Teams of health care workers, including obstetricians/gynecologists and midwives, serve two-month stints at various facilities throughout Libya to help address shortages in personnel. © UNFPA Libya

In the United States, nearly all births take place at hospitals staffed with teams of doctors and nurses. In this setting, midwives might seem antiquated. But in much of the world, midwives are the first and perhaps only option for pregnant women, new mothers, and others in need of sexual and reproductive health care.  

What do midwives do? 

Mobile health workers check on the welfare of families and provide information about infection control. © UNFPA Turkey/Esma Yılmaz

Midwives provide a broad range of services, including prenatal appointments, safe delivery care, post-birth check-ups, birth control consultations, support for survivors of gender-based violence, and more. They can meet 90% of the global need for sexual and reproductive health care. In some cases, the first time a woman may visit a health care facility is during pregnancy or childbirth. At key moments like these, midwives can connect women, their families, and their communities, with resources like refugee support programs, nutrition programs, and cash or voucher assistance.  

Midwives could save 4.3 million lives each year, if only they were given adequate support. Your contribution helps train and deploy midwives, so women and girls everywhere can access the lifesaving care they need

Meryem is a Syrian refugee living in a tent settlement in Turkey with her two young children. Her kids had never been to the doctor until a UNFPA mobile health clinic arrived at the tent settlement. UNFPA mobile health teams consist of a medical doctor, a midwife, a nurse, a pharmacist, and a driver. The clinic came to share information on COVID-19 infection prevention measures, but also provided essential care. When Meryem visited the clinic, she received a check-up and information on refugee support programs. Her children received their first vaccinations. Today, Meryem says the mobile health team is like family.  

How many midwives do we need?  

Midwifery students learn critical life-saving skills. © UNFPA Afghanistan

 We need 900,000 midwives to meet the current demand for care.  
This represents one-third of the midwifery force needed to save millions of lives. Tragically, the World Health Organization only expects this gap to grow. The world is experiencing a shortage of health care workers due to underinvestment. There are not enough programs training future midwives, recruiting them into needed positions, and equipping them with supplies and resources once they are in a community. And, burnout from the COVID-19 pandemic has only exacerbated the problem.  

Further, all women in health care are vulnerable to sex and gender discrimination. Many women health care workers face heavy workloads at home and have seen that burden increase during the COVID-19 pandemic. But, while 70 percent of the world’s health care workforce are women, more than 90 percent of the world’s midwives are women. This means discrimination in midwifery is especially pronounced. Some researchers have even linked the decline in the midwifery population to the medicalization of birth and to the idea that only doctors, who are more likely to be men than nurses or midwives, are qualified to deliver babies. This is a dangerous myth and it impacts pregnancies and childbirths across the world today.  

UNFPA is working to train, equip, and deploy midwives where they are most needed, like refugee camps in Bangladesh, in Haiti after the recent earthquake, and in rural communities in Madagascar. Your gift of $100 provides one midwife with enough supplies to support 5 women through safe deliveries. 

Training the Next Generation of Midwives 

Midwifery students at Madagascar’s Interregional Training Institute for Paramedics. ©UNFPA Madagascar

In Madagascar, UNFPA supports midwifery training programs. But, government funding cuts have ended programs that place graduates into clinics across the country.  

New midwives like Domoina have to find clinics on their own. This is difficult if, like 86% of the country, they lack access to computers or internet. But, Domoina is hopeful. She explains her dream, “I want to open a clinic in my native village – which is about 120 kilometers from the capital – to help the most vulnerable access services like prenatal consultations, contraception, and vaccinations. Many women live in remote areas with no health care facilities nearby, so they often can’t make it to the hospital on time, endangering the lives of both mother and baby.”   

How does the midwifery shortage affect women and girls?  

Tens of thousands of pregnant women are expected to need safe delivery services in quake-affected areas in the coming weeks. © UNFPA Haiti/Samuel Lamery Pierre

When women and girls are unable to access essential sexual and reproductive health care, they are more likely to become pregnant before they are ready, experience infections, injuries, or death during childbirth, and suffer from violence. Every day, 808 women die from preventable pregnancy and childbirth complications. More than half of these women live in humanitarian settings. And, for every woman who dies, an additional 20 to 30 women experience birth injuries and infections.  

Salma’s Safe Delivery 

Midwife Imama (left) checks on Salma and her newborn in Cox’s Bazar, Bangladesh. © UNFPA Bangladesh/Fahima Tajrin

Salma, a Rohingya refugee in Bangladesh, had already suffered nine miscarriages when she became pregnant for the 10th time. She was determined to become a mother, and had even adopted a little girl in the refugee camps. But, Salma was worried about her new pregnancy. When she visited Imama, a UNFPA midwife, for prenatal care, Salma learned she was diabetic and that her pregnancy was high-risk.  

Thankfully, Imama knew what to do. Through careful monitoring of Salma’s pregnancy and delivery, Imama made it possible for Salma to safely deliver a baby girl. Today, Salma is raising her two daughters in the Rohingya refugee camp. This happy ending would have never been possible without your support.  

Your support for midwives saves lives 

A midwife examines a pregnant woman using a portable ultrasound device. © UNFPA Kenya

Already, women and girls’ lives are at stake because of the midwifery shortage. The projected increase in the need for midwives means more women and girls are in greater danger. Your support will go toward programs like those in Madagascar, where women like Domoina receive midwifery training and the equipment they need to provide lifesaving care. These trainings will ensure future generations of women and girls have access to the care they need.  

Your gift will also go toward items like emergency birth kits, which provide pregnant women with everything they need to safely give birth in an emergency. For $5 you can provide one kit, which contains items like gloves, a plastic sheet, a razor, and soap, and save two lives: that of a woman and her baby. Through the month of December, a generous donor will double your lifesaving gift to reach women and girls around the world, no matter what.  

-Dana Kirkegaard