Birth & Midwifery in India
Resources for parents and practitioners
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Some of the following sites may not be in English; an online translator may be useful.
Birth Situation Room Report
Midwifery Today Country Contact*
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Manju Chhugani, Uma Handa, Lina Duncan and Vijaya Krishnan
Manju Chhugani is a lecturer at the College of Nursing Jamia Hamdard. She has been teaching midwifery since 1991 and is the secretary for the Society of Midwives (India), Delhi Chapter. She completed her PhD on HRD in Hospitals: A comparative study of nursing staff of public and private hospital in Delhi. She is working on Skilled Birth Attendant training project of the government of India.
Manju’s goals are to work toward raising the standards of nursing and midwifery education in India and to work persistently for safe motherhood and women’s empowerment. She is proficient in English, Hindi and Sindhi.
Uma Handa has a BS and an MSc in Nursing with specialization in obstetrics and gynecology. She has worked in the field of nursing since 1974, in nursing educational institutions in both the conventional and distance system, as well as in national and international health agencies. Countries in which she has worked include Sri Lanka, UK, Bangladesh and South Africa (University of Namibia—UNAM). She has received many special awards throughout her career. She speaks English, Hindi (her mother tongue), as well as Punjabi and Marathi.
Uma’s present goal is to promote independent midwifery practice in India to encourage mothers to go through natural childbirth and so that unnecessary medical and surgical interventions can be prevented. Organizations she is member of: Nursing Research Society of India (Founder), Trained Nurses Association of India (TNAI), White Ribbon Alliance India (WRAI), Society of Midwives, and Executive Committee member Birth India.
Lina Duncan is from the UK and has been a midwife since 1999, having trained in the US and the Philippines with 1000 births. Her training was 100% Midwifery Model of Care approach and once trained she was involved in training others. Since attending many high-risk women and babies in the Philippines she has set up a company along with her colleagues and has been working in India since 2008. Her company Justlink Health Services provides a variety of pregnancy and birthing services to women across Mumbai and Pune. Through Justlink, in her spare time, she provides free services for women that have no health care at all to avail of needed attention for often high-risk situations such as malaria and anaemia in pregnancy as well as routine care.
Lina and her colleagues plan to train doulas and midwives using an apprenticeship style in all sectors of society that will strive to work under the Midwifery Model of Care and in Mother-Baby friendly circumstances.
Lina was very happy to finally attend her first Midwifery Today conference in 2010 (France), and has networked with others through the NGO Birth India working towards the IMBCI goals and Mother-Baby friendly care. Lina speaks English, Cantonese, Hindi, Visayan (Southern islands Philippines).
How she envisions the future of birth and midwifery: I hope that in the midst of such a revolution of medicalized birth that somehow women can make informed choices to go back to the simple and natural way of birthing at home, that birthing centres would spring up worldwide to facilitate mother-baby friendly care and that each midwife will train one or more!
Dr. Vijaya Krishnan, CPM, DPT, MS, LCCE, FACCE, is a Certified Professional Midwife, co-founder and Director of Healthy Mother Wellness & Care and the leading official Lamaze Certified Childbirth Educator (LCCE) in India. She is a graduate of the Midwifery Program from National College of Midwifery, USA. Dr. Vijaya is the only Indian to be awarded the Certified Professional Midwife certification by the North American Registry of Midwives, the certification body for direct entry midwives. The LCCE certification is awarded by Lamaze International, the world’s leading organization that supports, promotes and protects Natural Birth. At the Lamaze International conference in September 2011 in Dallas, Texas, Dr. Vijaya was inducted as a Fellow of the Academy of Certified Childbirth Educators (FACCE) in recognition of the outstanding work she is doing to bring about positive, sustainable change in birth practices in India.
Vijaya has a doctorate in Physical Therapy and Physical Therapy Education and conducts Lamaze classes and wellness programs for mothers-to-be and new moms, building upon her specialization in body mechanics, fitness, and Women’s Health. In addition to being a Lamaze Certified Childbirth Educator (LCCE), Vijaya has designed the Healthy Mother Lamaze Teacher Training Course and Workshop, designed to help aspiring Lamaze teachers gain the knowledge and capability to impart childbirth education in the Indian context. Dr. Vijaya is also an Adjunct Faculty in the Perinatal Program of the College of Health Sciences, Douglas College, Vancouver, Canada.
