“I lost my baby because of the neglect of a midwife who attended to me. I was told to go the toilet and gave birth in the toilet,” said Christine Kabwe (not her real name).
When a woman is pregnant in Africa, it is assumed she has one foot in the grave and that her chances of being alive after birth are very slim.
Many mothers fear giving birth at a health facility, said Madame Callista Mutharika, first lady of Malawi, in her keynote address at the International Confederation of Midwives (ICM) 29th Triennial Congress, taking place in Durban South Africa.
Cultural traditions, a lack of sensitivity and poor treatment by midwives discourage women from accessing health services, she said, even where they are available. She reminded all midwives to remember the oath each one of them took when they started their job.
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“The State of the World’s Midwifery 2011: Delivering Health, Saving Lives,” a major report released at the Congress, says that women have cited a variety of abusive behaviours at clinics and hospitals as reasons for choosing the more perilous route of home birth. In some cases the provider does not speak the local language, or female providers may not be available when wanted.
In his forward to the report, Secretary General of the United Nations Ban Ki-moon wrote that there is need to ensure that every woman and her newborn have access to quality midwifery services which demands taking care of bold steps to build on what has been achieved so far across communities, countries, regions and the world..
“Our responsibility is clear we must safeguard each woman and child so they may live to their full potential,” said Ban Ki-moon.
One of the most important investments a country can make to reduce high rates of maternal and infant mortality is in human resources to ensure women have access to skilled care, particularly midwives, during labour and delivery.
“The report points to an urgent need to train more health workers with midwifery skills and ensure equitable access to their life saving services in communities to improve the health of women and children,” said Dr Babatunde Osotimehin, Executive Director United Nations Population Fund (UNFPA).
According to the report, 38 of 58 countries surveyed might not meet their target to achieve 95 percent coverage of births by skilled attendants by 2015, as required by Millennium Development Goal (MDG) 5 on maternal health, unless an additional 120, 000 midwives are trained, deployed and retained in supportive environments.
The new report also indicates that upgrading midwifery services could save more than 3.6 million lives each year by 2015 in the 58 developing countries surveyed.
“Each year, 358,000 women die while pregnant or giving birth, some 2 million newborns die within the first 24 hours of life and there are 2.6 million still births, all because of inadequate or insufficient health care,” says the report.
“There has never been a report like this,” said Bridget Lynch, president of ICM, noting that it had been supported by more than 30 agencies whose collective aim is to strengthen midwifery practices to prevent maternal death and disability and improve the health of newborns, families and the entire communities.
“The biggest challenge however remains the shortage of midwives,” said Lennie Kamwendo, chair of the board of trustees of the White Ribbon Alliance for Safe Motherhood in Malawi.
Meanwhile, Dr Joy Lawn, director of global evidence and policy with Save the Children, asked midwives to use the data in the report for advocacy. She said increasing women’s access to high quality midwifery services has become a focus of global efforts to realize the right of every woman to best possible health care.
The report makes a series of recommendations to governments, regulatory bodies, educational institutions, professional associations and international organizations that would help remedy these problems and reinforce the status of midwifery in the countries surveyed.