The Prevalence and Risks of Uncertified Midwives in Karachi and Interior Sindh

In many developing regions, including Pakistan, traditional birth attendants—often referred to as midwives—play a crucial role in maternal and neonatal care. However, a concerning trend in Karachi and interior Sindh is the widespread reliance on uncertified midwives, many of whom lack formal medical training. This practice poses severe risks to both mothers and newborns, contributing to preventable complications, infections, and even fatalities.

Why Do Women Rely on Uncertified Midwives?

Despite advancements in healthcare, a significant portion of the female population in Karachi and rural Sindh continues to prefer traditional midwives over hospital-based medical professionals. Several factors contribute to this reliance:

1. Cultural Preferences: Many families trust traditional birth attendants due to longstanding customs and beliefs that home births are more comfortable and natural.
2. Financial Constraints: Certified healthcare services, especially in private hospitals, are often expensive, making uncertified midwives a more affordable option for low-income families.
3. Lack of Accessibility: Many rural areas lack sufficient healthcare facilities, forcing women to turn to unregistered midwives for childbirth assistance.
4. Misinformation and Fear: Some women fear hospitals due to past negative experiences, misconceptions about medical interventions, or concerns over unnecessary C-sections.

Health Risks Associated with Uncertified Midwives

While traditional birth attendants have been a part of maternal care for generations, the absence of medical knowledge and proper equipment makes them a risky choice. The most common dangers include:

• Unsafe Delivery Practices: Many uncertified midwives use outdated or harmful techniques, increasing the risk of birth injuries and maternal deaths.
• Lack of Infection Control: Without proper sterilization methods, the risk of postpartum infections and neonatal sepsis rises significantly.
• Inability to Handle Complications: Conditions like postpartum hemorrhage, eclampsia, and obstructed labor require immediate medical intervention—something uncertified midwives are not trained to provide.
• High Maternal and Infant Mortality Rates: The lack of emergency response mechanisms increases the chances of fatalities due to preventable complications.

The Need for Regulatory Measures and Trained Midwives

To address these challenges, several steps must be taken to improve maternal healthcare in Karachi and interior Sindh:

1. Training and Certification Programs: More emphasis should be placed on training midwives through accredited institutions, ensuring they meet healthcare standards.
2. Public Awareness Campaigns: Educating communities on the dangers of unqualified midwifery can encourage families to seek professional maternal care.
3. Strengthening Healthcare Infrastructure: Expanding maternal healthcare services, especially in rural areas, can reduce the dependency on uncertified practitioners.
4. Government Policies and Regulation: Implementing stricter regulations on midwifery practices and cracking down on unregistered practitioners can improve overall healthcare outcomes.

Conclusion

The high reliance on uncertified midwives in Karachi and interior Sindh remains a major public health issue. While cultural and economic factors play a role in sustaining this practice, the risks far outweigh the benefits. Promoting certified midwifery programs, improving access to healthcare, and educating communities on safe childbirth practices can significantly reduce maternal and infant mortality rates. Ensuring that every mother receives proper medical care is essential for the well-being of both women and newborns, ultimately leading to a healthier society.