KARACHI, June 9: In every 20 minutes one mother and 17 babies die while 15 mothers suffer disability in the country following pregnancy and delivery-related complications due to lack of new- borns care and non-availability of Skilled Birth Attendants at the time of delivery.

This was pointed out in a seminar on "Midwifery and safe motherhood", organized by the National Committee for Maternal Health in collaboration with the UNFPA here on Wednesday.

Speakers at the seminar expressed their utter dissatisfaction on maternal health care services especially Emergency Obstetric Care at the time of emergency. They demanded that Traditional Birth Attendants (TBAs) should be replaced by Skilled Birth Attendants (SBAs).

It was suggested that the SBAs should be trained with the skills necessary to manage normal labour and delivery, who could recognize complications early and perform essential interventions.

The president of National Committee for Maternal Health, Prof Sadiqua N. Jafarey, delivered her presentation on "Why do we need Midwives?" and discussed the current scenario in Pakistan.

As per some estimates, she said that four million births occurred every year in the country on an average. Of them, she added, nearly 80 per cent took place at homes. "Ninety-five per cent of deliveries at homes are handled by traditional birth attendants and only five per cent deliveries by the skilled birth attendants while 10 per cent to 15 per cent of total deliveries receive post natal care," she said.

On the other side, she pointed out that around 25,000 maternal deaths; 375,000 estimated maternal morbidity and approximately 300,000 perinatal deaths had been occurring in the country.

Prof Jafarey said that no single factor could be held responsible for any improvement in maternal mortality. There was compelling historical and epidemiological evidence that showed a significant relationship between increased coverage of maternity care by skilled personnel and a reduction of maternal mortality ratios.

"The deaths related to complications of pregnancy and childbirth are strongly associated with inadequate medical care at the time of delivery," she added. She said that the skilled birth attendants must be supported with enabling environment including adequate supplies, equipment, infrastructure, effective system of communication and referral with transport.

Prof Jafarey said that midwifery had been neglected for a long time and need of midwives had not been recognized by the medical profession as well as by local community.

Regarding promotion of midwifery, she said that the related curriculum had been revised by the Pakistan Nursing Council with the assistance of UNFPA and was in the process of finalization.

Besides, she said that the textbook of midwifery and manual on emergency obstetric care had been translated into Urdu language by the National Committee for Maternal Health (NMCH) and the PNFWH.

NCMH's secretary-general Imtiaz Kamal underlined the need to create proper posts for midwives and impart quality training at midwifery schools. "Challenge to reduce maternal deaths cannot be met without recognizing midwives as professionals," she added.

Midwifery Trainer Mahmooda A. Ali said that majority of midwives were not aware of their responsibilities and role. Additional Secretary Health Iqbal Dewan identified midwife as important pillar of community health care system and said that his department was establishing more midwifery schools. Dr Azra Ahsan, Dr Nasreen Khan and Seema Naz also spoke at the seminar. - PPI