Five Things to Know about Midwives and Global Health

(A midwife in CAR. Photo credit: hdptcar)

1. Midwives are trained medical professionals who provide basic gynecological care, and assist with labor and delivery. They provide culturally acceptable care to make pregnancy and childbirth safer. When the World Health Organization talks about births taking place with a trained attendant, they are generally talking about midwives.

2. In the wealthy world, midwives have an important role in supporting less-medicalized birth, with a minimum of interventions. In the developing world, midwives are often the only birth attendants available, and they save lives with their training. The United Nations Population Fund (UNFPA) has stated that training more midwives could save 5 million lives by 2015.

3. The World Health Organization estimates that the world needs an additional 700,000 midwives to meet full demand. In partial response, UNFPA and the International Confederation of Midwives have a program to train midwives in eleven countries with high maternal mortality rates. It will support training in Benin, Burkina Faso, Burundi, Côte d'Ivoire, Djibouti, Ethiopia, Ghana, Madagascar, Sudan, Uganda and Zambia.

4. While all medical professions face some level of outmigration, midwives don't tend to be subject to brain drain. The developed world has a limited demand for midwives, which is met by domestic personnel. This is due partly to the low status of midwives in the wealthy world, where most women give birth with an obstetrician. (Personally, I think that births in the US would be safer and better for mother and baby if more took place with midwives.)

5. There is a lot of debate over "traditional midwives." These are individuals, usually women, with no medical training who attend births and use traditional methods and medicines. They may of some use, they may be useless, and they may cause active harm to woman and child. Some governments ban traditional midwives to avoid dangerous practices. Others try to train them and shift their birth participation into beneficial roles, such as birth companion or doula.