Midwives are desperately needed to help preserve life in developing countries according to a new report released by United Nations (UN) this week at The Triennial Congress of the International Confederation of Midwives (ICM) Durban, South Africa. An additional 112,000 midwives need to be deployed in 38 countries to meet their target to achieve 95% coverage of births by skilled attendants by 2015, as required under the Millennium Development Goals (MDGs). Globally, 350,000 midwives are still lacking.
Babatunde Osotimehin, Executive Director of UNFPA stated:
"The report points to an urgent need to train more health workers with midwifery skills and ensure equitable access to their life-saving services in communities to improve the health of women and children."
Up to 3.6 million deaths could be avoided each year in 58 developing countries if midwifery services are upgraded.
Ki-moon, Secretary-General of the United Nations continues:
"Ensuring that every woman and her newborn have access to quality midwifery services demands that we take bold steps to build on what we have achieved so far across communities, countries, regions and the world."
The report adds that if midwives are in place and can refer the most severe complications to specialized care, up to 90% of maternal deaths could be prevented. Each year, 358,000 women die while pregnant or giving birth, some two million newborns die within the first 24 hours of life and there are 2.6 million stillbirths.
Among the 38 countries most desperately in need of midwives, 22 need to double the workforce by 2015; seven need to triple or quadruple it; and nine, specifically Cameroon, Chad, Ethiopia, Guinea, Haiti, Niger, Sierra Leone, Somalia and Sudan need to dramatically scale up midwifery by a factor of between six and 15.
When a 16-year-long civil war ended in 1992, Mozambique's health care system was devastated and one in ten women were dying in childbirth. There were only 18 obstetricians for a population of 19 million. In 2004, Mozambique introduced a new health care initiative to train midwives in emergency obstetric care in an attempt to guarantee access to quality medical care during pregnancy and childbirth. These midwives now perform major surgeries including Cesareans and hysterectomies. As the figures now stand, Mozambique is one of the few countries on track to achieve the United Nations Millennium Development Goal of reducing the maternal death rate 75% by 2015.
Midwives refer women to general practitioners or obstetricians when a pregnant woman requires care beyond the midwives' area of expertise. In many jurisdictions, these professions work together to provide care to childbearing women. In others, only the midwife is available to provide care. Midwives are trained to handle certain more difficult deliveries, including breech births, twin births and births where the baby is in a posterior position, using non-invasive techniques.
Apart from childbirth and immediate postpartum care, midwives are the first line of care in pregnancy control and education of mothers-to-be. Typical information that is given to mothers includes information about food, alcohol, life style, travel, hobbies, sex, etc. Some midwifery practices give additional care in the form of preconceptional care and help with fertility problems.
Source: The United Nations
Written by Sy Kraft