Perceptions and Interventions of Public Health Midwives (PHMs)
Regarding the Reproductive Behavior of Women in Sri Lanka
K. Dilhani Wijesinghe
Reitaku University
a17001d@reitaku.jp

Reproductive behavior can be simply identified as the behavior of producing offspring.
Broadly, it implies the behavioral patterns that correlates to marriage union or co-residence, childbearing, child rearing, pre-natal or post-natal family controlling practices, and maternal care of thewomen who are in their reproductive span. Reproductive behavior is not equivalent in every society
and it depends on socio-cultural, ethnic, religious, economic, political and individual factors of thepopulation. Despite being a developing country, the success story of maternal and child health in SriLanka is acknowledged especially within the South Asian region with the pivotal role of Public
Health Midwives (PHMs).
The current study mainly analyses PHMs perceptions and interventions on reproductive
behavior in Sri Lanka. Accordingly, interventions of PHMs in reproductive decision making andmaternal and child health, the issues related to women’s dual role in the family, the support fromfamily members in child bearing and child caring, the status of women's autonomy and power on
reproductive decision making, PHMs perceived sectoral (urban, rural and estate) variations ofreproductive behavior (Women who lived in rural and estate sectors were 1.4 and 1.2 times,
respectively, more likely to prefer more children compared with urban women (Perera, 2017)) in Sri
Lanka are explored. Likewise, current study allows to share the Sri Lanka’s experience with other
South Asian countries in the region.
The data for the current study were collected from 16 face to face semi-structured interviews
conducted in urban, rural and estate sectors in Sri Lanka. Accordingly, 5 PHMs from urban(Battaramulla), 9 PHMs from rural (Dompe) and 2 PHMs from estate (Awissawella) sectors wereinterviewed. Interviews were aimed to gather in-depth information on PHMs training program andobligations, PHMs services, characteristics of the working area in each sector, PHMs perceived

fertility preferences of women in Sri Lanka, PHMs perceived support from family members in childbearing and child caring and contraceptive practices of women in Sri Lanka.
The findings revealed that regardless of service period, all PHMs have completed a two year
training period which includes one and half years of institutional training along with 6 months fieldtraining. Due to the core and expanded role of PHMs working in all three sectors women receive
pregnancy and postpartum care, child care services and several family planning services free of charge
throughout their reproductive life span. PHMs perceived that the women who live in rural and estateareas have lack of reproductive health knowledge. Even though number of children in a family isdecreasing, some urban areas show an increasing trend. Moreover, women in both urban and rural
areas have benefited from the great support provided by family members in child bearing and childcaring while estate sector women often receive minimum support. Unlike other South Asian
counterparts, Sexual preference is not a decisive factor for families in Sri Lanka. Instead, most families
wish to have births from both sexes. Likewise, unplanned pregnancies are very rare in both urban andrural areas in Sri Lanka and such unplanned pregnancies are also for 3rd birth. However, there is a highrisk of reporting unplanned pregnancies for 2nd and 3rd births in estate sector. Moreover, women in SriLanka have the power, autonomy and easy access to use their desired contraceptive method. Despite
that, most women in estate areas depend on a hormone injection (Depo-provera) by means ofcontraception since they have limited access for female sterilization (LRT).
Above findings suggest that PHMs have an essential role to play in Sri Lankan society.
Especially, PHMs expanded field services are immensely valued in rural and estate sectors wherematernal and child health facilities are scarce. However, it is necessary to re-design PHMs services inestate sector providing additional services such as estate based counselling services and familyplanning programs.

Reference
Perera, E.L.S. J. (2017). Fertility transition in Sri Lanka: is it a temporary phenomenon?. Journal ofbiosocial science, 49(S1). S116-S130.