Africa Daily — "Should more men train to be midwives?"

Host: Alan Kasuja (BBC World Service)
Guest: Robert Aule, male midwife in Baringo County, Kenya
Episode Date: February 19, 2025

Episode Overview

This episode tackles the underrepresentation of men in midwifery across Africa—a profession overwhelmingly dominated by women, with less than 1% male participation. Alan Kasuja interviews Robert Aule, a pioneering male midwife who has helped deliver over 500 babies in remote, underserved regions of Kenya. The conversation explores Robert’s career journey, the cultural stigma faced by male midwives, the technical and emotional aspects of assisting childbirth, and whether more men should enter this vital field.

Key Discussion Points & Insights

The State of Midwifery in Africa

• Severe Midwife Shortage: Africa suffers from a dire lack of midwives. According to the UN Population Fund, there are only 2 midwives per 10,000 people in Eastern and Southern Africa.
  • [02:15] B (Alan Kasuja): “...midwifery is seen as a female profession. Could encouraging more men to become midwives help bridge this gap in healthcare?”

Robert Aule’s Path to Midwifery

• Early Motivation and Training: Started as patient attendant/nursing aide at Capedo Mission, trained by Finnish missionaries from 1980, and delivered his first baby in 1982.
  • [04:10] C (Robert): “...started this job from Capedo Mission I as a patient attendant...in 1980 up to 91 March, the government of Kenya employers as a senior first aid.”
• Transition through Insecurity: Missionaries left due to security issues, Robert remained as local staff hero.
• Dedication to the Profession: Robert views his work as a calling, shaped by his own experience with disability and early medical care after birth.
  • [06:08] A (Robert): “After helping this mother deliver her baby, from that moment onwards I felt that my passion is helping mothers to deliver and I believe that is my calling.”

Cultural Perceptions and Stigma

• Male Midwives Rare and Stereotyped: Traditionally, childbirth is viewed as “work for women,” creating cultural hurdles for men entering the field.
  • [07:54] A (Robert): “Culturally, the people here do fear. But for me, because I had joined the work through church, I did not have reasons to fear, as I was only offering help. But you see, this is a practice that is not wholly embraced here culturally.”
• Local Acceptance: Despite initial skepticism, Robert is accepted and trusted by his community.
  • [08:15] A (Robert): “The people saw me as a professional carrying out my duties. They have accepted me. Even the men, when they see their wives start labor pains, they are quick to reach out to me. Men here are okay with me, and the patients too, are very comfortable with me.”

The Practice and Art of Delivering Babies

• Approach to Childbirth: Robert emphasizes kindness, patience, and support.
  • [09:24] A (Robert): “You must not be harsh with a woman. Treat her with dignity, be gentle with her...I dedicate myself. I sit next to her and I treat her gently.”
  • [10:05] A (Robert): “As a midwife, there will be a point at which you can see the baby isn't very far. It will be out soon. And that is the moment to say to the mother, look, the baby is almost yours. Now you just need to make the final push.”
• Handling Complications: Robert assesses each case and refers complicated ones to the district hospital, recognizing his limits and prioritizing safety.

Impact and Legacy

• Over 500 Deliveries: By his count, Robert has helped deliver over 544 children, some even named after him.
  • [13:05] A (Robert): “Oh, many, many...There are so many of them in Nyang area, and it's even a bigger number in the nearby villages. My names are Robert Aule, and many have been given both names, while others have been given my surname, Aule.”
• Personal Fulfillment: Robert’s motivation is rooted in gratitude and service, not profit.
  • [15:31] A (Robert): “Nah, they don't pay me any money. I only do this as a way of giving back because I myself received help when I was born.”
  • [16:41] A (Robert): “I'm not in this for any benefit. My fulfillment comes from committing myself to helping these people, my community. This is because I was born with a physical deformity, like I said earlier, but I was treated at birth by the missionaries.”

Should More Men Train as Midwives?

• Advocacy for Male Inclusion: Robert encourages men to join the profession, while noting cultural barriers remain.
  • [16:08] A (Robert): “I certainly encourage you to join.”
  • [16:16] A (Robert): “Oh, yes. But, you know, culture remains an issue here. It is definitely a matter you'd come face to face with if you offer to help as a male midwife...if they want to become midwives, I'm here to welcome them.”

Challenges and Barriers

• Infrastructure and Resources: He highlights the lack of ambulances, doctors, and basic dispensaries in remote communities—sometimes resulting in tragic maternal deaths on the way to care (14:30).

Notable Quotes & Memorable Moments

• On Stigma:
  • “[07:54] C (Robert): Culturally, the people here do fear. But for me, because I had joined the work through church, I did not have reasons to fear, as I was only offering help.”
• Empathy in Practice:
  • “[09:24] A (Robert): You must not be harsh with a woman. Treat her with dignity, be gentle with her.”
• Personal Motivation:
  • “[16:41] A (Robert): My greatest fulfillment for me is in helping this community.”
• On Acceptance:
  • “[08:15] A (Robert): Even the men, when they see their wives start labor pains, they are quick to reach out to me. Men here are okay with me, and the patients too, are very comfortable with me.”
• Encouraging Men:
  • “[16:08] A (Robert): I certainly encourage you to join.”
• Legacy:
  • “[13:05] A (Robert): Many...have been given both names, while others have been given my surname, Aule. Some have become teachers, others...doctors, others are nutritionists, and there are technicians. So many.”

Important Segment Timestamps

• [00:00-02:15] — Opening, context on midwifery shortage and gender imbalance
• [03:41-05:03] — Robert Aule’s career beginnings and training
• [06:59-08:41] — Cultural barriers and personal experiences with community acceptance
• [08:42-10:35] — Robert’s approach and philosophy in childbirth
• [12:06-13:31] — Impact of Robert’s work on community and namesakes
• [14:30-15:15] — Logistical and infrastructure challenges in rural healthcare
• [16:00-16:34] — Robert’s advocacy and advice for aspiring male midwives

Summary

This episode uses Robert Aule’s remarkable career to illuminate both the challenges and opportunities for men in midwifery across Africa. His story illustrates how, despite cultural stigma and resource constraints, a devoted professional can earn trust and make a life-changing impact. Robert advocates for greater male participation to fill crucial workforce gaps, but stresses the need to gently challenge and reshape societal attitudes. Ultimately, his testimony reframes midwifery not only as a medical skill, but as a courageous form of community service—open to anyone with compassion and dedication.