nd August 1886, Dr Mary Poonen Lukose was the trailblazer that set the wheels of change in motion. She championed the message that gender is no measure of potential. She is accredited with many legendary accomplishments. She was the first woman from Kerala to graduate in medicine; first lady gynecologist of Thiruvananthapuram; first lady legislator; and the first lady surgeon general (in the world) among many other firsts. Although extremely bright, she was denied admission into medicine because of her gender. She, however, did not let this prevent her from following her dreams and moved to London to secure an MBBS, an MRCOG (gynecology and obstetrics), and training in Paediatrics. As early as 1920, Dr Lukose delivered modern-day Kerala’s first C-section baby and began training professional midwives with the support of Travancore’s Maharani Sethu Bai.

In 1924, when she was promoted to head the medical department, she undertook many revolutionary steps, including the establishment of training classes for local midwives. By 1929, this led to 1.6 million residents of the state, having access to modern medicine. She was appointed Surgeon General of Travancore in 1938 and was awarded the civilian honor of Padma Shri in 1975 by the Government of India. She inspired women across the country to overcome stereotypes.

History is made by women of courage who shatter stereotypes and inspire change. Happy International Women’s Day to all the brave women out there. May your tribe grow!

 

Empowering Women to Shatter Biases since 1948

A gender-equal world is possible. A world free of bias, stereotypes, and discrimination is possible. We can make it possible!

For over seven decades, Fernandez Hospital has been breaking biases by empowering women to make choices and voice their views on issues surrounding birth. This International Women’s Day, we share how Fernandez Foundation has been breaking biases by empowering women to make choices and voice their views on issues surrounding birth.

As advocates of natural birthing, we have successfully sowed the seeds of Midwifery in India. Gaining momentum with each passing day, our midwifery initiative is reducing C-section, mortality, and morbidity rates in the state of Telangana.

We’ve shattered many birth-related biases by…

  • Promoting and establishing midwifery-led care at Fernandez Hospital
  • Working with Telangana Government in establishing midwifery care in public hospitals
  • Preserving the rights of pregnant women
  • Midwives, obstetricians, and doulas working together as a team
  • De-medicalizing births

Doctors breaking the bias

Bias: Only doctors can help women birth

Breaking the bias by letting Professional Midwives – my trusted colleagues – help women birth naturally. Midwives provide respectful, equitable, evidence-based care to low-risk mothers and I dedicate my expertise to high-risk pregnancies.

Midwives breaking the bias

Bias: Women can only give birth lying down

Breaking the bias by helping women birth in positions of their choice. I provide the highest standards of maternity care. I strive to reduce medical interventions and help mothers have normal, physiological births.

Mothers breaking the bias

Bias: I have no say in the way I birth

Breaking the bias by ensuring I have a say in everything related to my birthing journey. I seek midwifery care that protects my voice and my rights. My midwife keeps me in charge and helps me birth the way I want.

#BreakTheBias #IWD2022 #InternationalWomensDay2022

 

India Needs Midwifery Trainers

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