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.