Even the healthiest pregnancy can pose serious health consequences such as infection, obstructed labour, high blood pressure, and severe bleeding. The use of a midwife is key to a healthy and safe pregnancy and childbirth but they often work in decrepit health facilities and lack required resources, supplies and equipment.
The International Day of the Midwife, on 5 May, commemorates the work of midwives around the world. According to the UN, services provided by midwives could avert as many as 3.6 million deaths per year. Yet, a third of all births take place without a midwife or other skilled birth attendant.
More than 136 million women give birth per year and about 20 million of them experience pregnancy-related complications. A woman’s lifetime risk of maternal death – the probability that a 15-year-old woman will eventually die from a maternal health factor – is 1 in 150 in developing countries.
Annually, 16 million girls aged between 15 and 19 give birth each year. Ninety per cent of the births in developing countries occur in single teens or adolescent marriages. Many of these women have been married off as children and lack the education, money and status to get adequate healthcare services.
“Women are not dying because of illnesses we cannot treat. Women are dying because society has yet to decide that their lives are worth saving,” explains Mahmoud F. Fathalla, a renowned obstetrician.
Increasing women’s access to quality midwifery is critical in order to achieve the Millennium Development Goals (MDGs) and reduce the maternal mortality ratio by three quarters between 1990 and 2015. The first step is assessing the current situation and supporting critical success indicators.
“The world needs midwives now more than ever,” describes Dr Babatunde Osotimehin, the Executive Director of United Nations Population Fund (UNFPA).
To facilitate this, the UNFPA has supported the training of over 10 000 midwives between 2008 and 2013. They also allocate the provision of clean delivery kits, funding and supplies for healthcare facilities, and on-going training programmes.
Despite their efforts, many midwives still find themselves overburdened due to poor overall healthcare funding, deficient equipment and too few qualified personnel.
“Where I’m working, there are four midwives. And those four midwives, they have to cover maternity – that is their part – [as well as the] paediatric ward, female ward, children’s ward,” describes Enis Banda, a midwife.
“Those midwives, they are trying their best to work day and night… To them, it is a very difficult situation,” she emphasized.
“The issue is lack of proper working equipment… especially in the [area of] supplies. Sometimes in our facility, we experience shortages of drugs. Yes, we provide good services, but if you don’t provide the drugs, at the end of the day, you have not really helped that woman,” explains Anthony Kiplagat, another midwife.
In May, Ministers of Health from countries from around the world will discuss the “Every Newborn: an action plan to end preventable deaths” (ENAP) at the World Health Assembly in Geneva. The ENAP highlights the critical importance of addressing the needs of midwives.
”One of the ENAP’s key objectives will be to encourage governments to allocate adequate resources for maternal and newborn health services within national health sector plans. This should include funds for the training and retention of midwives. We will continue to support countries to develop and strengthen their midwifery services as a critical intervention to save the lives of women and newborns,” says Dr Elizabeth Mason, Director of WHOs Department for Maternal, Newborn, Child and Adolescent Health.
Engage the conversation on social media by using #SavingMothers.
Dr Couillard is an international health columnist that works in collaboration with the World Health Organization’s goals of disease prevention and control. Views do not necessarily reflect endorsement.
Facebook: Dr Cory Couillard
Twitter: DrCoryCouillard
