International Day of the Midwife (IDM), an opportunity to highlight the pivotal role midwives play in delivering healthcare, is celebrated across the globe each year on 5 May.
This year’s theme, Follow the Data: Invest in Midwives, will use new data and evidence to help spearhead global, regional and national efforts to engage stakeholders, shift policy and ensure better sexual, reproductive, maternal, newborn, child and adolescent health outcomes worldwide.
IDM 2021 coincides with the launch of the State of the World’s Midwifery (SoWMy) Report 2021. Co-led by the United Nations Population Fund (UNFPA), the World Health Organization (WHO) and the International Confederation of Midwives (ICM), the report provides an updated evidence base and detailed analysis on the impact of midwives on maternal and newborn health outcomes and the return on investment in midwives.
In celebrating IDM 2021, ICM is calling on midwives, women, partners and midwifery advocates globally to hold governments, decision-makers and policymakers accountable for taking action on the SoWMy data and investing in midwives.
According to ICM, the data shows investment in midwives is a cost-effective approach to improving health outcomes for mothers and babies and reducing maternal and neonatal mortality and stillbirth. Midwife-led models of care result in excellent maternal and neonatal outcomes and quality care.
Through this lens, ICM will lead growing efforts to position midwives as fundamental to improving quality maternal and newborn care, ending preventable maternal and newborn deaths and achieving the Sustainable Development Goal (SDG) to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030.
Data shows universal coverage of midwife-delivered interventions could save up to 4.3 million lives every year by averting 67% of maternal deaths, 64% of neonatal deaths, and 65% of stillbirths.
There is currently a global shortage of 900,000 midwives. To close the gap by 2030, 1.3 million new Sexual, Reproductive, Maternal, Newborn and Adolescent Health (SRMNAH) workers (mostly midwives in Africa) will be needed in the next decade.
Midwives are critical, especially during the global COVID-19 pandemic, ICM says. They can provide care for women, children and adolescents outside of health facilities and close to where they live.
Importantly, ICM says any investment in midwives must include investing not only in their numbers but also in their education, ongoing training, regulation and working environment. The SoWMy report revealed just four out of 73 countries have an adequate workforce to respond effectively to the needs of women and newborns.
“We now know that achieving universal health coverage through midwife-led continuity of care could avert 67% of maternal deaths and 64% of newborn deaths by 2035,” ICM President Franka Cadee says.
“These findings can’t be ignored and IDM is the perfect opportunity to bring together midwives, women, regional and international decision-makers and donors in a moment dedicated to underscoring the life-promoting and life-saving skills of midwives.”
Unlike past IDM’s, Ms Cadee says ICM and its partners have committed to ensuring global events and campaigns throughout 2021 and beyond that include the “voices and leadership of midwives and women together”.
“ICM sees the data demonstrating the impact of midwives as the golden ticket into these regional and global conversations,” she says.
“To that end, the aim of our 10-year-long Decade of the Midwife (2021-2030) campaign to be launched at this year’s ICM virtual triennial congress is to work with midwives, women and partners to mobilise women’s voices to advocate for their right to a positive birth experience through midwife-led continuity of care. This campaign will rely on the data to showcase midwives as the cost-effective investment for governments in their efforts to improve sexual and reproductive health and rights for women and so to achieve the sustainable development goals.”
Ms Cadee called on all midwives to spread the data that proves the profession’s value.
“The evidence is clear. For midwives to work effectively, investment is needed in our education, in our regulation and in our working environment. Let’s work together with the women we support and the growing numbers of partners who understand the significance of our work to make this year’s IDM about more than just celebrating. “We will demand increased investment in midwives together because we know increasing coverage of quality care by midwives will prevent suffering, through for example unsafe abortions and stillbirths, and so save millions of lives of women and babies. Now, let’s make sure the world knows too.”
Meanwhile, in Australia, Jeannine Bradow, a Lecturer and Midwifery Discipline Lead in the Charles Sturt University School of Nursing, Midwifery and Indigenous Health, says IDM 2021 presents an ideal opportunity to reflect on the fact many women in rural Australia have limited access to maternity care.
It’s been a persistent issue within the health system for two decades, she points out.
“It has forced women in these areas to travel – often hundreds of kilometres – just so they can give birth. For some women, the distance has proved too far, and they’ve had no other option but to give birth on the side of the road, without care.”
Since 1996, 130 Australian maternity units have closed, with local health services diverting maternity care to centralised maternity hubs operating out of larger regional centres, Ms Bradow says. Maternal and infant safety has been cited as one of the main reasons for diverting care to a larger centre where emergency facilities may be available.
“However, these closures pose ongoing issues and inconvenience for women in rural communities, as services close and women are required to travel to access maternity care, placing themselves at risk of intervention if they haven’t laboured by a certain date.”
Ms Bradow says evidence shows midwifery-led care, caseload midwifery or continuity of care is the gold standard.
“Let’s see what the WHO have in mind for supporting women in Australia; women and midwives want change, but who is going to take notice?
“It’s time for action, it’s time to reduce the intervention and birth trauma that women are experiencing, and it’s time to reduce the caesarean rate. It’s time to bring birth back to the bush.”
For more information on IDM 2021 visit internationalmidwives.org