Statement on Resourcing of Midwives and Decisive Measures to Reduce Carbon Emissions

Advocacy, Fragile Settings, Gender Equality and JEDI, Sustainability
Last Edited 31 January 2024 17:46 CET
Midwives are working in the female ward of Keraniganj Upazila Health Complex, Bangladesh. They provide essential care and support to pregnant women before, during and after childbirth. Their role involves monitoring the progress of labour, offering guidance, and facilitating a safe and positive birthing experience. Keranigonj, Bangladesh

Extreme weather events, heatwaves, air pollution, water contamination and related diseases are increasing because of climate change. The impacts of these factors are increased during pregnancy, birth, postpartum, as well as for newborns and young children. Climate change has the potential to be the greatest health challenge of the century. This has been recognised by midwives around the world, and 59 professional organisations have signed this urgent Statement on Resourcing of Midwives and Decisive Measures to Reduce Carbon Emissions.

As essential health workers working across community, clinic, hospital and other settings, midwives are seeing the devastating effects of climate change daily, and regularly respond to the health emergencies climate change is causing globally. For this reason, we, the undersigned professional midwives’ associations urge world leaders to come together for decisive climate action and significantly lowering carbon emissions.

Investing in continuity model of midwife-led care is key to lowering carbon emissions – put simply, midwives are critical to reducing the carbon footprint of reproductive and maternity services.

Midwives work in communities

The continuity model of midwife-led care throughout the pregnancy, childbirth and postnatal continuum is often community-based, reducing the carbon footprint associated with traveling to and from large, centralised health facilities. Research has shown that this type of care has excellent outcomes for the health and wellbeing of women and babies. It also ensures more equitable, easier access to care.

Because of their work in and with communities, midwives have a deep contextual understanding of community behaviours and can help implement more environmentally sustainable behaviours among those they serve.

Continuity model of midwife-led care uses fewer resources in the short- and long-term

Midwifery care is premised on the idea that pregnancy, birth and the postnatal period are normal, physiological events for most women and newborns. It is also premised on the autonomous role of midwives across the Midwifery Scope of Practice. Midwives are the only health professionals that are equipped and able to provide continuity of care to women and their newborns across the pregnancy and childbirth continuum. Midwives can provide more than 90% of essential care required by women and newborns and they work collaboratively with obstetricians, paediatricians, neonatologists, and other health professionals according to the needs of women and newborns.

This has a twofold benefit: on the one hand, specialised medical care is reserved for women or babies with complex health needs who truly need it, ensuring that health system resources are used responsibly. On the other hand, increasing the rates of normal birth across a population also reduces the amount of medical waste produced and the costs of unnecessary intervention and use of technologies, while also reducing the burden of morbidities for women and newborns associated with unnecessary interventions.

The continuity model of midwife-led care increases breastfeeding rates

Research has shown that midwifery care in the postnatal period helps women meet their breastfeeding goals, increasing overall breastfeeding rates, reducing the need for formula, bottles and teats. The infant formula industry has an enormous carbon footprint, including the fuel required to transport, process and prepare these for a baby. Increasing breastfeeding rates is also a key public health measure, that improves the health of women and babies.

Midwives are vital reproductive health service providers

Midwives are trusted sources of information on sexual and reproductive health in communities, and provide information on family planning, contraception, and child spacing. Taking control of the number and spacing of their pregnancies means that women can reduce their family’s vulnerability to climate change and build their economic resilience by giving them the freedom to opt for smaller families, work outside the home and be more financially independent.

Midwives are first responders to the climate crisis

When climate disasters strike, community-based midwives are uniquely positioned to quickly reach affected communities to provide vital reproductive and maternal health services. They are also an effective network through which information, supplies and medications can be distributed.

For these reasons, we call on policymakers to take the following steps to reduce the carbon emissions:

  1. Include midwives at climate and disaster response planning and decision-making tables;
  2. Ensure that climate policy includes investment in sustainable models of continuous midwife-led care;
  3. Ensure that midwives have an enabling environment, and the resources and legal frameworks that allow them to practice autonomously across the ICM Midwifery Scope of Practice and to the standard of the ICM Essential Competencies for Midwifery Practice;
  4. Take decisive and concrete action to reduce carbon emissions overall, including reductions in fossil fuel extraction and use, as well as implementing sustainable, net zero green technologies.