Almost 4.5 million maternal, stillborn and newborn deaths were recorded in 2023. What if there was a clear path to saving 83 percent of these people? To saving 3.7 million mothers, unborn children and babies annually?
According to the World Health Organization (WHO), this sort of large-scale life-saving is possible, if midwifery care is universally accessible and consistent with international standards.
“Expanding and investing in midwifery models of care is one of the most effective strategies to improve maternal and newborn health globally,” said Dr. Anshu Banerjee, director for maternal, child and adolescent health and ageing at WHO.
In a recently released report, WHO outlined how individual countries, with the support of the international community, can mobilise relevant stakeholders and institute policies which support midwives.
Midwifery models of care
Midwives worldwide work diligently to provide a continuum of care to women, including care surrounding sexual and reproductive health, pregnancy, childbirth and postnatal care.
Emphasizing personalized and culturally conscious approaches, midwifery is especially helpful in reducing access barriers for women in rural or conflict-affected regions where hospitals may not be accessible.
“Skilled midwives help women trust in their bodies, their abilities and their care…ensuring women are consistently part of decision making and have access to the information they need,” said Ulrika Rehnstrom Loi, a midwifery expert at WHO.
The WHO report emphasised that midwifery models of care are especially important as concerns of over-medicalisation in childbirth become more pronounced.
“In a world where childbirth is increasingly medicalised, [midwives] offer a person-centered evidence-based approach that respects the physiological process of birth, restores dignity and autonomy to maternity care,” said Anna Ugglas, Chief Executive of the International Confederation of Midwives.
Implementing a global imperative
Currently, the world faces a global shortage of around one million midwives. Concentrated and cross-sectoral action is needed to reverse this shortage.
“Midwifery models of care are not just smart solutions — they are a necessity,” Ms. Ugglas said.
The WHO report outlined that increasing the number of midwives worldwide requires policy action across many sectors, including health and education, in addition to advocacy campaigns.
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In Morocco, the Association of Midwives conducted an awareness campaign which distributed flyers and cultivated partnerships with women and civil society organizations.
This campaign ultimately led to legislation in 2016 which defined what midwifery was, the first of its kind in Morocco.
Like the Moroccan example indicates, the report said that policymaking, advocacy and implementation must all happen simultaneously and that each country must adopt an approach which is specific to their context.
“[Midwifery] approaches improve outcomes, maximize resources and can be adapted to all countries,” said Dr. Banerjee.
Case study in rural midwifery
A campaign in the West Bank led by the Palestinian Red Crescent Society, the Palestine Committee of Norway and the Palestinian Ministry of Health worked to address the challenges that women in rural areas face when accessing care.
Through coordinating with hospitals and community members, the campaign expanded midwifery services to six regional hospitals and 37 villages between 2013 and 2016. This led to a 20 per cent decrease in unplanned caesarean sections and a 21 per cent decline in preterm birth rates.
And these were just the short-term effects, but Mr. Banerjee said that expanded midwifery access can have longer-term effects too.
“[Midwifery models of care] also enhance women’s and families’ experiences of care – building trusted partnerships for health at this critical stage of life.”