Changing roles of midwifery in maternal health care services in Turkey

Pelin Cagatay Seckiner, Hacettepe University
Ismet Koc, Hacettepe University

Aim: This study aims to identify whether the assigned roles to midwives and the scope of midwifery practice regarding maternal health is narrowed down in Turkey. Materials and Methods: Descriptive analyses and statistical tests addressing the study objectives were done by utilizing data sets of demographic and health surveys conducted in 1993, 1998, 2003 and 2008. Results: Private health sector has gained importance in Turkey in the last decades. The share of private facilities in delivery process has increased from 5% to 22%. The proportion of pregnant women seeking for antenatal care services (from 67% to 92%) and, the proportion of births attended by health personnel (from 80% to 94%) have risen significantly between 1993 and 2008. On the other hand, physicians have become main providers of antenatal care services during the same period and the percentage of certified midwife-attended births dropped noticeably from 43% to 26%. Vaginal birth in which midwives usually take the primary responsibility has reduced dramatically while cesarean rates have reached 40%, as of 2008. Discussion: There have been major alterations in Turkey’s health system after 1990s. It is recognized that midwives are losing their autonomy and quietly disappearing in birth process.