While some people celebrate May 5th with tequila and nachos, the International Coalition of Midwives wants to remind us that midwives save lives by designating it the International Day of the Midwife. Although what they can do varies significantly by country, midwives provide comprehensive sexual and reproductive health care, including contraception, preventive care like pap smears, prenatal care, and normal deliveries, and also know when their patients require care from a physician. In North America and Western Europe, midwives are preferred over physicians by many women for their traditionally more holistic approach to pregnancy and childbirth. In low- and middle-income countries with severe health worker shortages, midwives are literally saving lives by providing maternal and newborn care, contraceptives, and safe abortion care.
When properly trained and supported, midwives can deliver babies, administer treatment for potentially deadly complications of pregnancy such as pre-eclampsia and post-partum hemorrhage, and provide newborn care. Although physicians will always be needed, much of their work can be shared with midwives. Most low- and middle-income countries need to double, triple, or quadruple their midwife workforce to fully meet their needs. Fortunately, midwives can be trained more rapidly than physicians and may be more likely to stay in rural and underserved areas than doctors. As countries develop, inequality between the rich and poor, and between urban and rural populations increases; training more midwives is a key strategy to ensure that women who are poor or live in rural areas are not left behind.
Countries that have focused on increasing the number of midwives and strengthening the quality of care they provide have seen dramatic decreases in maternal mortality. On this International Day of the Midwife, let’s not forget that reducing maternal mortality is not only about having a skilled birth attendant present at the time of birth; equally important are access to contraception for those who do not wish to be pregnant, and access to safe abortion care for those who are already pregnant and do not want to be. Midwives can insert IUDs and contraceptive implants and perform first trimester medical and surgical abortions as well as physicians and should be empowered to do so. Despite evidence that midwives can safely provide abortions, they are allowed to do so only in a minority of states in the US and countries worldwide. These restrictions are due to ideological objections in some cases, and due to lobbying from physicians in others. Neither objection is based in evidence.
Take a moment to thank your favorite midwife today, and as you advocate for increased access to reproductive health services, don’t forget how much midwives already contribute, and how much more they could contribute if politics weren’t in the way!