Having a baby is a wonderful but anxious time for any parent. Without access to trained health workers it can be deadly. Mary Lipy Rodrigues spoke recently to Aklima, a trained midwife, about the reality of working with mothers and babies in Bangladesh.

“It is not an easy task to perform. I have to risk two lives at a time - the mother and the baby,” says Aklima, 48. Aklima, a trained midwife living nearly 300 kilometres from the Bangladeshi capital of Dhaka, is hardworking and dedicated to her community.

Mary: Can you please tell us about yourself and your family?
I am Aklima and my husband is Abdul. We have two daughters, Shirin and Shammi.

Can you explain the traditional birthing practices in your community?
In our community, women normally give birth in their house. Sometimes they are kept in a separate room that is especially prepared for the delivery. Other times a woman arranges to give birth in their bedroom. In such cases a local midwife plays the role of doctor. If a mother’s condition becomes critical then we suggest sending her to the hospital or a nearby clinic. In such cases sometimes I also accompany the pregnant mother.

Before, mothers gave birth in dirty places and on torn cloth or even on the old jute bag. Now they are careful about hygiene. Before, people prevented the newborn from drinking the mother’s raw milk. Now they have changed.

Did you make any changes after receiving training from World Vision?
Oh yes, I have made a lot of changes. For example, before getting training I used to close all the doors and windows of the house during the delivery. Now I make sure that there is an availability of light and air where delivery will take place.

Before getting the training, midwives like me kept wearing jewellery during the time of delivery. Now, before I enter the room for a delivery, I change my clothes and take off my jewellery. Before I didn’t wear any hand gloves, didn’t cut my nails or wash my hands. Now I am serious about maintaining hygiene.

Can you tell us how many deliveries you have done?
I can’t tell you the exact number. But within these two months I have delivered nine babies who were born safely at home.

What is your role or responsibility to a pregnant mother?
I monitor the mothers who I assist from the beginning of their pregnancy. I suggest the woman eats nutritious food, drinks more water, takes extra food in the afternoon and takes proper rest every day.

I suggest that they go for a check-up at the World Vision centre and government maternity centre regularly when they become five months pregnant.

As they are poor, they cannot eat fish, meat, egg or milk in their daily diet. I suggest that they add dahl in their daily diet so that it can meet her protein needs.

How do you monitor the pregnant mother?
When a mother is pregnant she sends a messenger to visit her house. After visiting her I advise what to do or what not to do. Finally I perform the delivery and observe her condition for the next 12 hours.

If you have any complications what do you do?
When I find complications I immediately send the woman to the hospital. Sometimes I also accompany the mother.

Usually when do you receive a call from them?
It does not have any season, at any time a mother’s labour pain can arise. I have to be ready to be at their service. Whether it is 2am or 2pm I will go to their house. Sometimes I have to stay in the patient’s house for two or three days until the baby is born.

How much do you get paid for each delivery?
It’s their wish. Sometimes they give me 500 tk ($7 USD), sometimes 800tk ($11 USD). Sometimes they even give me sari as a gift. You cannot believe it, in the last few years I didn’t buy any saris. All the saris I have are gifts from my clients.

What is your husband’s opinion about your service?
My husband…inspires me by telling [me] that if I don’t help the poor people, who will stand beside them? He appreciates my service to the mothers in the community.

Why did you choose this job as your profession?
Actually I was inspired by my mother. She worked in the Government hospital as an assistant to a nurse. I got a chance to stay there while she was working and observed her work. I realised its value to poor people and liked it so much. That’s why I chose to do the same job.

Thank you Aklima!

Training and providing access to skilled health workers is just one solution that can reduce the unacceptable number of preventable deaths among mothers and babies worldwide.

Find out what the other solutions are at childhealthnow.com.au