Addressing Critical Knowledge Gaps in Newborn Health

Midwives matter: the evidence why

This blog was originally published by MamaYe. Written by Petra ten Hoope-Bender.  

What if you had all the evidence, data and considered arguments you needed to make the strongest case to government, donors and decision makers to invest in midwifery services? What would the world be like? How many women and babies would live who would otherwise die without access to these life-saving health professionals?

This ideal world is a long way off, unfortunately. Collecting detailed information across a wide variety of settings, where resources are often scarce, always makes for an incomplete picture.

However, the Lancet Series on Midwifery will go a long way to helping make the case that investment in midwifery is a highly effective way of improving a nation’s health, as well as just the right thing to do from a woman’s perspective.

So, the stage is set, the data collected, the evidence peer reviewed. The audience are waiting in anticipation to hear from the authors of the Lancet Series on Midwifery, all of us lined up to encourage the whole audience to take action. This was our rallying cry – let the Lancet Series set new standards of care and new stimulus for action.

We were a panel of women who have come together to help deliver this vital action, with chair and colleague Jim Campbell in the middle:

From left to right: Professor Caroline Homer, Associate Professor Rafat JanJim Campbell, lead investigator Professor Mary RenfrewProfessor Zoe Matthews, and finally me Petra ten Hoope-Bender, series coordinator

The audience gather swiftly to their seats, delightfully keen to hear from us – what is the evidence base? How can we make all women of the world benefit from midwifery services? Why does quality of care matter?

We take it in turns to outline the papers we have authored:

Paper one: Midwifery and Quality of Care, which lays the evidence base for a new Framework for Quality Maternal and Newborn Care from the perspective of women and newborn, as well as setting out short, medium and long term outcomes for health and well being – all important for defining a quality midwifery service and the specific role of midwives.

Paper two: Impact of Scaling Up Midwifery, which takes the framework to create a package of care, a collective of all interventions, rather than considering them in isolation. It means that we can begin to calculate the cost and benefits of investing in midwifery through the Lives Saved Tool (LiST), so that countries can hold and informed and evidence-based policy dialogue

Paper three: Deploying Midwives in High Burden Maternal Mortality Countries, which used experts from a wide range of disciplines, such as economics, statistics and health systems analysis, to outline lessons learnt from countries that successfully deployed midwives and reduced maternal and newborn mortality. Using country case studies as exemplars, it tells a story of what worked and how it worked.

Paper four: Improving Maternal and Newborn Health through Midwifery, which builds on the previous papers to provide the international policy brief for taking quality maternal and newborn care forward and links it into the global SRMNH agenda and the post 2015 discussions.

Separately, but by no means less important, two more papers will be published as well as numerous commentaries – one on Human Rights and Midwifery and one on the Research Agenda. All vital pieces of the jigsaw and embedding midwifery as central to improving health across the world.

Over to the audience, who are very engaged. Lots of lively questions, challenging and relevant, reminding us that midwives want evidence, but need to be able to see how it translates to the real world. The audience are generous with us when we are not able to tell more until publication on 23 June. They collectively promise to pick up the baton when the Lancet Series comes out.

How great to have so many advocates among the midwifery community ready to take action. We feel the enthusiasm of the audience well up while we speak and we leave the room confident that we have an army of midwives willing to be part of its implementation.

I would like to pay thanks to the big crew of 35 international researchers and many more reviewers and supporters who worked with us on the development and special thanks to Zoe Mullen of the Lancet who was a fantastic advocate for the series and for midwifery.

This is only the beginning. Some of the hard work has been done, but it is now over to all of you to use this to make a difference in your country. Keep following @MidwiferyAction or #LancetMidwifery for more information and play your part.