The International Day of the Midwife highlights the essential role midwives play in improving maternal health and advancing sexual and reproductive health and rights worldwide. Despite significant progress in healthcare, nearly 290,000 women died during or after pregnancy and childbirth in 2020, with the vast majority of deaths occurring in low- and lower-middle-income countries. Many of these deaths were caused by severe bleeding, infections, unsafe abortions, hypertensive disorders and obstructed labour, all of which are largely preventable when skilled care and emergency services are available.
Midwives are often the first and sometimes only skilled healthcare providers available to women during pregnancy and childbirth, particularly in underserved communities. They play a vital role in detecting complications early, providing emergency care and supporting safe delivery and postnatal care. However, the world currently faces a shortage of up to one million midwives, contributing to a broader global health workforce crisis that disproportionately affects countries with the highest maternal and newborn mortality rates.
Although global skilled birth attendance is estimated at around 80 percent, major inequalities persist between and within countries. Women living in rural areas, conflict zones, humanitarian settings and poor communities often lack access to trained midwives and quality maternal healthcare services. Access is influenced not only by the availability of healthcare facilities but also by factors such as transportation, affordability, staffing levels, medicine supplies, referral systems and the level of trust women have in healthcare systems.
Experts stress that safe childbirth and postnatal care are part of a broader continuum of sexual and reproductive health services. This includes health education, contraception, antenatal care, screening for sexually transmitted infections, emergency obstetric care, newborn support, breastfeeding assistance and safe abortion and post-abortion care. Strengthening this full continuum of care is considered essential for reducing maternal and neonatal deaths.
The current global maternal mortality ratio remains far above the Sustainable Development Goal target of fewer than 70 deaths per 100,000 live births by 2030. According to health experts, properly trained and supported midwives can provide up to 90 percent of essential sexual and reproductive health services. However, in many low-resource settings, midwives remain underpaid, poorly equipped, unevenly distributed and restricted from fully practicing their skills.
Investing in midwifery is increasingly recognized as one of the most practical and effective ways to improve maternal and newborn health outcomes. Experts emphasize the need for better education, fair wages, safe working conditions, strong regulation, reliable medical supplies and improved career pathways for midwives. Integrating midwifery services into primary healthcare systems and reducing financial barriers to care are also seen as critical steps.
Countries are already demonstrating innovative approaches to strengthen midwifery services. In Sierra Leone, mentorship programmes are helping midwives improve their practical clinical skills and confidence, while in Ethiopia, specialized training centres are educating disadvantaged rural girls to become skilled midwives in their own communities. These efforts are helping empower both healthcare workers and the women and children they serve.
Health advocates stress that midwives already save lives every day, but greater global investment is needed to ensure that women everywhere have access to skilled, respectful and life-saving maternal healthcare services.
