Midwifery could save lives of women and babies
Two papers published in The Lancet on September 21st 2014 present an evidence-based framework for Quality Maternal and Newborn Care (QMNC). The authors show that implementation of this framework will create the best possible conditions to keep pregnancy and childbirth healthy and uncomplicated. They also demonstrate how it can save the lives of millions women and babies and improve the health and wellbeing of many more. The framework encompasses respectful, skilled, supportive and preventive care that promotes normal reproductive processes, manages complications and provides skilled emergency care when needed. It is tailored to needs of women and their families and works to strengthen women’s capabilities.
“Women, newborns and their families need and want quality maternity care delivered by educated, competent and compassionate midwives. Our papers identify the important role midwives have in saving lives, reducing morbidity and improving long term health and wellbeing” says Professor Mary Renfrew, from the University of Dundee, Scotland.
The impact of scaling up midwifery has been modelled using the Lives Saved Tool (LIST). Professor Caroline Homer of the University of Technology Sydney, Australia, explains that: “in low-resource settings the model predicts that increasing midwifery care by 10% every 5 years would lead to a 27% drop in maternal mortality in 15 years time. An increase of 25% would reduce maternal deaths by 50%, while a 95% increase would prevent 82% of maternal deaths. The numbers are very similar for newborn deaths and stillbirths”.
There are huge health gains to be achieved in medium- and high-income countries, where little focus on health education, support, and prevention on one hand, and over-medicalisation of care including caesarean sections on the other hand, means that the health and wellbeing of mothers and babies is suffering and resources are being misused.
According to Professor Wim Van Lerberghe, Health Systems Advisor at WHO Euro, Copenhagen, Denmark “Rapidly deploying midwives and improving the network of services have been successful contributions to improving maternal and newborn health and services in countries like Morocco, Burkina Faso, Indonesia and Cambodia. Scaling up the contribution of midwives to the expansion of available RMNH care is a strategic option of considerable appeal among policy-makers today”.
Petra ten Hoope-Bender, Director of the Instituto de Cooperación Social Integrare in Barcelona, Spain, says: “The high-quality maternal and newborn care described in this Series should be at the heart of all subnational, national, regional, and global efforts to improve women’s and children’s health and wellbeing, and is a critical element in realizing the rights of all people to attaining the highest possible standard of health. It makes a vital contribution to current Millennium Development Goals and will be a crucial to a successful post 2015 agenda”.
The Series, produced by an international group of academics, clinicians, professional midwives, policymakers and advocates is a highly acclaimed, critical, wide-reaching examination of what constitutes quality maternal and newborn care. Two further papers will be published on 27 September.