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UN report sounds alarm on acute global shortage of midwives

The 2021 State of the World’s Midwifery report, launched on Wednesday by the UN Population Fund (UNFPA), the UN World Health Organization (WHO) and the International Confederation of Midwives, said that fully resourcing midwife-delivered care by 2035 would avert roughly two-thirds of maternal, newborn deaths and stillbirths, saving 4.3 million lives per year.

Natalia Kanem, Executive Director of the UN Population Fund (UNFPA), highlighted the “enormous impact” midwives have on women and their families.

“A capable, well-trained midwife can have an enormous impact on childbearing women and their families – an impact often passed on from one generation to the next.”

“At UNFPA, we have spent more than a decade strengthening education, enhancing working conditions and supporting leadership roles for the midwifery profession. We have seen that these efforts work”, she added.

The report called on governments to provide an enabling work environment for midwives, free from gender-related stigma, violence and discrimination. It also urged greater investment in the education and training of midwives and midwife-led service delivery, and midwifery leadership and governance.

Appointing senior midwives as leaders at country level would provide a significant lever for building capacity, it noted.

Providing health services, protecting women’s rights

Midwives do not just attend births, they also provide antenatal and postnatal care and a range of sexual and reproductive health services, including family planning, detecting and treating sexually transmitted infections, and sexual and reproductive health services for adolescents, all while ensuring respectful care and upholding women’s rights.

As numbers of midwives increase and they are able to provide care in an enabling environment, women’s and newborns’ health improves as a whole, benefitting all of society.

The report’s 2021 edition – the third in the series – noted, however, that despite previous warnings and presenting a roadmap to remedy the deficit, progress has been very slow. According to latest analysis, at the current rate, the situation would improve “only slightly” by 2030.

UNFPA Sudan/Soufian Abdul-Mouty
Midwives in Sudan continue to work to ensure that every childbirth is safe during COVID-19.

Learn lessons from the pandemic

Against this background, the report called on Governments and stakeholders to “build back better and fairer” from the pandemic, forging stronger primary health-care systems as a pathway to universal health coverage and fostering a more equitable world for all.

“We must learn the lessons the pandemic is teaching us, by implementing policies and making investments that deliver better support and protection for midwives and other health workers”, Tedros Adhanom Ghebreyesus, WHO Director-General, said.

“This report provides the data and evidence to support WHO’s longstanding call to strengthen the midwifery workforce, which will deliver a triple dividend in contributing to better health, gender equality and inclusive economic growth”, he added.

Follow the data, invest in midwives

The launch of the report coincided with the International Day of the Midwife, observed annually on 5 May, recognizes the crucial role these essential healthcare professionals have in preventing maternal and newborn deaths and empowering women to make the best choices for themselves and their babies.

This year’s theme is Follow the Data, Invest in Midwives.

Franka Cadée, President of the International Confederation of Midwives, appealed to governments and policy makers to act on the report’s recommendations.

“As autonomous, primary care providers, midwives are continually overlooked and ignored. It’s time for governments to acknowledge the evidence surrounding the life-promoting, life-saving impact of midwife-led care, and take action on the State of the World’s Midwifery report’s recommendations.” 

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