A comparative overview of child-birth in Iran and Australia: Role of Midwives

Over the last 30 years, medicalised birth models for healthy pregnant women have become the dominant care model around the world, including in Iran and Australia.

Iran has the second highest rate of Caesarean Section (CS) in the world, >40% in public hospitals and >90% in private hospitals. Some reports indicate the rate of CS is as high as 80% in some public hospitals in 2009 (Badakhsh et al., 2012) in contrast to the 33% CS rate in Australia (AIHW 2015).

However, policies adopted over past decades in each country’s maternity systems have changed the birth culture dramatically. In Iran, the role of midwives in maternal care has been mostly neglected and marginalised with mal-distribution of workforce and there is lack of support for women due to shortages of midwifery staff in the public system. Due to fee for service model, the absence of clear guidelines and lack of transparency at the organizational level in Iran, obstetric models dominate. This significantly impacts practice, maternity care, and outcomes for women and babies. This has created a culture of fear of normal child-birth among Iranian women (NCRI 2016).

Reorienting and relocating mainstream maternity services within a primary health care framework for healthy woman and babies can re-focus government policy. Implementation of some midwifery lead care models, e.g.  Australian Midwifery Group Practice (MGP) to Iran’s health system may initiate behavioural change in clinicians to alleviate the CS epidemic. This presentation considers the role of midwives in Iran and Australia, in providing women centred care and bringing back women’s trust in her own body and her ability for normal birth.