A woman goes into labour in rural Uganda. After a day in labour she is weakening and her husband brings her to the nearest facility although it has no running water or electricity. The midwife on duty recognises that the mother needs an emergency C-section, however, there is no doctor at this facility and the nearest referral hospital is a two-day drive away. The midwife takes action and finds a doctor who had observed a C-section as a medical student but had never performed one. He cuts the woman open from sternum to pelvis.
This is a familiar story for too many women around the world facing complications during childbirth, and a dangerous fight for mother and baby to survive.
In this story, the woman was my mother, and the baby was me.
The skills and persistence of the midwife and the courage of the doctor to perform an emergency C-section helped save my life and my mother’s life. I believe we are alive today because people shouted for us.Tragically, this is not always the case. The woman in the bed next to my mother died that night.. Without this informed voice and appropriate action, I could have been an intrapartum stillbirth or neonatal death.
Every year, 48 million women give birth without someone present who has recognised midwifery skills. As a result of complications during childbirth, 358,000 mothers and more than 800,000 newborns die, and an estimated 1.2 million babies are stillborn. Most of these deaths could be prevented with the right person in the right place at the right time. Reducing deaths at birth is the most critical step required for progress towards MDG 5 for maternal survival and MDG 4 for child survival, noting that 41% of child deaths are amongst newborn babies. Improving quality of care at birth will also reduce stillbirths – giving a triple return on investment.
Yet, the lack of coverage of health workers around the world is alarming. Africa, with 12% of the world’s population, experiences about half of the world’s maternal and neonatal deaths and stillbirths, but has only 3% of the world’s health workers. The C-section rate is zero in the rural parts of several West African countries. In South Asia, over half of births occur at home without a midwife. As well as more midwives, urgent investment is needed for other healthworkers both at community level and also at referral level, especially with the skills to undertake C-sections.
Midwives and others with midwifery skills are the single most important frontline worker for care at birth. Midwives hold the solutions in their hands and their voices are lifesaving to link women and babies to emergency care if needed. We need midwives now more than ever.
Photo: © The ONE Campaign and Living Proof
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