Male midwives in Lesotho challenging traditional gender roles

Male midwives in Lesotho are increasingly playing a vital role in improving maternal healthcare, particularly in remote areas where access to medical services is limited. At the Mpharane Health Centre in Mohale’s Hoek district, Ntlhane Sehloho, one of approximately 300 male midwives in the country, works tirelessly to support expectant mothers. With two decades of experience, Sehloho has become a trusted figure among the local community, helping to reduce maternal mortality rates and challenge long-standing gender norms in the field of midwifery. Lesotho, a landlocked nation with a population of just over 2 million people, faces significant challenges in providing adequate healthcare, especially in rural regions. Many women give birth at home due to the lack of nearby facilities, often resulting in preventable complications. To address these issues, the government, alongside international organizations such as UNICEF and the World Health Organization, has actively promoted the training of male midwives. This initiative aims to increase the availability of skilled professionals while addressing the shortage of female midwives in certain areas. Sehloho, who grew up in a rural community, recalls witnessing the dangers of unattended childbirth during his childhood. His experiences motivated him to pursue a career in nursing, eventually leading to his specialization as a midwife. “Our village is far away from the health facility, so most women who are pregnant, some were delivering at home, so it was just a mess,” he explains. “So, I then said that I’m going to grow and I’m going to be a nurse.” His dedication has made him a key player in transforming maternal care in Lesotho. Traveling for three hours each day along rugged mountain roads, Sehloho reaches the Mpharane Health Centre, where he provides essential care to women in need. He emphasizes that male midwives are not only necessary but are gradually gaining acceptance within the profession. “In most of our health centres, the ones in charge are those male midwives,” he notes. “Even in a class, you will find that we have twenty student nurses or student midwives and ten males. So that says for Lesotho it’s normal to be a midwife.” Despite the progress, there remain cultural barriers. Some women express discomfort with male midwives, preferring female caregivers. Blandina Motaung, coordinator for UNFPA’s Sexual and Reproductive Health and Rights program, highlights that male midwives may offer unique advantages. “Men, because they have not gone through the process, become more vigilant and more attentive to the nitty gritty, and that is its own improved quality of care that they provide,” she explains. However, personal preferences vary. Expectant mother Mpolokeng Mafereka prefers female midwives, stating, “I am more comfortable being treated by a female person. I feel more comfortable with a woman because men are not usually people who work in the space of pregnancy.” On the other hand, 21-year-old Bonolo Tebello has no issue with male midwives, asserting, “I’m happy to be treated by a male because they still provide the same level of care.” Sehloho understands the importance of building trust and often uses his own background to reassure patients. He shares stories of past deliveries and relates to their experiences, aiming to create a sense of comfort and familiarity. As Lesotho continues to expand its healthcare infrastructure, the presence of male midwives represents both a practical solution and a shift in societal attitudes. With maternal mortality rates remaining high, approximately 530 deaths per 100,000 live births compared to a global average of about 200, the need for additional trained professionals is urgent. The government and international bodies continue to advocate for greater participation from men in midwifery, emphasizing that gender should not dictate the quality of care received during childbirth.