Midwives and maternal, newborn, reproductive health

What is International Day of the Midwife? International Day of the Midwife - held on 5 May each year - was originally launched by the International Confederation of Midwives (ICM) in 1992 as a day on which to celebrate midwifery and to highlight the importance of midwives’ work worldwide. The occasion is an opportunity for meetings and conferences, for awards to be given, and for fundraising activities to be held to raise money for midwives overseas.

To mark the day, ICM President Bridget Lynch made a video address during a recent visit to Afghanistan.

The International Federation of Gynecology and Obstetrics (FIGO) - the only global organisation representing gynecologists and obstetricians, with member associations in 124 countries/territories - strongly believes that there are excellent reasons for obstetricians and gynecologists to collaborate closely with midwives to help strengthen midwifery.

2011 is an important year for all those connected with midwifery. The launch in June of a unique and ground-breaking global report - ‘The State of the Word’s Midwifery’ (co-ordinated by the United Nations Population Fund, and on which FIGO has been a key partner) - is timely, and will provide key healthcare professionals and other stakeholders with the information and tools they need to help advance the global work of midwives.

A global shortage - time for urgent action

FIGO is committed to highlighting the shortage of the world’s midwives. The World Health Organization (WHO) estimates that, globally, some 350,000 are urgently needed. Without their specialist skills, maternal mortality and morbidity cannot be reduced. The number of skilled workers in countries has not increased significantly, and has even started to decline, due to factors such as migration, AIDS-related deaths, inadequate pay and poor working conditions.

FIGO believes that it is essential that midwives receive proper training and support to enable more cost-effective and better quality maternal healthcare.

In 2009, FIGO joined forces with the International Confederation of Midwives (ICM), the International Council of Nurses (ICN), the International Pediatric Association (IPA) and the White Ribbon Alliance to sign a global open letter to G8 leaders - representing 14.3 million midwives, nurses and doctors - emphasising the fact that in many poor countries at least half of all women give birth alone or with no skilled midwife, nurse or doctor to help, and that politicians should help deliver the extra $10billion per year to build the health systems that will cut maternal mortality by 75 per cent by 2015.

FIGO recognises the multi-faceted role of the midwife outlined by UNFPA:

Caring for women during pregnancy, childbirth and the postnatal period
Treating complications due to miscarriages and/or unsafe abortions
Providing newborn care
Providing pre-pregnancy advice and health education
Recognising and addressing problems in women and newborns before, during and after childbirth
Offering general health information, including reproductive healthcare and family planning
Assisting women to breastfeed successfully
Referring women and newborns for higher level care when complications arise during and after pregnancy and childbirth
Providing additional health services in communities such as immunisations and treatment of common illnesses

(Source: UNFPA) http://unfpa.org/public/home/mothers/pid/4384#what_midwives_do

Collaboration is key

FIGO believes that partnerships between obstetrician-gynecologists and midwives can help produce effective professional results across several critical themes:

Credibility A partnership between two major collaborators in maternal and newborn health increases credibility.

Sustainability Achieving results in maternal and newborn health, and other areas of sexual and reproductive health and rights, requires systematic work over long periods. Working together promotes a methodical timetable.

Supplementing each other in competence Obstetrician-gynecologists and midwives have different professional strengths, roles and competencies. Working together on defined activities can make these strengths act in synergy for stronger overall effect.

Networking Midwives and obstetrician-gynecologists often have different networking channels eg in government, within the health system and with other national partners. Collaboration gives access to a larger, joint network.

Different perspectives Doctors and midwives often have different backgrounds, which may prompt new viewpoints when considering different population groups. This may help to enhance joint projects.

Organisational strengths An ob/gyn society is often organisationally stronger than its respective national midwifery society. Replacing professional rivalry with mutual interest should be the main goal in order to improve the health of women and newborns worldwide.

Most importantly, midwives are key healthcare facilitators in helping to achieve Millennium Development Goals 4 (reducing child mortality) and 5 (improving maternal health).

Vital work in progress - FIGO and partners

The Call to Action In June 2010 FIGO - along with other global organisations - highlighted the importance of strengthening midwifery in a special symposium in Washington prior to the highly successful Women Deliver conference. FIGO was a key player, presenting a session on ‘Professional Associations - Policy Development and Multi-Disciplinary Care’. The Symposium participants released a Global Call to Action: ‘Strengthen midwifery to save lives and promote the health of women and newborns’. This was a timely reminder that maternal deaths can be prevented when midwives and personnel with midwifery skills are authorised and supported by the health system to practice their full set of competencies, including basic emergency obstetric and newborn care.

‘The State of the World’s Midwifery’ Building further on this call to action, as a key partner, FIGO has been closely involved in the production of a new publication, ‘The State of the World’s Midwifery’, due to be launched in June at the ICM 29^th Triennial Congress in Durban, South Africa.

Analysis has shown that midwifery personnel and services are unequally distributed between countries as well as within countries. This report - the first of its kind and aimed at policymakers, development partners, aid organisations and all midwifery service providers - is intended to facilitate midwifery strengthening across the world, providing new information and data gathered from 60 countries in all world regions.

Its aims:

to examine the number and distribution of health professionals involved in the delivery of midwifery services
to explore emerging issues related to education, regulation, professional associations, policies and external aid
to analyse global issues regarding health personnel with midwifery skills, most of whom are women, and the constraints and challenges that they face in their lives and work
to call for accelerating investments for scaling up midwifery services, as well as ‘skilling up’ the respective providers

FIGO LOGIC (Leadership in Obstetrics and Gynecology for Impact and Change) Initiative in Maternal and Newborn Health

A grant from the Bill & Melinda Gates Foundation enables FIGO to help improve the lives and health of women and newborns in low- and middle-resource countries with high maternal and newborn mortality and morbidity, especially underserved populations. Midwifery associations in all of the initiative’s countries are actively involved with this project. Countries in the first phase of the initiative are: Burkina Faso, Cameroon, Ethiopia, Mozambique, Nigeria, Uganda, India and Nepal.

FIGO Saving Mothers and Newborns Initiative

FIGO has been building and sustaining the capacity of the ob/gyn and midwifery societies in 10 developing countries to conduct essential projects relevant to the promotion of safe motherhood and the improvement of maternal health. Countries involved are: Haiti, Kenya, Kosovo, Moldova, Nigeria, Pakistan, Peru, Uganda, Ukraine and Uruguay. The initiative addresses maternal and newborn health priorities, especially in urban poor and rural areas.

FIGO, in consultation with ICM, affirming the importance of collaboration between the two organisations at a global level to achieve health-related MDGs, agreed to hold a FIGO plenary session at the upcoming ICM 29^th Triennial Congress (19-23 June 2011). Top FIGO officials will participate in this plenary session. A meeting is scheduled to be held between the FIGO and ICM leaderships to investigate ways of strengthening collaboration between the two sister organisations to save and improve the quality of lives of women and newborns around the globe.

A global voice

In addition to its work with midwives through its major projects, FIGO has recently participated in joint statements with the ICM and other partners. These emphasise the close links that have formed between FIGO and other relevant global organisations concerned with advocating good reproductive health.

Midwives unite: Looking ahead to Durban

FIGO believes that 2011 will be a critically important year for the cause of midwifery and looks forward to collaborating closely with its member societies and many global partners to advance the work and accomplishments of dedicated midwives at both national and global levels.

Sources/useful links

http://www.internationalmidwives.org/