The Time is Now for Midwives

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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.


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