TORONTO – The past few decades have brought incredible progress for women and children’s health. Since 1990, preventable child deaths have declined by 50%, and maternal mortality has fallen by 45%. But far too many mothers and newborns are still dying from preventable causes. With access to qualified midwives, many of their lives could be saved.
Each year, one million children, on average, still die during their first day of life; more than million babies are stillborn; and more than 300,000 mothers die during pregnancy and childbirth – a death toll exceeding the entire population of Namibia. A majority of these deaths – 56%, to be precise – are preventable.
If all women had access to a midwife during pregnancy and labor, not to mention facilities equipped to provide basic emergency care, one million lives would be saved every year. And yet midwifery is still chronically neglected and underfunded by governments and communities around the world.
As birth attendants, midwives are ideally positioned to save the lives of mothers and children during childbirth. A midwife with the right skills and training can provide 87% of the essential health care needed during pregnancy and following birth. And the care they provide is high quality and comprehensive across health contexts. Whether you are an American billionaire or a smallholder farmer in Tanzania, a skilled midwife can provide you with expert support that is unlike that of any other health professional.
Midwives’ services extend far beyond pregnancy and birth to include essential education, health monitoring, and primary care for babies, adolescents, and mothers throughout the life cycle. Midwives are also a front line of defense against disease. They provide information about reproductive health, which can help stop the spread of HIV and other sexually transmitted diseases, and about hygiene and healthy lifestyles; and they are often the ones who administer and monitor the vaccination and immunization of expectant mothers, newborns, and infants.
Moreover, midwives’ integrated, frontline approach helps them bridge the gap between isolated rural health centers and the communities they serve. Owing to their unique training and deployment, midwives are often the pillars upon which universal health-care coverage rests.
Given that midwives are such a practical and affordable solution to many maternal- and community-health problems, it is baffling that world leaders who claim to stand for women and children’s safety do not give midwifery more political support. And this is not just a problem in low- and middle-income countries. High-income countries such as Canada have also struggled to recruit and fund enough midwives to meet demand.
This has to change. Worldwide, 350,000 more midwives are needed to bridge the gap between the health-care haves and have-nots. And, from a fiscal standpoint, midwifery is an extremely cost-effective way to achieve that goal. Policies and funding to support midwife education, training, and regulation can produce up to a sixteenfold return on investment, because when midwives are involved in pregnancy and childbirth, mothers are less likely to require expensive emergency interventions such as caesarean sections.
The fact that governments and civil-society organizations have given midwives such short shrift is as surprising as it is disappointing. All governments that value their citizens, and all citizens who value their families, should favor policies to expand this area of health care. With the proper resources, midwives will save lives before, during, and after a woman gives birth, and health-care outcomes will be improved across the board.
To bring more attention to midwives’ unique role, the International Confederation of Midwives is gathering this week in Toronto, Canada, for its 31st Triennial Congress. For nearly 100 years, the ICM has advocated for women by supporting the midwives who protect them.
We cannot rest until we have addressed the millions of lives that are still lost each year in pregnancy, childbirth, and early life. That is why we are asking governments and donors around the world to give midwifery the attention that it deserves as a commonsense solution to a global health problem.
World leaders need to stand up for those who support women and children when they are most vulnerable. It is time to give them the resources they need to continue performing their essential work. After all, midwives do not just deliver babies; they deliver lives.
Jakaya Kikwete, a former president of Tanzania, is a member of the International Commission on Financing Global Education Opportunity. Toyin Saraki is the founder and president of the Wellbeing Foundation Africa.
By Jakaya Kikwete and Toyin Saraki