A new report says more than three and a half million lives could be saved in 58 developing countries if there were enough well-trained midwives.
The State of the World’s Midwifery 2011 was released Monday in Durban, South Africa, at the Triennial Congress of the International Confederation of Midwives. It says because of a lack of midwives, nearly 360,000 women die while pregnant or giving birth each year; about two million newborns die within the first 24 hours of life; and over two and a half million infants are stillborn.
“Midwives are very important because they provide services throughout the childbearing years of a woman. So, they cover all the needs that exist in families for reproductive health, for education, family planning, obviously everything to do with pregnancy and childbirth and, generally, sexual and reproductive health issues,” said Petra ten Hoope, midwifery adviser and a main author of the report.
She said midwives are often required to handle sudden emergency situations.
“The major killers are bleeding after birth. So, the baby is born, but the placenta isn’t born and women bleed and can bleed profusely. When a baby is not positioned correctly there’s obstructed labor, as we call that, and there’s a need for an intervention for helping the baby out. There are a lot of infections after the birth,” she said.
Complications can also occur from high blood pressure and after poorly performed attempted abortions, according to the report.
“A lot of women can’t find access to real, full quality services. So they bleed a lot after other kinds of interventions to stop a pregnancy,” she said.
Petra ten Hoope
The report said midwives are needed in both urban and rural areas of developing countries, but especially in rural settings.
“So that women don’t have to walk far; don’t have to be transported to midwifery services during hours when they’re in these very high emergency conditions,” said ten Hoope.
The report calls for an additional 112,000 midwives, but it takes time to train them.
“In principle, full midwifery education,” she said, “takes about three years. And 50 percent of that is in the classroom, but the other 50 percent most importantly is in a clinical setting, where you learn together with experienced midwives what to do and how to do birth, how to support women, how to kind of scan for the need for interventions when things start going wrong.”
People who are already nurses may need less than three years to qualify as midwives.
“Distributing or deploying them is really not a difficult thing, though it’s very much limited by the financial situation of a country. But if we can really get them out there, the 112,000 additional [midwives] would kind of have an enormous impact,” she said.
The report also said it would help achieve the Millennium Development Goals [MDGs] relating to women and child health. The MDGs are due to be reached in 2015.
The report said besides a shortage of midwives, there is also a shortage of training institutions and employment opportunities for midwives.