Midwives save lives
Today marks International Day of The Midwife where the efforts of midwives globally are recognised for the care they provide to mothers and newborns. This year’s event has the theme, follow the data: Invest in midwives. The theme is in line with the launch of the 2021 State of the World's Midwifery Report, co-led by The United Nations Population Fund, The World Health Organisation and The International Confederation of Midwives. The report is packed full of the most current data and evidence on the impact of midwives on maternal and newborn health outcomes and the return on investment of midwives.
"Call the midwife"
Midwives and an increase of midwife intervention is essential for stopping preventable maternal deaths and for achieving sustainable development goal 3.1, which aims to reduce global death from pregnancy and childbirth to less than 70 per 100,000 live births by 2030. If you didn't know, the Sustainable Development Goals or Global Goals are a collection of 17 interlinked global goals designed to be a "blueprint to achieve a better and more sustainable future for all" which were set out in 2015 by United Nations General Assembly and are intended to be achieved by the year 2030. The picture below (which you might have seen before) shows the main Sustainable Development Goals in a visual way.
The number of women dying in childbirth varies greatly across the planet and is largely down to the investment (or lack thereof) of midwives. For every 100,000 live births 220 women die in South Asia, 150 in South East Asia, compared to 37 in the slightly more affluent East Asia. For some context this number ranges between 4 and 10 per 100,000 in most European countries, including the UK at around 9 per 100,000.
Follow the data: Invest in midwives
Midwives could provide up to 90% of essential sexual, reproductive, maternal, newborn and adolescent healthcare across the planet if properly invested in. There is a global shortage of midwives of almost 1 million and with our growing population this number will continue to climb as our health resources get stretched further and further.
The report that coincides with today’s event outlines the significance of midwives and how they could be a cost-effective and realistic way to improve health outcomes. A small increase of 10% in midwife-delivered births every 5 years could save 22% of maternal deaths, 23% of newborn deaths, 14% of stillbirths and 1.3 million lives per year by 2035. Similarly, increasing midwife delivered births to 25% every 5 years could save 2.2 million deaths while universal coverage from midwives could save a massive 4.3 million deaths every single year.
Unfortunately the cost of this initial investment is high and exceeds current government commitments and official development assistance from donor countries and other funders. An investment of 115.5 billion dollars in health systems and health workers, including well-trained midwives, is required over the next 10 years in 120 priority countries globally. Almost 40% of this, about 43 billion dollars, is needed in the Asia-Pacific region alone.
The impact of Covid-19 on midwives and mothers
The struggles of midwives and expectant mothers have only been intensified by the Covid-19 pandemic. Anxiety levels are high with staff being stretched beyond their limits or being diverted to other health sectors to help bare the load. Lack of PPE is still a massive issue in many countries and is leaving midwives and mothers vulnerable. Many midwives will have contracted the virus and will have had to leave their patients and colleagues behind while they recover leaving those left to struggle even further.
Expectant mothers are also feeling the pinch of the pandemic with many being unable to access appropriate care or feeling scared they will contract the virus. After giving birth, many UK mothers have reported feeling forgotten about, with post birth checks being quick phone calls rather than in person appointments or not happening at all.
Today is for us to recognise the efforts of those who bring new life into the world every day, who probably bought you reading this into the world too. While midwives are being (stretched sometimes beyond their means) they are always there for the community, even risking their lives to care for women and their babies and for that we give thanks. If you know any midwives don’t forget to give them some love and check in on them to see how they are coping during this pandemic, because we need them now more than ever.