SANTA MONICA, Calif. — Every day, hundreds of women in developing countries die from preventable deaths related to pregnancy and childbirth because they lack access to skilled health professionals. A greater investment in midwifery could drastically reduce these numbers.
Midwives provide essential care during pregnancy and childbirth. They are especially crucial during the birthing period, as timely and skilled treatment can save the lives of both mother and child if complications arise. Often in developing countries, mothers are undereducated about obstetric and gynecological issues. Midwives not only deliver babies; they have the capacity to educate women and girls to care for their health, offer family planning counseling and provide services to prevent mother-to-child transmission of HIV. A World Health Organization study finds that “one in four maternal deaths are caused by pre-existing medical conditions, such as diabetes, HIV, malaria and obesity, whose health impacts can be aggravated by pregnancy.” Midwives are knowledgeable about the health care solutions available to prevent or manage such conditions during pregnancy, while many mothers are not.
In the publication, “The State of the World’s Midwifery 2014: A Universal Pathway, A Woman’s Right to Health” (SoWMy,) 73 developing countries are shown to account for 96 percent of maternal deaths. They also possess only 42 percent of the world’s midwives and health care professionals. The report urges countries to reevaluate the chronic lack of investment in midwife services in order to save the lives of millions of women and children each year.
Most deaths occur in low-resource settings, in which women lack access to midwifery services. The factors most responsible for preventing women from receiving these services are poverty, long distance, lack of adequate information or services and cultural norms. Poor women in remote or rural areas are especially unlikely to receive the care they need for a safe birth. Less than half of the women in developing countries — especially in sub-Saharan Africa and South Asia — have even basic access to skilled care during childbirth.
But there have been many recent improvements. Since 1990, maternal mortality worldwide has decreased by almost half. In fact, 11 developing countries have reached the Millennium Development Goal target of a 75 percent reduction in maternal mortality and many others have increased the recruitment, training and deployment of midwives. There have been improvements in four key areas: availability, accessibility, acceptability and quality of midwifery services.
However, it cannot be denied that there still remains a critical shortage of midwives and other health professionals that takes a massive toll among women and children. Unfortunately, a lack of accurate data interferes with proper monitoring of many poor countries. This makes it difficult to assess common causes of death and where to allocate the most resources.
SoWMy offers a series of recommendations to reach the objective of universal access to midwifery services for all women and girls of reproductive age. Fundamental policy measures include the training of midwives in “professional, supportive and preventative” capacities. The publication also advocates for birth preparedness sessions, access to emergency services if needed and extensive sex education. There is a widespread consensus that the prevention of maternal deaths can be achieved by providing the basic right of quality healthcare through greater investment in midwifery services.