Some 73 countries in Africa, Asia and Latin America are responsible for 96% of global maternal deaths and more than 90% of newborn deaths. Yet, these same countries are home to only 42% of the world’s health workforce.
Increasing the number of midwives could prevent as many as two-thirds of all maternal and newborn deaths, says a new report released today by the UN’s Population Fund, the World Health Organization and the International Confederation of Midwives. Making investments in the training and education of midwives can go a long way to save lives.
“Midwives are the unsung heroes of maternal and newborn health. Indeed they are the unsung heroes of global health,” said UNFPA Executive Director Dr. Babatunde Osotimehin on the press call.
It is now understood that hemorrhage, hypertensive disorders and sepsis were responsible for half of all maternal deaths between 2003 and 2009. Simply giving mothers magnesium sulphate is able to halve the risk of them dying from pre-eclampsia. Improving the health workforce will increase overall coverage, but there is a need for workers who are specialized in maternal and newborn health.
Enter the midwife.
Midwives are capable of providing as much as 87% of the essential care for women and newborns, says State of the World’s Midwifery 2014: A Universal Pathway – A Woman’s Right to Health. The ability to save lives is why Pakistani midwife Farida Shah decided to become one. As a child she saw how a trained midwife saved the life of an unconscious pregnant woman. The look of relief and joy that cam over the woman’s family inspired her to join the profession.
On December 16, 1996, a similar situation presented itself to Shah. A woman, also named Farida, was unconscious due to excessive bleeding. The region where Shah was working is cut off from the majority of the country during the winter due to snow. Travel to a hospital would take too long if Farida was to survive. An examination by candlelight revealed a tear in the girl that Shah was able to repair.
The date is memorable for Shah because it is an example of why she decided to be a midwife. It is also because the family offers her thanks on that day each year. Sixteen years later, Shah received a letter from Farida’s son to personally thank her for saving his mother’s life. The experience has led her to campaign for midwives and support their training by working with the Baltimore-based NGO Jpheigo.
“I enjoy working with the midwives because they are saving lives. It gives me so much satisfaction when a midwife saves a mother and her newborn. Midwives contribute to making strong families,” said Shah.
Presently, less than half of the 73 low and middle-income countries analyzed in the report have taken action to promote the deployment of midwives in remote areas. It underscores the key needs recommended by the report authors and its supporters: more midwives are needed. Doing so requires support for training, government-level policies and licencing and better data collection.
“Investing in midwives means in investing in midwifery education, so more midwives can be educated and more lives can be saved,” said Frances Day-Stirk, President of the International Confederation of Midwives, in a press call. “Education is an absolutely crucial pillar to midwives.”
An increase in the number of midwives not only supports the health of mothers and newborns, it is a step towards universal access to all forms of sexual and reproductive healthcare. Midwives are allowed to provide at least one form of family planning product in 71 out of the 73 countries assessed (China and Iraq are the exceptions). Four options are provided by midwives in 57 countries, making midwives a key component to increasing family planning access.
“This report shows the glaring gap between the reproductive needs for women and the healthcare workforce,” said Osotimehin.
An investment in midwives seems rather obvious. The case for midwives is bolstered by a case study from Bangladesh which projects a 1,600% return on investment in midwives. 500 midwives are currently being educated and deployed in the central Asian country. If all goes well, they have the potentialto help reduce maternal mortality by 80% and infant mortality by 70%.
To put it another way, these midwives can save tens of thousands of lives, each, over their careers.