NewsBreakingOnline

One-in-500 women die in childbirth in Bangladesh – with cultural factors as much to blame as a lack of medical care There’s hardly a man to be seen in the maternity ward of the Maternal and Child Health Training Institute in Dhaka, the capital of Bangladesh. Despite the lack of any law forbidding men to enter the delivery room, fathers are normally not present during the birth of their own child – an attitude that needs to change, say the country’s first midwives, who are due to graduate next month. “Men need to be involved in the labour process if we are to reduce maternal mortality,” says Mala Reberio, one of the 20 midwives being trained to international standards in Bangladesh, which is still heavily reliant on community skilled birth attendants, who lack the skill and the authority to perform more complicated deliveries. Currently, one in 500 women in Bangladesh dies during childbirth. “If [men] could see firsthand the complications of childbirth, they would be more likely to send their pregnant wives to proper medical facilities and less likely to insist on early childbirth after marriage,” says Reberio. More than 75% of deliveries take place at home, and the average age of women having their first child is just 16 years, according to the UN. Fathers are not present during the delivery. The support role is usually taken on by the father’s mother or another senior female member of the family, said Dr Roushon Ara Begum from the United Nations Population Fund (UNFPA), the organisation leading the training. However, recent figures show that attitudes towards childbirth are changing. According to the government’s Bangladesh Maternal Mortality and Healthcare Survey 2010 , women are increasingly choosing to use professional medical facilities (mainly due to a growth in private practices). The proportion of women giving birth in medical facilities has more than doubled, from 9% in 2001 to 23% last year – a trend that is likely to continue as fertility rates decrease, incomes increase and education levels improve. “I would recommend to everyone to give birth in a hospital for comfort and safety,” says Samia Zakia Sultana, 20, who is expecting her first child in a few weeks. Bangladesh is on target to meet MDG5 – reducing maternal mortality. According to the BMMS 2010, the maternal mortality ratio in Bangladesh has declined from 322 per 100,000 in 2001 to 194 in 2010. However, data collection in this area is notoriously difficult and there tends to be a large margin of error and much disagreement about the exact figures. Other reports from 2010 place Bangladesh as the worst in south Asia for maternal mortality.