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.

What We Live By

"A person is a person through other persons." -Desmond Tutu

More than 10 years ago, I took time off from school and work to spend 18 months teaching, serving and loving the people of Central and South America. It was one of the happiest times of my life. Never before had I completely given myself to something or someone in that way. My life was full and meaningful. At the same time, I felt inadequate, humbled and utterly vulnerable.

This past week, as I arrived in Senegal, those same feelings of happiness, purpose, humility and vulnerability swallowed me up. This was my first trip to Africa and I wasn’t sure what to expect, only that I didn’t want to go back home feeling like I hadn’t helped in some way. No, I wanted to roll up my sleeves and ingratiate myself with the Senegalese culture and people. I wanted to lose myself in loving and helping them.

But as it usually happens, they have been the ones to teach and love and nurture me. Last Friday, we rode over bumpy dirt roads to Daloto, a rural village on the southeastern corner of Senegal. We spent the day interviewing the local chief, mothers, and children, and preparing for the celebration of WWHI's new malaria and anemia program. We were dirty, tired and hungry, but feeling good about our day’s work. We made one last visit to the local midwife, Monique. As we entered her home (the size of my bedroom), she told us she had cooked dinner for us. Rice, fish, yams, and cold fruit juice she had made herself. We sat on the floor and ate from a big communal bowl, laughed and talked (me, mostly in charade-like hand gestures).

Afterward, we walked back to our car and were thronged by dozens of small children who held our hands and said in broken English, “I love you ... I love you.” I confess, I got teary. I love the people of Daloto. Not only because I’ve spent hours with them in their huts and hospitals, but because they have so willing loved me back.

Monique’s life work — midwifery — is about giving back, improving life, alleviating human suffering and sorrow. Her life’s work, our life’s work — to love others — is what we all live by. As Desmond Tutu, a South African activist, says: “None of us comes into the world fully formed. We would not know how to think, or walk, or speak, or behave as human beings unless we learned it from other human beings. We need other human beings in order to be human. I am because other people are. A person is entitled to a stable community life, and the first of these communities is the family."

This is what Women’s World Health Initiative aspires to do every day through our health programs — build, heal, inspire, preserve and, yes, love.

It’s hard work, but it is all so worth it.