- Jamia Hamdard, a seat of higher learning in Unani Medicine, Islamic Studies, Biosciences, Pharmacy, Nursing and other areas of knowledge
The Impact of Education in India
I think that education is the key to change. I teach Lamaze classes and one of the questions I am most frequently asked is, “How can we question the doctor”? I tell people that birth is as non-medical an event as it gets and that they should collaborate with their doctor. Well-informed mothers and fathers do have better birthing experiences. We also do Lamaze Teacher Training workshops, so that more pregnant families can have access to good childbirth education.
I often tell expectant parents in my Lamaze classes that they are pioneers, in that they are the harbingers of changing birth practices by asking, questioning and demanding better birthing experiences from their doctors. It is never about us (birth professionals) getting on a soap box and demanding change—sustainable change is always driven by consumers.
Having said that, “doctor,” in India, is still seen as the top of the hierarchy and it is difficult for people to start questioning doctors. Yet, I know that we are making a slow but steady change in Hyderabad, India. The doctors who serve as back up OBs for my birthing center clients have gone from, “Oh, that healthy mother thing” to “This mother really wants a normal delivery.” One of the OBs has started giving her mothers a much longer trial at labor. She says, “If a healthy mother can do it, we can try, too!”
In the perception of doom and gloom, there are quite a few silver linings. If you keep up with it, the small but effective changes surely will build up to better birthing practices in India, as anywhere else in the world. We have been officially accepted as a Motherbaby Network (MBnet) by International MotherBaby Childbirth Initiative (IMBCI). We are thrilled and honored by this, and rededicate ourselves to bettering motherbaby care. We still have a long way to go, but we are changing birth practices in India one mother at a time and, maybe, even one OB at a time!
— Vijaya Krishnan
Newborns Belong at Home in Their Mother’s Arms
“Location, location, location” doesn’t just apply to real estate—it can determine who lives or dies. Throughout the world, economic disparities strand millions of newborns without the medical care people in industrialized countries take for granted. Too often, it costs babies their lives.
This is certainly the case in India, which has the greatest number of babies who die within the first month of life, accounting for more than one in every four newborn deaths in the world. This devastating situation is starting to change, thanks to the application of midwifery and doula techniques that keep babies at home in their mother’s arms, nursing within an hour of delivery.
A report on global health from the Bill and Melinda Gates Foundation brings news of a landmark decision by India to employ accredited health care activists (AHCAs) to make home visits that are projected to reduce neonatal mortality by 30 to 60 percent, based on studies. This is a change from previous efforts that focused on getting women to give birth at health facilities.
A key element of the new approach, which provides for two pre-natal visits and three post-natal visits, is to make the first post-natal visit within 48 hours, which doubled the neonatal survival rate. Health workers teach mothers the importance of early and exclusive breastfeeding, skin-to-skin contact with their infants, and hygienic care of the umbilical cord and skin.
Health workers also check for evidence of neonatal infections, which they can treat with antibiotic injections, and monitor maternal health by inquiring about hemorrhaging, infection, hypertension and nutrition—a step that, combined with referrals to health facilities as needed, is projected to reduce maternal deaths by one-third.
While this is a promising new direction for India, people throughout the world can benefit from this reminder to insist on caring for babies the way nature intended—with a little help from antibiotics.
— Caroline Rodgers
We have recently established Birth India. Our aim is to educate and provide non interventionist birth in India and to address the rights of women in birth. I have given our mission statement below. We are looking for speakers for our inauguration conference.
Birth India promotes best practices and benefits of non interventionist child birth, both physical and psychological. Our aim is to reduce child and mother mortality and birth related disability amongst the poor and to reduce the amount of unnecessary cesarean sections in hospitals, thus promoting an ideal atmosphere for all births in India.
We aim to
- Provide support to and educate the Traditional Birth Attendant (TBA).
- Train midwives and birth coaches who can offer their service as support for home or hospital births during pregnancy, delivery and the newborn.
- Promote ideal natural birthing practices in slums, public and private hospitals, nursing homes, birth teachers and to all those involved in the field of birth; via seminars, pamphlets, brochures, film and consultancy.
- Train birth teachers and hold our own pre- and post-natal classes.
- Create a Web site:
- to promote and provide information.
- to offer a forum for women to talk to other women about their experiences
- to provide a place to keep statistical information.
- to provide links to other sites giving factual information on natural child birth.
- Disseminate information via the media.
- To join hands with government and NGO groups involved in this field, as well as organisations abroad.
- Establish birthing clinics which provide the best atmosphere for natural birth; the profits of these clinics fund free birth clinics for the poor providing a safe and loving atmosphere.