Midwife receiving training 

Credit: Department of Foreign Affairs and Trade on flickr, under Creative Commons

NEW YORK (WOMENSENEWS) –Midwives in many parts of the world are being under-utilized to the detriment of women’s health and even survival, finds a report published this week, The State of the World’s Midwifery 2014.

Midwives often lack the materials needed to prevent severe bleeding, infections and reduce high blood pressure, three of the most common causes of maternal death.
The report urges countries to provide universal access to midwifery care to all women and adolescents. It also urges countries to make midwifery care a priority in their health budgets and to provide midwives with better education tools.  
The report analyzes the status of midwifery in 73 countries—all either low- or middle-income–that account for 92 percent of the world’s maternal and new born deaths. Often, midwives lack such basic supplies as first aid kits and blood for transfusions that can help reduce the risk of maternal and newborn deaths.
Authors find only 42 percent of the medical, midwifery and nursing personnel who are available in these countries are being tapped.  
Investing in midwifery benefits the health care system by allowing doctors and nurses to tend to other health needs, finds the report, which was coordinated by the United Nations Population Fund, the International Confederation of Midwives and the World Health Organization.

Call for Universal Access

Midwifery2030, a policy initiative that accompanies the report, calls for all women of reproductive age to have universal access to midwife services.
These services range from preventing mother-to-child transmission of HIV and treating sexually transmitted diseases to preventing pregnancy and providing abortions where they are legal, according to the report’s definition of the field.
Out of the 73 countries studied, 45 percent are attempting to retain their midwifery work force in rural areas while 28 percent are increasing recruitment and deployment of midwives. Only 20 percent of the countries have regulatory codes for their midwives.
Low wages for midwifery are a key hurdle to expanding the available work force and recruiting new practitioners, authors find.
The lack of geographical data on the workforce and health facilities in these countries prevents health workers from understanding the accessibility of midwifery services. Although most of the countries surveyed in this report have policies to deliver sexual, reproductive, maternal and newborn health care, little is known about how well midwives are accepted by women and their communities.
Even though countries have up-to-date curricula the report finds that there is still a lack of necessary infrastructure and resources. Lack of adequate funding prevents teaching institutions from purchasing quality equipment and hiring qualified teaching staff which ultimately impacts the quality of midwifery care.  
Nicole Deniflee is an editorial intern at Women’s eNews
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