As Seema observed the pink-clad midwives in the Antenatal Care Clinic (ANC), her eyes were drawn to an unexpected sight: male midwives in pink scrubs working seamlessly alongside their female colleagues. This progressive integration of men into a traditionally female role gave her a pause. Like many other women in the waiting area, she found herself wondering if she would feel comfortable having a male midwife involved in such an intimate aspect of her care.

 

When she was called and cared for by the midwife, she felt a sense of relief wash over her. Gone was the turmoil and impersonality of her previous hospital visits when she was pregnant with her first child; in its place was a sense of warmth, connection, and being truly seen and heard. Empathy was woven into the fabric of the midwives' care, allowing them to see things from a woman's perspective and understand the intricate web of emotions and experiences that accompanied every pregnancy. As Seema spoke with her midwife Pukhraj, she felt an immediate bond of trust forming, a sense that she was in good hands and that her unique birth experience would be honored and respected.

 

After the check-up, she exchanged a glance with her husband, and at that moment, a profound sense of reassurance settled over them both, easing the anxiety that had accompanied them to the hospital after their early morning departure from home. Her initial hesitation about male midwives had completely dissolved, replaced by confidence in the professional and compassionate care she had received.

Midwifery: Then and Now

From traditional birth attendants to highly skilled professionals, midwives have evolved to bridge the gap between holistic care and modern maternal health solutions. When educated, licensed, regulated and integrated into health systems, midwives are a high return investment proposition.

Midwifery is a practice that traditionally involves supporting women through low-risk pregnancies, childbirth, and the postpartum period. Midwives are known for their holistic approach, emphasizing client-centered care and natural childbirth options. Midwives prioritize the emotional and psychological well-being of their clients, fostering a collaborative and supportive birthing experience. Historically, in India, traditional birth attendants have not been recognized as formal medical professionals but have been integral to the birthing process, particularly in rural areas. 

Today, midwives play a critical role, offering personalized care, emotional support, and knowledge of local birthing practices, despite the lack of formal recognition as a distinct cadre and underutilization within hospital systems.

The government tertiary healthcare system has long struggled with overcrowded hospitals and overburdened doctors. For many women, this translates into rushed appointments and unmet needs. To address this, the Government of India launched the Midwifery Services Initiative, however, in Rajasthan, the program implementation is being undertaken by the Government of Rajasthan in collaboration with the United Nations Population Fund (UNFPA). Under the collaboration, a comprehensive training programme has been launched aimed at developing a new cadre of nursing professionals called midwives, midwifery educators (MEs) and nurse practitioner midwives (NPM). These midwives are being integrated into high-delivery-load hospitals, where they provide comprehensive antenatal, intrapartum, and postnatal care to women with low-risk pregnancies. By doing so, they are supporting the work of obstetricians by reducing their workload and enabling them to focus on high-risk cases that require specialized care and attention. 

Dr. Indira Lamba, Professor (OBGY), SMS Medical College, and Nodal Officer and Medical Preceptor for the Midwifery Services Initiative explains, “Midwives are not replacing doctors but complementing them”. “They take over low-risk cases, allowing obstetricians to focus on complications. This ensures women receive proper counselling and personalized care.” Thus, the midwives serve as a crucial link between the doctors and the women, supporting both.

At the heart of this initiative is the woman-centric approach, Respectful Maternity Care (RMC and evidence-based practices). Practices like holistic antenatal care (pre-pregnancy consultation and exercises), natural births, de-medicalisation of childbirth, no unnecessary episiotomies, no fundal pressures, alternative birthing positions which prioritize women’s comfort and choice, informed consent, and emotional well-being are important aspects of this initiative. And at the forefront is the new cadre of midwives—highly trained professionals redefining childbirth experiences. And among them, an unexpected group is challenging long-standing gender norms: male midwives.
 

 

Breaking Barriers and Transforming Maternal Care

A strong midwifery initiative can enhance the capacity of existing healthcare facilities, improving maternal and neonatal outcomes. Midwives — including male midwives who are breaking gender barriers — are redefining caregiving and proving that investing in midwifery is key to strengthening healthcare systems and advancing universal health coverage.

 

Pukhraj sits in his pink scrubs as he talks about the importance of prioritizing the needs of pregnant women, “It’s not just about assisting with childbirth, it’s about making mothers feel safe and heard. Consent isn’t just a protocol; it’s respect.” He also emphasizes the need for a relationship between the patient and the midwife that eases the woman into a space of comfort and security for her maternal journey. For instance, “Whenever I meet a pregnant woman, I start by asking how her family is doing. Only after building that trust do I discuss her pregnancy.” 

Adorning their pink scrubs, these ‘Men in Pink’ are breaking barriers in a traditionally female-dominated field. Initially, women are hesitant as one of the clients in Udaipur admits she was unsure about being attended to by a male midwife. But “their pink scrubs melted away my doubts,” she says.

