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The world is facing a shortage of 900,000 midwives, according to the latest State of the World’s Midwifery (SoWMy) report, released today on the International Day of the Midwife (IDM). According to the report, the global COVID-19 pandemic has exacerbated the issue by overshadowing the health needs of women and newborns and disrupting midwifery services, including midwives being deployed to other health services.

Millions of lives of women and newborns are lost, and millions more experience ill health or injury because the needs of pregnant women and skills of midwives are not recognised or prioritised, the report argues.

Fully investing in midwives by 2035 would help avert about two-thirds of maternal, newborn deaths and stillbirths, saving 4.3 million lives per year.

The 2021 SoWMy report, undertaken by UNFPA (the UN sexual and reproductive health agency), the World Health Organization (WHO), and the International Confederation of Midwives (ICM), presents findings on the Sexual, Reproductive, Maternal, Newborn and Adolescent Health (SRMNAH) workforce from 194 countries.

The acute shortage of midwives, which represents a third of the required global midwifery workforce, is taking a toll in the form of preventable deaths, authors say.

Despite the warnings of the last SoWMy report back in 2014, which also provided a roadmap on how to boost midwifery-led care, progress over the past eight years has been slow.

The new report’s analysis shows that, at current rates of progress, the situation will have only slightly improved by 2031.

Key takeaways from the report include the role of gender inequality driving the massive shortage, and the continued under-resourcing of the midwifery workforce being a symptom of health systems not prioritising the sexual and reproductive health needs of women and girls, and not recognising the role of midwives.

Investment is urgently needed in education and training; management, regulation and work environment; leadership and governance, and service delivery. For midwives to achieve their full potential, bold investments by governments, policymakers, educational institutions, and professional associations are required at country, regional and global levels.

“As autonomous, primary care providers, midwives are continually overlooked and ignored,” says Dr Franka Cadee, President of the ICM.

“It’s time for governments to acknowledge the evidence surrounding the life-promoting, life-saving impact of midwife-led care, and take action on the SoWMy report’s recommendations.”

WHO Director-General Dr Tedros Adhanom Ghebreyesus said the report provides the data and evidence to support WHO’s longstanding call to strengthen the midwifery workforce, which will deliver improved health outcomes, gender equality and inclusive economic growth.

“Midwives play a vital role in reducing the risks of childbirth for women all over the world, but many have themselves been exposed to risk during the COVID-19 pandemic. We must learn the lessons the pandemic is teaching us, by implementing policies and making investments that deliver better support and protection for midwives and other health workers.”

Ahead of today’s IDM, the Australian College of Midwives (ACM) argued that continuity of midwifery care is the gold standard of maternity care because it leads to the best possible outcome for mothers and babies. However, access to continuity of midwifery care remains very low across the country.

ACM says it wants every woman in Australia to be able to make informed choices about the model of maternity care they receive throughout pregnancy, birth and the postnatal period.

“Becoming a parent is one of the biggest changes you can make to your life and we want that moment to be even better, for even more women in Australia,” ACM President Joanne Gray says.

“We want every woman to emerge from her birth experience feeling well, strong and confident.”

Access the full report here