The International Need for Midwives

By Sarah Vitello

According to the WHO, approximately 287,000 women die every year due to pregnancy and childbirth related complications that are often preventable. 2.9 million infants die during the first month of life.
This international problem has a solution: midwives. Midwives are essential to the health of mothers and children worldwide. They care for mothers during their pregnancy, labor, and post-partum period as well as the newborn. Midwives help prevent health issues that endanger the health of the mother or fetus during pregnancy, they detect abnormal conditions and make contingency plans, triage and obtain medical assistance when necessary, deliver babies safely and execute emergency procedures as able.  Although midwives are more accessible than physicians in hospitals located miles way, many developing countries do not have enough midwives to meet the needs of vulnerable communities they work within. The reasons for maternal mortality are ‘simple’ but these simple preventions are complicated for midwives by rough terrain and lack of infrastructure, lack of training and supplies, and low consumption of healthcare by the people in the area.

A study published in April 2011 piloted a project conducted by an American and a Zambian university and government doctors studied the effectiveness of midwifery on decreasing infant mortality. The researchers compared survival rates of newborns: the first week death rate dropped from 11.5 to 6.8 deaths per 1000 infants, a 50% decrease. The project’s total cost was $20,244, which was an estimated $208 per life. Midwives from 18 Zambian clinics taught basic courses in newborn care, including teaching how to clean and warm a newborn, resuscitation, breast feedings, and diagnosing common illnesses.
Organizations such as UNICEF and USAID are supporting midwife-training programs for countries in need around the world. Investing in midwife training ranges by country, averaging a cost per student per year of $1,250 to $11,800.  UNICEF has helped train midwives in Afghanistan to implement more female doctors, nurses, or midwives in facilities.  The USAID midwife-training program in Liberia recognizes the culture of home birth and knowledge of traditional midwives, and works to develop home-based life-saving skills training.
As much as outside organizations help with this issue, governments need to provide opportunities for midwives to update their skills, and should adopt legislation that enables midwives to use their full expertise.
Women’s World Health Initiative supports the important work of midwives by enacting projects that help provide maternity supplies and training to Community Healthcare Workers. Help WWHI continue to support midwives with a donation.

U.S. Maternal Mortality Rises

Maternal mortality is a global crisis, reaching even the United States.  A study published last month in the medical journal The Lancet estimated that 293,000 women around the world died of pregnancy or childbirth-related causes in 2013.  The study also found that the American maternal mortality rate has gone up in the past decade, placing it with seven other countries showing an increase: Afghanistan, Belize, El Salvador, Guinea-Bissau, Greece, Seychelles and South Sudan.
Almost 800 moms-to-be in the United States perished in 2013 from maternal health problems, or about 18 women for every 100,000 births.  That rate is double that of Canada and more than triple that of the U.K.  Half of worldwide maternal deaths occurred 24 hours or more after childbirth or during the following year, and the study found that 55 percent of American maternal deaths happened during this delayed postpartum timeframe.
The specific causes of maternal death differ between American women and their counterparts in developing countries.  The report found that fatal pregnancy and birth-related complications seen in other parts of the world- obstructed labor, hemorrhage, infection, and abortion-related issues- are becoming less common in the U.S.  But more American moms-to-be are experiencing high-risk pregnancies due to preexisting health problems like diabetes, heart disease, kidney problems and obesity or because of increased maternal age.  Data also showed that combined maternal deaths from anesthesia complications, embolism and heart failure have increased in the United States.
We can see from these findings that though some factors differ by our geography, women throughout the world are united by this common threat.  But together we can be united in finding solutions.  Join us in the fight by visiting the Get Involved section of wwhi.org.

Hepatitis B: A Hidden Threat in Senegal

Women and their children in Senegal are facing a growing threat of hepatitis B infection, which can lead to liver cancer and sometimes death.  A recent news report states that over two million Senegalese have the disease, and most don't even know they are infected.  Ninety percent of cases are asymptomatic, and the country doesn't have universal screening, even though 350,000 people in Senegal are chronic carriers.

Hepatitis B can pass from mom to baby during birth, so pregnant women in more developed countries are screened for the disease and infants are vaccinated within 12-24 hours of birth to prevent infection.  The World Health Organization says all infants should be vaccinated by 24 hours old, but most Senegalese babies aren't until at least six weeks, because they were not born in a hospital where the vaccine was on hand.  To make things even more difficult, birth-doses of the vaccine aren't usually covered by international health organizations.

The danger is significant.  WHO states that hepatitis B kills around 600,000 people every year and causes the majority of liver cancers.  Even if the disease is not transmitted during birth, an unvaccinated child is still vulnerable to contracting it at home from contact with an infected caregiver or close relative. Screening and prevention are necessary as those infected as infants or young children are more likely to become chronically ill.

WWHI equips Community Healthcare Workers in Senegal to provide better care to women and their children at the local level.  Rather than having to walk for miles to the nearest clinic, pregnant women can be monitored and educated in their own villages, so threats like hepatitis B can be prevented, and if necessary identified and treated.  Check out the Get Involved section of our site to find out how you can help in this vital mission.

How I Will Celebrate My First Mother's Day as a Mom

Stephanie with her firstborn

  

By Stephanie Owens

I’m fortunate to have had the unique experience of working at an OB-GYN office while being pregnant. I've seen what good obstetrical care looks like from the inside out. During my time there, I witnessed joy, excitement and hope; both my own and that of the women I interacted with each day. There was no question that these women and their babies were in the hands of skilled professionals. The peace of mind this affords is something every expectant mother should experience.

At each visit, we had our vitals checked by a nurse or medical assistant. If there was any cause for concern, the doctors would be notified right away so the necessary care could be given. We were given the proper tests and had the necessary ultrasounds.I never had to go without prenatal vitamins to ensure my son got what he needed for his development. 

I was proud to be a small part of such a vital mission, and grateful to receive such excellent care myself. It never occurred to me that mothers-to-be in other parts of the world were having a drastically different experience. The thought of no medical supervision or giving birth alone would have been outrageous to me.

So upon initially hearing the words "maternal mortality," I was shocked that such a tragedy still exists. In my mind, women had died in childbirth centuries ago, but certainly not since then. Surely not in our modern world, with all of our medical technology, could such a widespread and preventable catastrophe be possible. But all of the advances in the world don't do much good in areas of poverty where women can’t access them. 

It’s difficult to imagine, in our affluent culture, that a pregnant woman might have to walk for miles to have a checkup. Had I not crossed paths with Women's World Health Initiative, I never would have. But for thousands of women in developing countries this is the harsh reality, with no foreseeable hope of giving one's child a better start. These women are equally concerned for their babies' health and their own. There's a significant chance that they may lose their own lives to give life. 

Did you know that every year, 287,000 women die as a result of complications during pregnancy and childbirth? That's one woman every two minutes. For each of these deaths, an average of four orphans are left behind. These women are not only the caretakers, they are often the teachers, the health care providers, the community leaders, and the ones who ensure children get immunizations, education and clean water.

But this Mother's Day, we can make pregnancy and childbirth safer for every mother. By making a donation at wwhi.org in honor of the special women in your life, WWHI sends a Mother's Day card via email or regular mail to the recipient of your choice. Your gift will help women in rural villages of West Africa lead longer lives, raise healthy families, and strengthen their communities. 

Visit wwhi.org to order a card for the special women in your life, and also give hope to women worldwide. 

Happy Mother's Day!