Delivering Joy: Midwives are the Key to a Future with Healthy Mothers and Babies
June 18, 2014by Her Royal Highness Princess Sarah Zeid of Jordan
I had no choice but to become an advocate for maternal health. Four years ago, if it were not for the skilled professionals by my side when I developed an amniotic fluid embolism, I would have died. This experience led me to act, speak and stand in solidarity for all women's reproductive health. No woman should die during pregnancy or childbirth, especially when the survival and health of mothers and their babies can, in fact, so often be saved. After reading the findings of a breakthrough report published this month, I had to speak out in support of midwives.
The State of the World's Midwifery report looks at the 73 countries that carry the burden of 96 percent of maternal deaths, 93 percent of newborn deaths and 91 percent of still births, yet have only 42 percent of the world's midwives, nurses and doctors. In these countries, two-thirds of the nearly 3 million babies and almost 300,000 women who die each year from birth complications could be saved if they had access to an educated and trained midwife -- approximately 2.3 million lives each year!
These needless deaths and suffering are heartbreaking. Imagine being pregnant and alone, turned away from receiving care because of lack of funds, or having your healthy newborn die in your arms because there was no one there to teach you simple, cost-effective, life-saving techniques. Only four of the 73 countries have a midwifery workforce that can meet the universal need for key life-saving interventions. The report proves that midwifery is the answer to tipping that scale in the other direction. In fact, educated midwives can deliver nearly 90 percent of the necessary health care to ensure that mothers and newborns survive and thrive.
For someone who knows what it feels like to be in a crisis, the helping hands, the compassion and the commitment we see in midwives is what not only saves lives, but will ultimately help propel health indicators, growth and prosperity in the coming years.
As we work to grow a global network of quality midwives, we cannot shy away from the challenge of countries gripped by emergencies. In Sudan, for example, a woman is 100 times more likely to die in childbirth than in an industrialized country.
For mothers who are fighting for their lives on multiple fronts, midwives are often the only key to survival. In places like Syria, midwives have assisted thousands of women and girls who have become pregnant since the conflict arose three years ago.
With simple tools such as clean delivery kits -- a bar of soap, a clear plastic sheet to lie on, a razor blade for cutting the umbilical cord, a sterilized umbilical cord tie, a cloth to keep the mother and baby warm and latex gloves -- midwives stave off death to thousands of families in complex situations, like the storm-ravaged Philippines or countries caught up in conflict.
In Afghanistan, where there currently is no legislation recognizing midwifery as a profession, the population is projected to grow by about 46 percent by 2030. To achieve universal access to sexual, reproductive, maternal and newborn care, by the year 2030 midwifery services will need to respond to 1.6 million births per year, 73 percent in rural settings. If nothing changes in the country however, by 2030 only 8 percent of women will have access to skilled midwives. That said, if the government invests, implements and develops regulations for midwifery programs, it is projected that 31 percent of women will have access to skilled midwives by 2030. That's a massive shift in the right direction.
According to a case study from Bangladesh, training 500 midwives has a 16-fold return on investment. We know there is a direct link between fragile states and weak health systems. These nations will get stronger if they strengthen the systems that care for their most precious resources -- women and babies. Not to make such a commitment should be inconceivable.
We have to change the hearts and minds of communities. Midwives are not only present on the most important day of a child's life, his birthday; they also provide family planning and contraceptives, advice about nutrition and sanitation, and are at the forefront of real time data collection that helps to identify the needs and target investments.
There is also a clear correlation between gender development and maternal mortality. The State of the World's Midwifery report outlines a path towards 2030 and advocates for delaying marriage; it champions the completion of post-secondary education for girls and stresses the need to educate young people about contraceptives and HIV.
World leaders must heed the recommendations of the report and take a stand for women, mothers and babies. This is something we should all strive to be proud of. If we can have a legacy for the future of development, it should be rapidly expanding the number of qualified midwives, our heroines, and deploying and supporting them where they are needed most. After all, midwives deliver joy.
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