On International Women’s Day today it seems that a profession concerned with the happiness and wellbeing of women is walking quietly into the history books — midwifery.
“In the past, private midwives would deliver 20 or 30 children per month and hospital midwives would deliver 100 or 200 a month. Now, a private midwife doesn’t deliver a dozen babies a year, and the hospitals don’t even have midwives anymore,” one midwife said.
Not only are there fewer babies for midwives to deliver, this year will also be the last that the national midwifery exam is given.
Yang Sheng-tsai (楊盛財), head of the Ministry of Examination’s Department of Professional and Technical Personnel, said the midwifery exam is given twice a year, but with the disappearance of nursing schools the number of people sitting the exam and the number of people passing it has been dropping for several years.
In 2005, 61 people registered for the exam and 29 passed. In 2006, 44 people registered and 26 passed, while in 2007, 21 registered and eight passed. When the first test this year was held in late January, only seven people had registered with the results due on March 24.
During the Japanese era, the governor passed regulations requiring midwives to take a professional exam before passing a midwifery law. Kuo Su-chen (郭素珍), head of the Taiwan Midwives Association, said the period from the Japanese era up until the 1960s was the golden era for midwives.
The government encouraged midwives to go to the countryside and the overall conditions encouraged childbirth.
Because of conservative attitudes and a shortage of obstetricians, pregnant women had to rely on midwives for pre-natal assistance and delivery. At that time, midwives were delivering as many as 400,000 children annually.
From the 1970s onward, economic growth led to the establishment of large hospitals. Twenty years ago, midwives were removed from health centers and nurses began to take over their duties in hospitals.
As the number of jobs diminished, fewer students enrolled in midwifery schools. Of the more than 20 nursing and midwifery schools during the golden era, the only ones that remain are the Introduction of Midwifery Department at Fooyin University in Kaohsiung and the Graduate Institute of Nurse-Midwifery at the National Taipei College of Nursing in Taipei.
There are currently more than 300 registered and licensed midwives, out of whom a little more than 130 are professionally active.
The national health insurance has added to the troubles of midwives. Midwife Chiu Ming-hsiu (邱明秀) said the national health insurance originally did not include private midwifery centers and a special agreement was arranged only after midwives protested at the Department of Health.
Chen Hsiu-mei (陳秀玫), secretary at the National Union of Midwives Association ROC, said that as most pregnant women rely on their obstetrician from their first visit to delivery there is no need for other personnel. In addition, nurses can be transferred between departments, while a midwife is tied to the maternity ward and as a result most hospitals will only hire nurses, putting midwives at a disadvantage.
Director of the Bureau of Medial Affairs Shih Chung-liang (石崇良) said many hospitals have obstetricians and will do fine as long as they hire nurses. To avoid overlap between staff there is less need for midwives, which is simply a function of market demand.
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