Whenever people talk about healthcare, the most common personnel that come top of mind are doctors, nurses, and clinical officers. We tend to forget a crucial and little recognized sector in healthcare, and that is midwives. Unsung heroes who are responsible for safely bringing thousands of babies into the world, doing their very best despite broken health systems, lack of supplies, and poor pay.
Healthcare systems around the world have failed midwives by not investing in educating, training, hiring, and remunerating them well. There is only so much anyone can take especially in a system that leaves them exhausted, overworked, and underpaid. As such, many midwives are unable to dedicate themselves fully to midwifery since they have to get out there and make additional income. Many eventually leave midwifery entirely to focus on other economic activities or to study in more fulfilling fields.
And yet, the statistics for maternal health issues are sobering. Upto 40% of African women do not have access to crucial pre-natal care which can help detect problems in the pregnancies before they blow up. More than half of all deliveries in Africa take place at home in the absence of medical help and this means no post natal care for the women either. About 300,000 women lose their lives annually during childbirth, with 82% of these deaths being preventable. Approximately 1.5 Million children across Africa are left without mothers due to maternal mortality. These numbers obviously highlight a severe shortage, and the need to close the glaring gap in provision of maternal health services.
The case for a strong midwifery sector is therefore a strong one. A 2020 research by Lancet showed that fully resourcing and equipping midwifery by 2035 could avert 67 per cent of maternal deaths, 64 per cent of newborn deaths, and 65 per cent of stillbirths. This would mean an estimated 4.3 million lives saved per year.
On the plight of midwives and what improvements they would like to see in their workplaces, the White Ribbon Alliance has unveiled a report dubbed Midwives Voices, Midwive’s Demands. The report which is intended to inform health policies, programs and practices at the national and community levels clearly details the grievances that midwives face, and what they would like done to make things better. White Ribbon Alliance spoke to a total of 56,105 respondents from Ghana, India, Kenya, Malawi, Nepal, Nigeria, Pakistan, Uganda and the United Kingdom.
If we could use Kenya as an example, we have 3,532 respondents whose demands are as follows:
- Supplies and functional facilities: 1,915 = 47%
- More and better supported personnel: 982 = 24%
- General health and health services: 438 = 11%
- Professional development and leadership: 403 = 10%
- Respect, dignity, and non-discrimination: 208 – 5%
- Power, autonomy and improved gender norms and policies: 98 = 3%
This is just one country but the common thread throughout the report is that there is need for improvement. Midwives are very much an integral part of the whole reproductive health spectrum and they play an important role in reduction of maternal deaths. If anything, shunning them and their demands flies in the face of the the millennium development goals, which encompass reduction of child and maternal deaths as one of the pillars.
The Midwives Voices Midwives demands report makes for important reading and is a call for all of us to take whatever part we can to help improve the plight of midwives in the country. The report is available here.