NEW STATE OF THE WORLD'S MIDWIFERY REPORT ISSUES URGENT LIFESAVING RECOMMENDATIONS
Report launched on the International Day of the Midwife 2021 with significant implications for Asia-Pacific and globally
Fully investing in midwives by 2035 would avert roughly two-thirds of maternal, newborn deaths and stillbirths, saving
4.3 million lives per year.
UNITED NATIONS, New York / Bangkok, 5 May 2021 -- Millions of lives of women and newborns are lost, and millions more experience ill health or injury, because the
needs of pregnant women and skills of midwives are not recognized or prioritized.
The world is currently facing a shortage of 900,000 midwives, which represents a third of the required global midwifery
workforce. The COVID-19 crisis has only exacerbated these problems, with the health needs of women and newborns being
overshadowed, midwifery services being disrupted and midwives being deployed to other health services.
These are some of the key takeaways from the 2021 State of World’s Midwifery report by UNFPA (the UN sexual and reproductive health agency), WHO (World Health Organization), International Confederation
of Midwives (ICM) and partners, which evaluates the midwifery workforce and related health resources in 194 countries.
The acute shortage of midwives is exacting a terrible global toll in the form of preventable deaths. An analysis
conducted for this report, published in the Lancet last December, showed that fully resourcing midwife-delivered care by 2035 could avert 67 per cent of maternal deaths,
64 per cent of newborn deaths and 65 per cent of stillbirths. It could save an estimated 4.3 million lives per year.
Despite alarms raised in the last State of the World’s Midwifery report in 2014, which also provided a roadmap on how to remedy this deficit, progress over the past eight years has been too slow. The
analysis in this year’s report shows that, at current rates of progress, the situation will have improved only slightly
by 2030.
Gender inequality is an unacknowledged driver in this massive shortage. The continued under-resourcing of the midwifery
workforce is a symptom of health systems not prioritizing the sexual and reproductive health needs of women and girls,
and not recognizing the role of midwives – most of whom are women – to meet these needs. Women account for 93 per cent
of midwives and 89 per cent of nurses.
Midwives do not just attend births. They also provide antenatal and postnatal care and a range of sexual and
reproductive health services, including family planning, detecting and treating sexually transmitted infections, and
sexual and reproductive health services for adolescents, all while ensuring respectful care and upholding women’s
rights. As numbers of midwives increase, and they are able to provide care in an enabling environment, the health of
women and newborns improves as a whole, benefitting all of society.
For midwives to achieve their life-saving and life-changing potential, greater investment is needed in their education
and training, midwife-led service delivery, and midwifery leadership. Governments must prioritise funding and support
for midwifery and take concrete steps to include midwives in determining health policies.Quotes from partners:
Dr. Franka Cadée, President of the International Confederation of Midwives:
“As autonomous, primary care providers, midwives are continually overlooked and ignored. It's time for governments to
acknowledge the evidence surrounding the life-promoting, life-saving impact of midwife-led care, and take action on the
SoWMy report's recommendations. ICM is committed to leveraging the strength of our global midwife community to carry
forward these powerful findings and inspire country-level change. However, this work is not possible without commitment
from decision makers and those with the resources to invest in midwives and the quality care they provide to birthing
women."
Dr. Natalia Kanem, UNFPA Executive Director:
“The State of the World’s Midwifery report sounds the alarm that currently the world urgently needs 1.1 million more
essential health workers to deliver sexual, reproductive, maternal, newborn and adolescent health care, and 80 per cent
of these missing essential health workers are midwives. A capable, well-trained midwife can have an enormous impact on
childbearing women and their families – an impact often passed on from one generation to the next. At UNFPA, we have
spent more than a decade strengthening education, enhancing working conditions and supporting leadership roles for the
midwifery profession. We have seen that these efforts work, but they need greater investment.”
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General:
“Midwives play a vital role in reducing the risks of childbirth for women all over the world, but many have themselves
been exposed to risk during the COVID-19 pandemic. We must learn the lessons the pandemic is teaching us, by
implementing policies and making investments that deliver better support and protection for midwives and other health
workers. This report provides the data and evidence to support WHO’s longstanding call to strengthen the midwifery
workforce, which will deliver a triple dividend in contributing to better health, gender equality and inclusive economic
growth.”
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The launch of the 2021 State of World’s Midwifery report includes policy recommendations to improve sexual, reproductive, maternal, newborn and adolescent health service
delivery and midwifery leadership and governance.
These policy recommendations will be the subject of a meeting of health ministers on 18 May and a dialogue at the 74th
World Health Assembly (24 May), where WHO Member States are anticipated to adopt the evidence-based Global Strategic
Directions for Nursing and Midwifery 2021-2025 with a Resolution on nursing and midwifery.