“Every day in every part of the world, midwives save the lives of women and babies and promote the health and well-being of entire communities,” writes UNFPA Executive Director Dr. Natalia Kanem in honor of International Day of the Midwife. “They deserve our respect and gratitude, but that is not enough. Midwives deserve greater investment in their capabilities, and workplaces that empower them and fully acknowledge their skills and contributions.” Investment in midwifery could save millions of lives per year – an estimated 4.3 million annually by 2035.

The 2021 State of the World’s Midwifery (SoWMy) report is dedicated to health workers who lost their lives to COVID-19. According to Amnesty International, at least 17,000 health workers have died from COVID-19. The pandemic has made clear the need for midwives as essential primary care providers, yet they are not properly protected from COVID-19.  “[Midwives] have faced increasing pressure during the COVID-19 pandemic, and heightened inequalities in their workplaces. Often short on protective gear, and with less access to vaccines than other healthcare workers, midwives have put their own lives at risk serving others. Such dedication is an invaluable resource, yet too many health systems depend on it without commensurate backing of midwifery as a profession,” writes Dr. Kanem.

Investing in midwives is investing in women. Over 90 percent of midwives across the globe are women, and they experience gendered disparities in pay rates, career pathways, and decision-making powers. Midwives must hold leadership positions to advance the needs of midwives, yet only half of reporting countries have midwife leaders within their national Ministry of Health.

The SoWMy report calls for greater investment in four key areas: health workforce planning, management, and regulation in the work environment; high-quality education and training of midwives; midwife-led improvements to sexual, reproductive, maternal, newborn, and adolescent health (SRMNAH) service delivery; and midwifery leadership and governance.

Properly trained midwives can meet around 90 percent of the SRMNAH care needs. And while a common perception is that midwives only provide perinatal care, this aspect of their work only accounts for 55 percent of the global need for midwives. Midwives are also needed for other sexual and reproductive health interventions such as counseling, contraceptive services, and detection and management of sexually transmitted infections. Evidence shows that investing in midwives leads to improved birth and health outcomes, safe and effective comprehensive abortion services, increased supply of workers in the workforce, and positive economic growth. Additionally, midwife-led care that is woman-centered has been shown to reduce the incidence of disrespect and abuse toward those seeking SRMNAH services.

Unfortunately, there is a global shortage of midwives. To meet the care needs of women and children, the world must add 900,000 more midwives to the care workforce, especially in low-income countries and throughout Africa, where they are most needed. At current rates, there will be 750,000 fewer midwives than needed to meet universal care coverage by 2030, and the gap between rich and poor countries will widen.

“We have the evidence and know what must be done,” writes Dr. Kanem. “Health systems everywhere need to take note – and take action – because investing in empowered midwives is one of the surest ways to safeguard life and protect the health and well-being of all.”

Read more:

• Listen to Indigenous Midwives on the Importance of their Practices

• Impact of Midwives Study Shows Midwives Can Save Millions of Lives 

• Indigenous Midwife-Led Models of Care Improve Health Outcomes for Indigenous Women

• Event Honors 100 Women Leaders in Nursing and Midwifery