Acute shortage of midwives is exacting a terrible global toll in the form of preventable deaths
The world is currently facing a shortage of 900,000 midwives, which represents a third of the required global midwifery workforce, a report by 2021 State of World’s Midwifery report by UNFPA— the UN sexual and reproductive health agency, World Health Organization (WHO), International Confederation of Midwives (ICM) and partners, which evaluates the midwifery workforce and related health resources in 194 countries, has said.
“The COVID-19 crisis has only exacerbated these problems, with the health needs of women and newborns being overshadowed, midwifery services being disrupted and midwives being deployed to other health services,” it added.
According to the report, the acute shortage of midwives is exacting a terrible global toll in the form of preventable deaths. An analysis conducted for this report, published in the Lancet last December, showed that fully resourcing midwife-delivered care by 2035 could avert 67 per cent of maternal deaths, 64 per cent of new-born deaths and 65 per cent of stillbirths. It could save an estimated 4.3 million lives per year.
Responding to the launch of the 2021 State of the World’s Midwifery report, Helen Clark, Chair, The Partnership for Maternal, Newborn and Child Health (PMNCH), said, “The need to fund recruitment and training of midwives adequately and provide them with fair pay and safe working conditions, is fundamental to the health of women and newborns, and for building stronger health systems for all. As the world seeks to rebuild in the wake of the devastating COVID-19 pandemic, it is only through the power of strong partnerships among governments, health professions, NGOs, the private sector, donors and other stakeholders that we will ensure that this crucial profession is given the recognition and resources it deserves, as highlighted in PMNCH’s Call to Action on COVID-19.”
Despite alarms raised in the last State of the World’s Midwifery report in 2014, which also provided a roadmap on how to remedy this deficit, progress over the past eight years has been too slow. The analysis in this year’s report shows that at current rates of progress, the situation will have improved only slightly by 2030.
Gender inequality is an unacknowledged driver in this massive shortage. The continued under-resourcing of the midwifery workforce is a symptom of health systems not prioritising the sexual and reproductive health needs of women and girls and not recognising the role of midwives – most of whom are women – to meet these needs. Women account for 93 per cent of midwives and 89 per cent of nurses.
Responding to the launch of the 2021 State of the World’s Midwifery report, Dr Tedros Adhanom Ghebreyesus, Director-General, WHO, said, “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. This report provides the data and evidence to support WHO’s long-standing call to strengthen the midwifery workforce, which will deliver a triple dividend in contributing to better health, gender equality and inclusive economic growth.”