Beyond supporting mothers, male midwives are bridging another gap: involving fathers in the childbirth journey. A female midwife sheds light on the role male midwives play “They connect with the men in families, helping them better understand their roles during pregnancy and delivery,” a conversation that was erstwhile more difficult for female midwives to have with male relatives. This shared understanding fosters an environment of inclusivity, turning childbirth into a family experience.

For male midwives, the journey requires breaking more than professional barriers. It’s about dismantling societal perceptions. By embracing positive masculinity, these men demonstrate that caregiving and empathy transcend gender. “It’s not about being a man or a woman,” Ashish, another male midwife, reflects. “It’s about being there for someone when they need you the most while also ensuring that you are providing the best quality of care.” 

This development brings a new dimension to the growing movement to engage men in reproductive health, highlighting the importance of male involvement in promoting healthy reproductive practices and challenging traditional gender norms.

 

A New Model of Maternal Care

A larger, fully enabled midwifery workforce can increase women’s, children’s and adolescents’ access to health care. And a healthier population can build a stronger economy. 

At training institutes like the National Midwifery Training Institute (NMTI) in Udaipur and State Midwifery Training Institute (SMTI) in Jaipur, cutting-edge tools like virtual reality (VR) labs along with skill labs with humanized mannequin models are equipping midwives with evidence-based, best practices to provide high-quality, woman-centered care in a rapidly changing healthcare environment. Bibiana, an international midwifery educator, emphasizes this. “The most important part of medical training is practice, practice, practice. That is what the competency-based training through skill labs, VR Labs and supervised clinical practica do,” she says.

As midwives take on more responsibilities, they’re reshaping maternity care into something personal and inclusive. The program bridges the gap between clinical expertise and emotional support, ensuring every mother feels seen, heard, and empowered. Techniques like promoting alternate birthing positions—such as sitting or squatting according to women's convenience instead of the conventional supine position—are central to this transformation. Additionally, the initiative promotes having a birthing companion present throughout pregnancy, delivery, and postpartum to ensure emotional and physical support for the mother.

Neerma Khatik, a 29-year-old woman, traveled nearly 70 kilometers to Udaipur Hospital for the birth of her second child. Her first child, now four years old, had faced complications during delivery, which prompted her to seek better care this time. Speaking about her experience, she shared, “I heard that Udaipur hospital had better facilities and midwives who offer personal care. This time, I wanted a delivery that felt safe and comfortable.”

The midwives at the hospital were instrumental in making her experience a positive one. “They encouraged me to deliver in a semi-sitting position, which made me feel in control and eased my pain,” Neerma explained. This approach gave her a sense of agency during childbirth. The midwives guided Neerma on breastfeeding, newborn care, and the importance of healthy pregnancy spacing. 

Throughout her delivery, Neerma was accompanied by her sister-in-law, Meenaxi, as her birthing companion. Meenaxi, too, was impressed by the midwives’ dedication. “They treated Neerma with such care—constantly checking on her, offering water, helping her with labour exercises, providing pain management interventions like backrubs, and deep breathing exercises and supporting her during every moment of the delivery. Moreover, the hospital had warming equipment for the baby and a comfortable chair for Neerma to relax in, after the delivery” she recalled. 

The personalized and compassionate care didn’t end with the birth. Post-delivery, the midwives guided Neerma on breastfeeding and newborn care, ensuring she felt confident and supported in her recovery. The Midwifery Services Initiative is transforming maternal healthcare by prioritizing natural births and holistic care. For women like Neerma, it’s not just about delivering a healthy baby; it’s about feeling empowered, safe, and supported throughout the journey.

The Road Ahead

Midwives contribute to positive birth experiences and by delivering about 90 per cent of essential sexual, reproductive, maternal, newborn and adolescent health interventions, improve health outcomes, saving more than 4.3 million lives a year by 2035

As Rajasthan’s midwives continue their work, they symbolize a cultural revolution in healthcare. They are proof that empathy and care can transcend gender norms, offering a model for inclusivity and respect. Male and female midwives working side by side demonstrate that collaboration between genders can redefine traditional roles and create a more inclusive healthcare system. For women like Seema, this shift is life-changing. “The midwives treated me as a person, not just a patient,” she says, highlighting the transformative impact of compassionate, personalized care. By fostering an environment of trust and respect, Rajasthan’s midwives are setting a new standard for maternal care, where the focus is not just on delivering babies but on nurturing mothers.

In their pink scrubs, these midwives are more than just healthcare providers; they are agents of change. Their work demonstrates that when compassion leads and collaboration thrives, barriers can be broken, and lives can be transformed. 

The needs of a pregnant woman are diverse and multifaceted, requiring a comprehensive approach to care that addresses her physical, emotional, and psychological well-being throughout the pregnancy, childbirth, and postpartum periods.

The midwifery initiative in Rajasthan is not just about better healthcare; it is a beacon of hope, paving the way for a future where every mother’s journey is one of dignity, respect, and empowerment.