Soheir Sukkary-Stolba
THEME: The traditional midwife in Egypt has been seen as a threat by medical planners in their field with the claim of modernity which the conventional midwife does not possess. It is interesting that close to half of the country’s population would prefer the services of the midwife rather than the maternal healthcare practitioner. An examination of the role played by the traditional midwife will help support the need to have the conventional midwife retrained and allowed to practice in maternal health care facility and not to be treated as a stranger based on modernity and development of science.
I. Introduction
Traditional midwives across the third world countries are believed to have little or no knowledge of modern healthcare practice. Some claims point out that they are ignorant.
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A good percentage of women in the middle-class urban areas and the poor continue to use the services of traditional midwives and appreciate them as being better than maternal health caregivers.
Midwives play a more significant role in maternal care than maternal health care practitioners according to research and records of medical anthropologists.
Doctors and health planners argue that traditional midwives should be extinguished in the healthcare development plans based on their little knowledge of applying modern medicine to maternal care.
It is believed that the duality of partnering in healthcare will cut off the misconception about traditional midwives and build bridges in the modern and traditional health care.
II. Who is a Traditional Midwife in Egypt?
They are referred to as ‘Dayas’ which was stereotyped as ‘ignorant and unskilled women believed to cause the death of a mother and the child during birth. Midwives were purely female.
They like to be called ‘Um Ashraff’ or ‘Um’ which means mother.
Their services were rendered more traditional and did not embrace modern medicine and had to be replaced by advanced health care services that provided ante-natal and post-natal care.
They were believed to have come from nearby locations and hence understood their people better than strangers.
The government-sponsored education and training were ceased, and the licences of all the traditional midwives were invalidated reducing their practice in healthcare facilities.
III. How did They Acquire Their Knowledge of Midwifery?
Heredity was common among midwives’ families. Women who came from families that practised midwifery acquired knowledge through observation and teaching.
Mothers who were midwives passed the profession to their daughters who in turn passed it to their daughters.
Mothers who experience childbirth are at an upper hand to become midwives as they can handle the cases which they went through during birth without fear.
Government sponsored education on midwifery before 1969 helped many women acquire midwifery skills. They learnt current methods of handling delivery and care.
Seeking knowledge from nearby chemists and pharmacist stores on a new injection or drugs that they had not known. Some did personal research and tests.
IV. What are the roles played by a Traditional Midwife?
A Traditional midwife offered consultation services on the diet of the mother before and after birth and can advise on the nature of the pregnancy.
Help women deliver safely without hostility. Respondents asserted that some nurses were harsh and hostile to them and found the midwife to be calm and helpful during birth.
Provide post-natal care to the mother and the child for at least seven days to help women fully adapt to motherhood smoothly.
Detecting complicated cases and refer the matter to a specialist. This is during the observation and supervision period after delivery.
They prepared a clean and safe environment for delivery since the baby ought to find a clean and peaceful place don birth.
V. Advantages of Using a Traditional Midwife over a Nurse in the Hospital
The services of a traditional midwife are cheap as most of them only accept gifts unlike in hospitals where there is a fixed charge.
A traditional midwife can easily be reached since they live nearby. They are flexible and respond quickly.
A conventional midwife understands the mother and hardly humiliates or harasses the mother.
They provide post- natal services by supervising the cleaning, dieting and dressing of both the mother and the baby.
They advise and consult on the right type of injection after or before birth.
VI. What makes the Service of the Traditional Midwife Popular among the poor and the middle class in Egypt?
Most midwives have been raised in the same locations and famous in the region for safe deliveries and general ante-natal care. Midwifery families are also renowned.
They speak and understand the language among this groups. They know individuals better together with their surrounding.
Midwives are mostly tied by the bonds of friends who make referrals and continue to popularise the services of midwives.
Their services are inexpensive which makes the poor and the middle class prefer their service than the costs of hospitals.
The traditional midwife struggle and continuously seek to incorporate modernity into their services.
VII. How does a Traditional Midwife Do to embrace modernity?
The traditional midwife continually seeks new knowledge and experience that has been introduced in the current maternal health care setting.
They also seek to be identified as professionals in white ‘Aprons’ commonly worn in the hospitals as a way of identification.
It is believed that the traditional midwife makes an effort to create friendship and attract more customers for their service, unlike the conventional ways.
They apply modern methods in delivery, for instance, using a specific injection to stop bleeding and other medication to imply advancement from the old ways.
They have adopted and learnt on the skills of family planning including the use of the pill which they advise their clients instead of the traditional methods.
VIII. What are The Steps Suggested To The Egyptian system to promote the Role of The Traditional Midwife?
Re-introduction of the government-sponsored education for traditional midwives and granting of licences to the midwives for practice.
‘Daya’s understanding of the communities can be an advantage in posting them to nearest maternal health care centres to act as agents between the community and the centres.
Traditional midwives to be given the mandate to perform the duties of the healthcare organisation such as communication to communities or as community health workers.
To impart more knowledge on the traditional midwives regarding family planning to enable them to educate the community on proper spacing of the children.
To incorporate the ideas of the traditional midwife, science and modern medicine to achieve duality that will help in making informed choices.
OPINION: The Traditional midwife is not a stranger in maternal health care because it is a practice that has been done for a long time. She plays an active role that is highly regarded. Instead of getting rid of the traditional midwives and their practices which are crucial in healthcare, the healthcare system could analyse these roles and combine them with the ideals of modern medicine to practice duality. Similarly, it is important to continue training the traditional midwife to add their knowledge of modern medicine.
