The Time is Now for Midwives

With a planet in peril, it is time to examine closely the societal and geopolitical structures that we have created to nourish our fellow people, and that we have trusted to sustain the exquisite natural systems on which we depend. With nearly every major system on Earth at the brink of collapse, we must pause to reflect on how we treat one another and the planet, and to begin to envision a brighter future. Perhaps it is time take a look at where it all begins: birth.

The significance of Birth

Birth is a natural physiological process; a miracle that is not without risks, but that, in general, women’s bodies are perfectly equipped to carry out. Eons of human evolution have ensured that each and every woman is endowed with the perfect cocktail of hormones and the wisdom of her instincts to bring life forth into this world within her own body. For nearly all species of mammals, the moments immediately after birth shape the life of the being and its relationship to the world around it. Around the world, cultures relate to this physiological miracle very differently, but nearly all hold it as a sacred life event, a rite of passage. Birth represents perhaps the single most important event in our lives.

The challenges birth faces

In recent history, however, the processes of birth and labor have become cloaked in fear, shame and sometimes, greed. An extreme medical model of care has built a relationship to pregnancy centered on illness, to birth as an emergency. Midwives, the women who have compassionately assisted their sisters through pregnancy and birth for millennia, have been sidelined. With the ancient wisdom of midwives largely ignored, doctors who are trained in western medicine, which can sometimes include harsh medical interventions during birth, have reigned.

Indeed, emergency care, including medical interventions, has saved lives when used appropriately. But not every birth is an emergency, and often interventions do more harm than good for a low-risk pregnancy. For most, a well-trained community midwife can provide the essential care needed to save a life. Yet this seemingly simple solution is being overlooked. Every year, 287,000 women around the world die from pregnancy-related causes. That means approximately 800 mothers die while giving life every day. Another 5.7 million suffer severe or long-lasting illnesses or disabilities caused by complications during pregnancy or childbirth. Losing this vast number of women every year has a serious negative ripple effect, impacting families, communities and nations. Children without mothers are less likely to receive proper nutrition, health care and education, keeping them locked the cycle of poverty.

Moving forward

It’s time to refocus on midwives. Local midwives are the caregivers who are most accessible to most women around the world, especially to women in rural areas. Its time for them to be respected, legitimized and well-trained so that they may continue providing maternal care to the women within their own communities. We know that ensuring skilled attendance at all births, backed by emergency obstetric care when needed, would reduce maternal deaths by about 75 percent. Midwives offer a practical, low-cost solution because they provide localized, culturally appropriate maternal healthcare that requires relatively few inputs. They are less expensive to train, and their knowledge may be passed on from generation to generation, ensuring a lasting cultural conduit.

I serve on the Board of Directors for Midwife International, an organization working to support the critical role of the midwife around the world. Founded in 2011, Midwife International is a charitable organization that empowers and strengthens the capacity of midwives through the skills, resources and structural support they need to achieve the best possible outcomes for mothers and babies worldwide.

Midwife International is currently focusing efforts in Guatemala, which has one of the highest maternal mortality rates in the world. In this small Central American nation, approximately two women die every day from pregnancy and childbirth related causes. While traditionally in Guatemala women were attended by community midwives called comadronas, many births are now happening in hospitals, while those women who can’t reach a hospital receive no care at all. Perhaps not surprisingly, birth outcomes are getting worse rather than better.

Midwife International is working in partnership with Asociación Manos Abiertas (AMA) to train a new generation of highly skilled midwives in the Mayan Highlands of Guatemala. Asociación Manos Abiertas (AMA) is a locally run women’s health clinic that is currently addressing a full spectrum of women’s health needs, including compassionate prenatal, delivery and postpartum MotherBaby care, in the department of Sacatepéquez, Guatemala. To learn more about the issues and to take action, visit

References: United Nations Population Fund (UNFPA) State of the World’s Midwifery Report, 2011


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