Skilled Midwives Essential for Maternal Health

The day is noted in many different ways - examples of activities include holding meetings and conferences about new developments within midwifery; giving awards to midwives for special pieces of work; and participating in fundraising activities to raise money for midwives overseas where resources are stretched or scarce. 

What is the role of the midwife? 

‘The basic services midwives routinely provide to protect the health of the mother and baby include: 

• 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 health care and family planning
• Assisting women to successfully breastfeed
• 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) 

Midwives and the importance of the Millennium Development Goals (MDGs) 

Midwives are key healthcare facilitators in helping to achieve Millennium Development Goals 4 (reducing child mortality), 5 (improving maternal health) and 6 (combating HIV/AIDS, malaria and other diseases)  

Important statistics: 

• Midwives can help to reduce child mortality  - nearly 11 million children under the age of 5 die in the world every year, most from easily preventable or treatable causes  (Source: Why do the Millennium Development Goals matter?, UN)
• Midwives can help to improve maternal health Only 28 in 100 women giving birth are attended by trained health personnel in the least developed countries (Source: ActionAid)
• Midwives can help to combat HIV/AIDS, malaria and other diseases There are 42 million people living with HIV and AIDS worldwide; it is a global emergency claiming approximately 8,000 lives every day in some of the poorest countries (Source: Oxfam)

To sum up, there is an urgent, critical need to recruit skilled health workers, notably midwives, in developing countries. More than half a million women die in pregnancy and childbirth every year - one death every minute. Of these deaths, 99 per cent are in developing countries

(Source: UNFPA) 

FIGO’s stance: Putting the case for midwives  

The International Federation of Gynecology and Obstetrics (FIGO) is the only global organisation representing gynecologists and obstetricians, with member associations in 124 countries/territories. It strongly believes that there are very good reasons for obstetricians and gynecologists, as individuals and as societies, to collaborate closely with midwives to help strengthen midwifery associations for the following reasons: 

•Credibility While working at the national level, 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 increases the chances of achieving 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 channels through which they network 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 undertaken.

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

FIGO’s work: 

FIGO, midwives and Safe Motherhood

FIGO puts a high value on the essential role of midwives in its work towards eradicating maternal and child mortality and calls for greater implementation of skilled staff ‘on the ground’.  Two current major projects - the FIGO Maternal and Newborn Health Initiative and the FIGO Saving Mothers and Newborns Initiative - concentrate on the need to improve the experience of safe motherhood in developing countries.

FIGO Maternal and Newborn Health Initiative (MNH) A grant from the Bill and Melinda Gates Foundation enables FIGO to help improve the lives and health of women and newborns in 15 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 (SMNH) FIGO is 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, midwives and global partnerships

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.  

• Adolescent Reproductive Health and Adolescent Pregnancy (ICM-FIGO-IPA)
• Family Planning: A Key Component of Post-Abortion Care (ICM-FIGO-ICN-USAID)

FIGO, midwives and the Global Maternal Mortality Campaign

Through its involvement with the White Ribbon Alliance for Safe Motherhood - an organisation that aims to decrease maternal and newborn death globally - FIGO is a leading voice within its Global Maternal Mortality Campaign.  Last year, FIGO joined forces with the 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.  The letter emphasised 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 $10 billion per year to build the health systems that will cut maternal mortality by 75 per cent by 2015. 

FIGO’s continuing commitment to midwives 

From 5-6 June 2010 FIGO, along with other global organisations, will be highlighting the importance of strengthening midwifery in a special symposium in Washington (‘Saving Lives, Promoting the Health of Women and Newborns’), as a prelude to the Women Deliver Conference (7-9 June 2010).  

FIGO therefore reiterates its commitment to the highlighting of International Day of the Midwife on 5 May 2010, and continues to collaborate with professional midwives and their organisations towards securing the best maternal, newborn and reproductive health for women globally.   

Useful links: http://www.internationalmidwives.org/