In Kashmir’s remote, roadless villages, midwives still bring babies into the world

They remain lifelines in isolated hamlets, even as hospitals and modern deliveries reshape childbirth in the Valley

Srinagar: In the roadless, snowbound hamlets of Kashmir, childbirth still begins far from hospitals, ambulances, or official records. It begins with a quiet knock on a door or a hurried call to a ‘warieen’—the local midwife—whose hands have guided generations into the world.

Despite decades of healthcare expansion, these traditional birth attendants remain the lifeline for villages cut off by mountains and winter snow.

Two or three generations ago, doctors and nurses were distant figures, often hours away on treacherous roads. Women gave birth at home, relying on midwives like Taja Begum and Rehti Begum. Their only tools were experience, mustard oil, and a sharp blade.

“I learnt midwifery from my mother,” recalls Taja Begum, 81, from a remote village of north Kashmir’s Bandipora district. “I no longer deliver babies; women today opt for caesareans to avoid labour pain. But in my day, I assisted many births, and the money I earned helped my family survive.”

Rehti Begum, 87, from Lolab valley in Kupwara district, has been assisting deliveries for over fifty years. “There are countless moments etched in my memory,” she says. “I know when a birth will be smooth and when it is not. If I see danger, I advise going to the hospital immediately.”

Her judgment, honed over decades, has saved countless lives.

Modern hospitals and schemes like Janani Suraksha Yojana have increased institutional deliveries in Kashmir, reducing maternal and infant mortality. According to the National Family Health Survey (NFHS-5, 2019-21), 92.4% of births in Jammu and Kashmir now take place in healthcare institutions—a remarkable improvement from 85.5% recorded in NFHS-4.

In rural areas, where roads and winters continue to challenge access, institutional deliveries remain slightly lower at 86%, reflecting the persistent reliance on traditional midwives.

Yet terrain and weather remain formidable barriers. In winter, many villages in Kupwara, Bandipora, and other districts have no road access or are cut off by snow, making hospital journeys impossible. Here, ‘warieens’ act as first responders, assisting normal deliveries, managing labour, and providing postnatal care.

Government health officials report successful deliveries with the help of ‘warieens’. A gynecologist at a health facility in Bandipora says, “In 2025, nearly two dozen deliveries were assisted by traditional midwives. Both mothers and babies are healthy.”

Yet, these midwives remain largely invisible to the formal healthcare system. Concerns over hygiene, complications, and lack of formal training persist. Many ‘warieens’ have adapted, using clean delivery kits, encouraging antenatal check-ups, and liaising informally with ASHA workers. Some even accompany women to hospitals, offering continuity of care and emotional support that rushed wards often cannot provide.

Beyond childbirth, they advise women on nutrition, spacing pregnancies, and postnatal recovery—guidance often shared more openly than with doctors. “She knows our bodies and our fears,” says Nusrat, a young mother from south Kashmir’s Kulgam district.

As institutional healthcare spreads, home births may decline. Yet in Kashmir’s remote, snowbound villages, ‘warieens’ remain a lifeline, operating without pay, recognition, or certificates.

Their knowledge, passed down through generations, bridges modern medicine and the most isolated communities. Supporting and integrating them, rather than sidelining them, may ensure safer births while preserving a centuries-old tradition of care.