Making The Case For Midwifery

In 1998, Fatimata Kané was still a practicing midwife, visiting a local village when she met Kadija.* Kadija was pregnant and nearing the end of her third trimester. Fatimata could immediately see that Kadija was not well: she looked exhausted, was severely anemic, and had edema in her lower extremities. If she didn't seek care right away, both she and her baby could die during labor. Fatimata told the woman and her family that she needed to get to a hospital quickly, but the family did not understand. Kadija had many children and had never once received pre-natal care or been to a hospital. All of her babies had been delivered at home, and she used the traditional medicines available in her village. She lived over 10 miles from a hospital and the trip was expensive.

After a lot of persuading, Fatimata convinced the woman's family to let her deliver in the hospital. Sadly, they could not get to the hospital fast enough to save the baby, but were able to save Kadija's life. Fatimata often replays the moment over and over in her head. Had she not been there, and had she not been trained as a midwife, she would not have known that Kadija was in urgent need of care.

Fatimata, now the director of FCI-Mali, is using her firsthand knowledge of the need for quality reproductive, maternal and newborn health care at the community level to advocate full time for improved maternal and newborn health care in Mali. She makes the case for strengthening midwifery through increased investments in training and supportive policies so that midwives can continue to provide lifesaving care to pregnant women and newborns, including pre-natal and post-natal care and family planning, in their communities.

Midwives, like Fatimata, can be a profound and powerful voice for change in their countries. If their services were available and accessible to all women and babies who need them, midwives could help avert two-thirds of the nearly 300,000 maternal deaths and half of the 3 million newborn deaths that occur each year, provided they are well-trained, well-equipped, well-supported and authorized. Midwives understand the health care needs of women and newborns, because they work to meet those needs every day. They see the gaps in the health care system -- in resources, staffing, facilities, and policies -- because they struggle to fill those gaps, day in and day out. And they are uniquely positioned to speak the truth about midwives' need for training, for support, and for enabling policies - because they have dedicated their lives to doing this crucial job for women and their families.

In partnership with Johnson and Johnson, the International Confederation of Midwives and UNFPA, Family Care International (FCI) is helping to prepare midwives to advocate for improved maternal and newborn health services using evidence from a new report on The State of the World's Midwifery. Although providing quality midwifery care will always be their first priority, midwives can also be champions for their profession, helping to hold governments accountable for keeping the promises they've made to women and babies, and ensuring that young midwives just starting out in their careers will enter a workplace that recognizes, values and supports their role.

National midwives associations have already been successful in advocating for new policies ranging from a policy for development of a national education system for midwives in Afghanistan to a policy on improving quality family planning services to improve maternal health in Nigeria.

Enis Banda, a midwife from Malawi, said on this year's International Day of the Midwife that "life starts in the hands of a midwife." With tools to support their advocacy efforts, stronger policies and programs to improve midwifery care and maternal and newborn health can start in the hands of a midwife too.

How will you help make the case for midwifery in your community?

*Not her real name