Laila, a Yemeni midwife from Abyan, had to walk for more than an hour after midnight in a dangerous journey to attend to a delivery in a neighborhood that was under attack: “This is what midwives do in such dangerous environment, they put their lives at risk to save other’s’ lives.” she said.
When Laila began to attend to the delivery, an airstrike hit right next to the house. The whole house shook. The woman who was about to give birth, panicked and tried to escape despite her suffering and pain, but the brave midwife managed the situation, calmed her down and ensured the safe delivery of a healthy baby.
When pregnant women in war torn areas cannot access health centers, midwives like Laila travel to remote areas and provide professional reproductive care services. We should always recognize and appreciate midwives’ contributions and bravery. This cadre of primary health care providers plays a pivotal role in decreasing maternal mortality particularly in humanitarian settings.
Every pregnant woman deserves a safe delivery, and midwives are capable of providing this care, saving lives in the process. Giving birth safely, comfortably and conveniently at home or in clinics should not be a luxury, but a woman’s basic human right. Therefore, midwife-led reproductive and maternal care should be considered a central component of all health systems at all times, especially during emergencies and in situations of fragility.
Midwives also serve as agents of change at the community level with high potential to effect positive behaviour change; they provide advice, care and support for women and their babies during pregnancy, labour and the early postnatal period. Moreover, they educate, empower and enable women to lead healthy lives and exercise their right to sexual and reproductive health.
Yet the Arab region has a shortage of 128,000 midwives, and hundreds of thousands of women and newborns continue to die each year during pregnancy and childbirth due to preventable complications and illnesses. These can be prevented if midwives are empowered and trained to provide proper antenatal, delivery and post-natal care services. A recent study from 88 countries that account for the vast majority of the world’s maternal and neonatal deaths and stillbirths concluded that universal coverage of midwife-delivered interventions could avert two-thirds of these deaths and save 4.3 million lives per year by 2035.
Every day, midwives stand by women when they are most vulnerable, they often risk their own lives to save pregnant women and newborns, they operate in different settings and during the toughest circumstances and are always on the frontlines to support childbearing women in order to ensure safe and healthy pregnancies, taking every precaution to protect the women they serve. However, they are often not included in emergency preparedness and response planning.
Midwives must be included in the national emergency preparedness planning, to ensure that midwifery is not overlooked when responding to crises and disasters. It is also essential for education and training curricula to include the provision of effective reproductive, maternal, newborn, child and adolescent health (RMNCAH) care in a crisis.
Despite their role in the fight for the rights of women, children and communities, midwives often deprived of their own rights: to rest and self-care, to decent work and pay, and protection from discrimination. To achieve their full life-saving, health-improving, system-strengthening potential, midwives must be well educated, adequately trained, and appropriately regulated. They must also work in an environment that enables them to be effective.
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