The International Day of the Midwife is celebrated on the 5th of May each year to highlight the important role midwives play in the health of families. Access to a skilled midwife can help reduce and prevent deaths of more than 287,000 people who die while giving birth, those who are left with morbidities and 2.7 million newborns who die within the first 28 days of life because they have no mothers. Most of these deaths would be prevented if there were enough qualified and adequately resourced midwives. The World Health Organization, UN agencies, and other international agencies have identified that midwives are the key to achieving reductions in maternal and newborn deaths and disabilities globally. There is substantial evidence to support the fact that midwives save lives.

Key midwifery concepts that define the unique role of midwives

• partnership with women to promote self-care and the health of mothers, infants, and families;
• respect for human dignity and for women as persons with full human rights;
• advocacy for women so that their voices are heard;
• cultural sensitivity, including working with women and health care providers to overcome those cultural practices that harm women and babies;
• a focus on health promotion and disease prevention that views pregnancy as a normal life event.

Midwives, Mothers, and Families: Partners for Life!

This year's theme is Midwives, Mothers, and Families: Partners for Life! The best partnership for a healthy low-risk pregnant person is with a qualified midwife. Midwives contribute to achieving the Sustainable Development Goals (SDGs) by reducing child mortality and improving maternal health. A huge global problem is the lack of midwives. Only 22% of countries have enough midwives now and in the future. Investing in midwives is investing in healthy and safe families & newborns.

For many people around the world, there is simply no access to reproductive health and maternity care services. Or this care is hard to access due to transportation issues and financial limitations. Extending access to midwives to all pregnant people would save millions of lives each year. It is estimated that 56% of maternal, fetal and newborn deaths could be prevented if all people were able to give birth with a midwife in a facility that is capable of providing basic emergency care. Midwives educated to international standards could also deliver 87 percent of all essential sexual, reproductive, maternal and newborn health services. Yet only 42 percent of people with midwifery skills work in the 73 countries where more than 90 percent of all maternal and newborn deaths and stillbirths occur.

Additionally, midwives are able to educate families on how to delay, space or limit pregnancies and provide family planning services to achieve the healthiest outcomes for women, newborns, infants, and children. This healthy timing and spacing of pregnancies leads to better outcomes for both mother and baby.

"The world focuses on maternal health because saving women stimulates the economy, bolsters communities and strengthens families. Women's unpaid work equals about one-third of world GDP; when a woman dies, children risk of dying within two years increases tenfold."- International Confederation of Midwives

Midwifery in the USA

I find it interesting, examining the state of midwifery in the United States, that despite research demonstrating that out of hospital birth is as safe as hospital birth for healthy low-risk families, only 32 states have permitted Certified Professional Midwives (CPM) to offer services legally. Six states have an active CPM bill in legislative process, six states have future plans for CPM legislation and six states have no plans to legalize the Certified Professional Midwife. All states recognize as legal the attendance of a Certified Nurse Midwife (CNM) at an out of hospital birth.

The USA has the worst maternal mortality rate in the developed world. It may be time to make midwifery more accessible to all who are interested in the USA. 50% of all births in the United States are covered under Medicaid. It is time for Medicaid to cover out of hospital birth. That can realize a significant cost-savings and result in better outcomes.

Celebrate and learn

Regardless of where you are located, you can participate in the Virtual International Day of the Midwife (VIDM.) This is an annual free 24-hour online international conference celebrating midwifery and birth-related matters on the International Day of the Midwife - May 5th. This year sees the 9th annual conference and organized by individuals having backgrounds in midwifery, education and online facilitation. The International Confederation of Midwives is proud to offer this conference entirely free of charge in order to enable midwives, and others interested in the birthing process, to network and participate in continuing professional development. Access the program here.

Midwives are saving the lives of pregnant and birthing people and their infants all around the world. They are often doing this work with extremely limited resources, minimal financial compensation and at great expense to their own families and quality of life. It is not easy being on call and traveling great distances to go where a midwife is needed. While May 5th is recognized as the International Day of the Midwife - any day of the year is appropriate for thanking the men and women who serve to improve maternal-infant health outcomes. So thank a midwife for the job they do and encourage your clients, students, and patients to do the same. If you are interested, download the IDM 2017 Resource Pack for your use. It is available in English, Spanish and French.

Resources

Asking different questions: research priorities to improve the quality of care for every woman, every child

The Lancet Series on midwifery

Standards for improving quality of maternal and newborn care in health facilities

The State of the World's Midwifery (SoWMy) 2014: A Universal Pathway. A Woman's Right to Health

Unicef. (2014). Trends in maternal mortality: 1990 to 2013. World Bank Publications.

What Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low and Middle Income Countries from the Provider Perspective

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