American University of Beirut

Caring Birthing Practices are an Art of Public Health

​​​​​​​"What is more precious than holding a new life in your hands? Looking at the tiny faces of newborn babies, I feel overwhelmed with joy. I simply adore children! That is why I studied midwifery," says Batoul Kassem. Batoul continued, “In Lebanon, midwifery is largely misunderstood by the general public who does not know what midwives are really capable of." Her friend Nahida Akari nods in agreement, “I remember one incident when a woman was in labor, and the doctor could not reach the hospital on time because of bad weather. So, I assisted the woman in giving birth. The mother and the baby were healthy. The family, having lived in Canada and know the concept of midwifery, were very happy, but the doctor was not." She adds, “Unfortunately, many Lebanese families do not trust midwives to be the health professional attending the birth of their babies, and this needs to change!"

Batoul is a midwife by training. She has a Bachelor's degree in midwifery, and has been promoting maternal and child health for over 30 years. She served in hospitals and non-governmental organizations (NGOs), and currently works at a Lebanese Red Cross clinic. Batoul conducts health communication sessions on vaccination, breastfeeding, and reproductive health and rights through different NGOs, and in public and private schools. Nahida is also a midwife with a Bachelor's degree in midwifery and a Master's degree in public health. She currently teaches at the Lebanese University and volunteers in different NGOs and has over 30 years of experience in the midwifery field. She too has worked in many Lebanese hospitals.

Nahida recalls, “Back in the 90s, the situation was difficult. Hospitals did not know what it means to be a midwife. For example, in the maternity section, the person responsible was a nurse, and not a midwife. It took a lot of hard work to prove our ability to the hospital management. With time, we proved ourselves. But, the situation of midwives in Lebanon is far from being a perfect one. Currently, we do all the medical care during labor, but the childbirth is attended by the doctor."

Midwifery training offers its students a robust education that enables them not only to attend births but also to provide reproductive health counseling and information. Nahida notes, “To graduate, a midwife student needs to attend the birth of 55 babies as the main health care provider in charge. Our students are very well equipped to provide comprehensive antenatal and postnatal care. We encourage active participation of pregnant women in their health care decisions and advocate for natural births."

When asked about the Lebanese law regarding practicing midwifery, Nahida replies, “The Lebanese law permits midwives to be the sole skilled birth attendant, which is a testament of our capabilities. We also have the right to open a private clinic where we can provide counseling and care for pregnant women. Midwives are allowed to prescribe specific kinds of medications. We can have a National Security Social Fund (NSSF) number, and we can put our patients' bills on the NSSF. We can provide this care as long as everything is normal. If there is any medical or obstetric complication, we refer the pregnant woman to a specialized doctor."

Midwifery deserves to take its appropriate place in the health care system. The midwifery model has proven its efficacy in improving the health of mothers and newborns. By preserving the physiological process of birth and contributing to the practice of community health, midwives promote public health. Midwives understand the profound experience of pregnancy and provide individualized maternal and prenatal care, which is based on mutual trust. Midwifery is caring, building confidence, and allowing women to participate in decisions about giving birth. Caring birthing practices are an Art of Public Health! ​

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