I became passionate about midwifery beginning in 1996 when I began learning about women’s issues, particularly sexual and reproductive health and gender politics. Since then I’ve come to realize that midwives are a unique cadre among healthcare professionals. They have the compassion and the courage to break the silence in the healthcare delivery system and to educate and empower women for their crucial role in producing and reproducing human beings.
To me a midwife challenges gender stereotypes, ideas, societal norms and values imposed on women and their bodies. She helps women become self-sufficient, and she supports women and men to work for the betterment of the whole society. I feel great about what I am doing to develop the midwifery workforce in Nepal, helping mothers and families so that our nation can prosper and midwifery become a respected profession.
I joined the Women’s Rehabilitation Centre (WOREC) in 1996. I had not heard of this NGO, but my nursing college faculty mentor suggested I join when she learned it was seeking a nurse with my credentials. At WOREC I came into contact with innocent Nepali girls and women who had been sold into sexual slavery – many by their own relatives – and whom WOREC was rehabilitating. Some were pregnant, others infected with HIV, and some had children.
A few years later I joined Paroparkar Maternity and Women’s Hospital to gain experience in a clinical setting in providing care to childbearing women and newborns. This provided me an opportunity to learn directly how childbearing women have been treated by healthcare professionals: without dignity, respect or love, and especially towards women and family members who were socioeconomically deprived or from marginalized populations.
After three years of experiential learning both at the clinical and community I went back to earn my bachelor of nursing, and then a master of public health in Australia. For my project on maternal health I surveyed 671 rural Nepali women and men to determine maternal health status, primarily focusing on the prenatal, natal and postnatal periods. The findings of this study provided me further insight and deepened my interest in doing something significant to improve women’s health in Nepal.
I returned to Nepal in 2006 but decided not to work for an NGO at the grassroots level, because I wanted my efforts to challenge the status quo at the central level. While searching for an opportunity to do something significant, I came across the Government of Nepal’s “National Policy for Skilled Birth Attendants 2006.” That inspired me to establish the first and only nurse-midwife-led private independent birthing center with the notion of social enterprise as the model for its sustainability. I had read about social enterprise and thought of putting it into practice in a real-world scenario in the Birthing Centre’s concept note. Some of my colleagues were interested and I approached nurses working at other hospitals. In the beginning, we were 11 female healthcare professionals who wholeheartedly decided to put my concept of the birthing center into real-world practice. We registered the Birth Center in April 2007 and started to provide services in July.
After three years of experiential learning at the Birthing Center, I realized how important it was to have an organization that spoke with one voice about midwifery, so I and another group of women involved in providing midwifery services or teaching midwifery, established the Midwifery Society of Nepal.
After our tireless advocacy Nepal now has started a bachelor’s of midwifery education program. The Ministry of Health recently asked me to help to draft the Midwifery Education and Workforce Management. And this year Minister of Health Gagan Thapa nominated me to be on the committee for the reformation of nursing and midwifery. The Government of Nepal also nominated me to serve on the board of the Nepal Nursing Council. Now many challenges still remain, among them the need to implement the recommendations we made to the Ministry of Health.
I feel good about what I am doing and I love the “challenge of change.” I am not doing it for my own sake, of course, but for the goal of developing and supporting dignified and empowered mothers who can provide healthy and strong new humans to our society.
Blog by Laxmi Tamang, RN, MPH, PhD, is an executive member of the Perinatal Society of Nepal, WOREC board member, and a lead cofounding member of the APS Birth Centre and Midwifery Society of Nepal. (This blog is part of our midwifery blog series.)
Do you know a midwife who is working to make a difference for the world’s mothers and babies? Help tell her story! Over the coming weeks leading up to the ICM triennial congress we will collect stories about midwives who are leaders in their field and champions for newborns. Send us a 300-600-word blog that include the midwife’s name, country of work, details about their career and how she or he is making a difference in the world for newborns.
Please send all blog submissions to email@example.com. We will post blogs on HNN and our social media accounts with the hashtag #MidwivesVoices and #ICM2017.