Dr. Evita Fernandez on Rewriting India’s Childbirth Story

From once seeing childbirth as a medical emergency to championing natural, woman-led births, Dr. Evita Fernandez has witnessed a profound shift in maternity care.

After nearly five decades as an obstetrician, Dr. Evita Fernandez remains driven by a single belief—childbirth must be rooted in dignity, respect, and informed choice. In this candid conversation, she unpacks the journey that transformed her thinking and reshaped maternity care at Fernandez Hospital.

In an exclusive conversation with DC, She speaks about what changed her—and what still needs to change.

Excerpts:

When Dr. Evita Fernandez looks back at her journey, she smiles at the span of time it covers. “I have been a doctor, an obstetrician, way back since 1978. So that’s a long time,” she says. But for her, the turning point came much later. “I would like to focus on when the change happened in my thinking,” she begins. Trained like every obstetrician in India to make pregnancy and childbirth safe, she remembers how the system taught doctors to view childbirth “as a catastrophe waiting to happen.” Fear was central to the way births were handled, and somewhere along the way, the understanding that childbirth is “a normal physiological event, a natural event,” was lost.

That shift in her thinking began in the early 2000s. A book by Nutan Pandit opened a new door. “She wrote for mothers, telling them—enjoy this period, bond with your baby, don’t get worried. This is natural.” Dr. Evita loved that philosophy, and soon invited Nutan Pandit to conduct antenatal sessions at Fernandez. When she sat in on one of the classes, she had a moment that shook her. “While I believed all of this was natural and mothers should enjoy their journey, when they actually came into the birthing room, we took over. Mothers had no choice. We told them what to do. I realized, to my horror—this is terrible.”

That realisation set off deep reflection. “If Fernandez wants to be honest and do the right thing, we had to change.” What followed was a complete 180-degree shift. “We opened our minds to re-learning and changed childbirth practices in Fernandez.” That change began around 2011, and she says, “We have had no reason to regret that decision.”

The first step was empowerment. “It is a basic human right of every woman to be given the right information.” Dr. Fernandez began encouraging women to stay physically fit, eat the right food, understand labor, and learn how to handle pain. “Fear is the biggest thing women are afraid of,” she says. So childbirth preparation classes started in Hindi, Telugu, and English. “No woman should be left behind.” For 16 months, she conducted classes free of cost. “We had 4,000 couples come through our doors.” When the model proved its value, the hospital set a very low fee to ensure access.

Next came birth plans. “Asking her—how would you like your labor to be? Who do you want in the room? Bring music you want. Walk around. Choose a birthing position. Bring in respect. Give the woman the power to make choices.”

But Dr. Evita knew that doctors could not physically provide continuous support during long labors. “As an obstetrician, I can’t sit with you for six to eight hours. I may have an outpatient clinic or an emergency Cesarean.” The answer lay in midwives. “Midwives are trained to take care of women who are healthy, with no complications. They take charge, walk with the women through antenatal care, and are there in labor.” The difference, she says, is fundamental: “A nurse takes instructions. A midwife takes charge.”

Her greatest revelation was realising that doctors are not the centre of a normal birth. “I thought I was the most important person in that birthing room. But when I started my journey with midwifery, I realized—good God—if a woman is having a normal birth, she can birth beautifully without me.” Doctors bring essential skills when complications arise, she says, but the collaborative model ensures “you are using your human resource appropriately.”

She also reflects on a phase before the midwifery shift, when the hospital became known nationwide for painless labor. “We introduced 24/7 epidural analgesia in 1997. We became a centre for teaching anesthetists across the country.” While she believed it was the best option then, she later realised that “there are other ways of handling pain.” With natural birth and non-pharmacological methods, “the mother is walking around and still enjoying her labor.” The thinking evolved dramatically once midwifery training began.

For Dr. Evita, the contrast between a normal birth and an unnecessary C-section is stark. She describes the joy of a natural birth vividly—dim lights, a calm room, a companion, movement, and freedom. “At the end of it, she births the baby, you give her the baby skin-to-skin… the joy, the confidence, the love exuding out of every pore—it’s incomparable.” She also points to scientific evidence indicating that babies born by unnecessary C-sections have higher risks of allergies, asthma, childhood obesity, diabetes, and possibly autism. “If I do an unnecessary C-section, I am birthing a baby who’s going to start life on the wrong foot.”

She is equally clear about the myth that a previous C-section mandates another. “Not at all.” The real issue, she explains, is whether a hospital has a 24/7 team to manage labor safely: anesthetist, pediatrician, and staff who can respond if the scar gives way. Without this support, “the doctor is justified” in choosing a planned C-section, but the solution lies in systems, not fear.

After nearly five decades, she has seen the profession transform. “Youngsters today are far more sure of themselves,” she observes. Yet their stress levels concern her. The pressures of city life, long hours, motherhood, expectations, and social media create enormous strain. This is why Fernandez follows a team-based model. “You may not have the doctor of your choice, but you will have a competent doctor.” It reduces burnout and ensures better decisions.

What remains constant in her philosophy is simple: “Put the woman and the baby at the center. Treat her with respect, compassion, and kindness. Competence is a given. But empower her, involve her in decisions—and the whole experience becomes life-giving.”