Today is the annual International Day of the Midwife.  Every year on May 5th, global attention turns to the role of the midwife in helping families grow all around the world. This year’s theme is “Follow the Data: Invest in Midwives.”  Lamaze International childbirth educators are committed to sharing evidence based information and best practices so families can make informed decisions about their perinatal care.  The research on midwifery care demonstrates that midwives are critical to ending preventable deaths for birthing parents and newborns.  The United Nations Sustainable Development Goal (SDG) 3.1 is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030, and globally, we are not on track to meet that target.  If there is any hope to to reach this important benchmark, there will need to be more midwives, and a greater acceptance of the integrated role for the midwife in perinatal care around the world.

The COVID-19 pandemic has impacted forward momentum toward achieving this stated goal and both midwives and birthing parents have lost both their lives.  In many cases, due to the pandemic, families have seen their rights to make decisions that feel appropriate for them diminished or taken away entirely.

Governments, health systems and policymakers must make decisions using the data that is available to them and be accountable for increasing the number and availability of midwives in their health care systems.

Today, on the International Day of the Midwife (IDM), a new analysis of midwifery care is being published collaboratively by the International Confederation of Midwives, the World Health Organization and the United Nations Population Fund.  The State of the World’s Midwifery (SoWMy) Report 2021 brings the latest evidence to the forefront of global health discussions amongst decision makers, on the critical importance of investing in quality midwifery care.  Making the data easily understood and accessible will allow governments, health systems and policy makers to commit to taking actions to increase the number and diversity of midwifes in every corner of the globe with the data to back to back up their plans.  As this year’s them states - “Follow the Data: Invest in Midwives.”

Key information from the SoWMy Report 2021

An increased investment in midwives that would result in universal coverage could save up to 4.3 million lives every year by averting 67% of maternal deaths, 64% of neonatal deaths, and 65% of stillbirths by 2035.

There is a global shortage of 900,000 midwives.  Substantial barriers are preventing existing midwives from achieving their full potential.  More midwives would not only give more people, adolescents and newborns access to their unique skills, but would also free up doctors and nurses to focus on other health needs that are outside the scope of midwifery care.

The data on midwives found in the SoWMy Report 2021 further demonstrates to the global community that midwives are fundamental to ending preventable maternal and newborn deaths and achieving SDG 3.1 (reduce the global maternal mortality ratio to less than 70 per 100 000 live births by 2030).

In addition to saving lives, midwives can improve health, too. Midwives could provide up to 90% of essential sexual, reproductive, maternal, newborn, and adolescent health care across the lifespan.

If the past year has shown us anything, midwives are critical – even and especially during a global pandemic.  COVID-19 has dramatically impacted all aspects of health systems, including sexual, reproductive, maternal, newborn, and adolescent health care. Service disruption risks eroded hard-fought gains in health outcomes and increased unintended pregnancies, sexually transmitted infections, unsafe abortions and increased health risks for parents, newborns and adolescents. And, at the same time, COVID-19 has worsened the existing global shortage of midwives.  One of the many great things about midwives, is that they are able to provide care for women, children and adolescents outside of existing health facilities and offer services in their very own communities, since this can prevent medical services from being overrun.

Having an option of home births for healthy, low risk pregnant people can protect them and their newborns from exposure to COVID that may be prevalent inside health facilities.

To achieve their full life-saving, health-improving, system-strengthening potential, midwives must be well educated, adequately trained, and appropriately regulated. In order to be as effective as possible, they must also work in an environment that considers midwives as part of a supportive, multi-disciplinary team and be provided/have access to appropriate resources.   There must be steady and ample investment in increasing the numbers of midwives, improving the education and ongoing training that is available to them, providing fair and equitable midwifery regulations and a safe and respectful working environment.

Investments in midwives is a direct route – and one of the most cost-effective strategies – to achieving full sexual and reproductive health coverage and reproductive freedom for all who give birth.

We cannot talk about midwives (93% of whom identify as women) without recognizing the fact that there is a gender equity issue.  Midwives are being hindered from providing a full range of care; sexism is to blame.As a result of harmful and outdated gender norms, midwifery and the role of caring for pregnant, birth and postpartum parents and newborns is widely undervalued across society.  All too often,  midwives’ voices are excluded or ignored during decision-making, leading to vast gender gaps in both leadership and pay.   Every day, midwives suffer from gender-based abuse and harassment on the job. They deserve better – policies, pay and protections.  Gender transformative policies are needed to challenge the underlying causes of gender inequality and end gender discrimination in the health sector.  Gender discrimination and a devaluation of women in the health sector are evidenced by a lack of investment in training and the professionalization of midwifery practice worldwide.

Midwives are central figures in the fight for the rights of families, children and communities. All too often, they are deprived of their own rights: to rest and self care, to decent work and pay, and protection from discrimination. To move towards gender equity in health, more midwives in leadership positions are needed now.

Isn’t the time right to follow the data and invest in midwives for the health and safety of all growing families?  Lamaze International recognizes the contribution of global midwives and would like to invite you to join us in thanking midwives everywhere for the safe and evidence based care that they provide.

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