Meet Dr Evita Fernandez who is spearheading the midwifery initiative in India
Renowned obstetrician, Dr Evita Fernandez is the advocate of natural birth over cesarean. In 2011, Dr. Evita spearheaded the midwifery initiative with the PROMISE Campaign that is committed to creating a national cadre of midwives who are vital in the care and delivery of low-risk pregnant women.
Obstetrician Dr Evita Fernandez, the chairperson of Fernandez Foundation, a not-for-profit healthcare organization established in late 2000s, was born in a family of doctors. Her parents Leslie and Lourdes Fernandez started Fernandez Hospital in 1948 with just two beds.
She inherited the hospital in the early 90s with 30 beds and took her parents’ initiative to new heights. Today, the hospital has five units with over 300 beds spread across Hyderabad.
In 2011, Dr Evita spearheaded the midwifery initiative with the PROMISE (Professional Midwifery Services) Campaign that is committed to creating a national cadre of midwives who are vital in the care and delivery of low-risk pregnant women.
Midwifery deals with pregnancy, childbirth, and the postpartum period (including care of the newborn), in addition to the sexual and reproductive health of women throughout their lives.
Dr Evita is also an advocate for the need to reduce Caesarean Sections and make childbirth a natural and positive experience for all women.
Talking to HerStory about her journey into pioneering the midwifery initiative in India, Dr Evita recollects that back in the early 2000s Fernandez Hospital had built a 24*7 comprehensive care infrastructure so it had become a sort of a reference centre for people living in Hyderabad and around for complicated pregnancies.
“By 2007, the hospital was overflowing with patients and we would get pregnant women who were so sick that we couldn’t save them. We were losing young pregnant women and that tore me apart. I started to read about maternal mortality and I realised that countries with low maternal mortality rate were investing in a midwifery cadre,” she says.
“It formed the backbone of maternity services in those countries but we didn’t have that in India.”
Institutional deliveries in India have risen sharply from 47 percent in 2007-08 to over 78.9 percent in 2015-16 (NFHS4) while safe delivery has simultaneously climbed from 52.7 percent to 83.2 percent in the same period.
In 2007, the Maternal Mortality Ratio in India was 212 per 1,00,000 live births.
According to Dr Evita, the hospital was handling close to 5,000 deliveries a year.
“I realised that the childbirth practices that we had incorporated were not the best. Since we were trained to practice it in a certain way and that we are so driven by the ‘what if’ circumstances, we didn’t realise that we have become horribly interventional in the process of childbirth,” she says.
Dr Evita Fernandez with trainee nurses
"The more I read about midwifery I learnt that it revolves around working with pregnant women, empowering them with knowledge, preparing them for labour and supporting them in natural childbirth,” Dr Evita elaborates on childbirth and how midwifery changes the experience from cesarean to natural birth.
Doctors are causing more harm to women by excessive intervention in the process, she says. “We are doing it because that’s how we have been trained over the last decade,” she says.
Dr Evita also approached the Andhra Pradesh government at that time to introduce the midwifery programme in the state but the government did not concede. So she decided to launch a pilot training program in midwifery at Fernandez Foundation.
In 2011, she also launched a two-year Professional Midwifery Education and Training (PMET) Programme. Dr Evita also works closely with the Ministry of Health & UNICEF to increase normal births and train nurses and doctors in public hospitals.
In 2018, Telangana Health Commissioner V Karuna also joined Dr Evita in her effort of reducing C-Section births and increasing natural births led by midwifery in the state. One of the initiatives was to train 30 nurses in midwifery in 10 remote hospitals of Telangana which she claims has proved to be a gamechanger in maternity care.
Dr Evita states that midwifery is woman-centered. “The woman is supported, given privacy, respect, compassion and confidence. The whole idea is that her birth experience is positive even if it is a C-section delivery.”
Fernandez Foundation has been training nurses of Telangana’s public hospitals in midwifery. These nurses work in district hospitals so the poorest of poor women in Telangana go to the hospital where the midwives are now posted and get the same care, compassion and support as they would here at Fernandez Hospital.
“Natural births are increasing in Telangana now can anything be more soul-satisfying than that?” asks Dr Evita.
Edited by Affirunisa Kankudti