Worldwide, we have seen maternal deaths decline in recent years. In no small part, this is due to an underappreciated commitment by a highly valued global human resource: midwives. As the 30th Triennial International Confederation of Midwives (ICM) Congress begins in Prague, we must recognize that midwives provide a critical entry point for pregnant women and their newborns to receive life-saving health care services that are respectful and women-centered.
A range of services is necessary to protect and enhance women’s health and well-being before, during and after a pregnancy. Most maternal deaths are caused by the underlying health conditions of the mother before or during pregnancy, or by poor quality care in the critical hours and days before and after a birth.
Four key services comprise the continuum of care during pregnancy:
- Antenatal care with a skilled provider, ideally to include several visits beginning in the first trimester
- Delivery with a skilled attendant, including the routine monitoring of the progression of the delivery and the availability of drugs, such as oxytocin, for the prevention of postpartum hemorrhage
- Immediate emergency care for medical complications that arise during pregnancy and childbirth
- Postpartum and postnatal care for the mother and baby shortly after birth to ensure both are healthy and that the baby receives essential newborn care while the mother receives family planning counseling
Midwives throughout the world are capable of providing a range, if not all, of these services. But their role is more crucial in health care systems in low- and middle-income countries. In some regions, midwives are already making a dramatic difference by providing pregnancy and delivery services in low-resource settings. We need to ensure that regions without such midwifery-led services receive equal access.