Midwives could save 3.6-million lives

90% of all maternal deaths could be prevented if pregnant women were cared for by trained midwives, with specialised back-up in case of emergencies.

This is according to the first-ever report on the State of the World’s Midwifery released at the International Confederation of Midwives in Durban yesterday.

The report estimates that the lives of up to 3.6 million mothers and newborn babies could be saved every year by midwives working in a supportive health system.

“The needless loss of life is a reminder of global injustice,” says the report, noting that a woman’s chance of dying as a result of pregnancy is 1 in 31 in sub-Saharan Africa and one in 4 300 in the developed world.

The report is the result of research conducted in 58 countries, mainly in Africa and Asia, that account for 91% of the world’s maternal deaths (women dying during pregnancy and labour).

Over 7000 babies are stillborn, some 5 480 newborns die within 24 hours and almost 1000 mothers die every day in the world.

But these deaths could be slashed with proper maternal care. Unfortunately, there is a global shortage of at least 350 000 midwives.

The World Health Organisation recommends 1 midwife per 175 pregnant women, but in Rwanda, for example, there is 1 midwife per 8 600 births.

There are no figures for how many midwives there are in South Africa because they are simply classified as nurses.

Bridget Lynch, President of the International Confederation of Midwives, said South Africa was renowned for training some of the best midwives in the world in the 1970s but they had been “subsumed by nursing regulations”.

The figures for maternal mortality in South Africa are also disputed, ranging between 400 and 625 per 100,000.

While it is hard to get an accurate maternal mortality figure, the Saving Mothers’ Report indicated that the five major causes of maternal death during 2005-2007 were non-pregnancy related infections, mainly AIDS (43.7%), hypertension (15.7%), haemorrhage (12.4%), sepsis (9.0%) and pre-existing maternal disease (6.0%).

Some 38,4% of the 4,077 maternal deaths reviewed were avoidable within the health care system.

“Although the exact figure is disputed, South Africa’s maternal mortality rate is high for a middle income country,” said research Loveday Penn-Kekana. “The figure has also doubled since 1990, mainly as a result of HIV/AIDS.”

Bunmi Makinwa, the Africa Director for the UN Population Fund (UNFPA), which co-ordinated the report, urged governments to “make employment conditions more attractive for midwives”.

“Safe childbirth is not a luxury, it is a human right,” said Makinwa.

Read this and other stories on Health-e.org.za

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