Follow the data: Invest in midwivesWednesday, May 05, 2021
Today, May 5, is celebrated annually as the International Day of the Midwife. This year's theme is 'Follow the Data: Invest in Midwives'. The theme for this year is quite timely and points to the fact that, as a country, we need to advocate for investment in respectful, and quality midwifery care; further improving sexual, reproductive, maternal, newborn, child, and adolescent health.
For the purpose of this article, please note that a midwife is not a nurse. To clarify, a midwife is a person who has successfully completed a midwifery education programme, usually two or four years in Jamaica, and who has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery and use the title midwife, and who demonstrates competency in the practice of midwifery (International Confederation of Midwives (ICM), 2021).
The scope of practice of the midwife includes (1) being recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the post-partum period; to conduct births on the midwife's own responsibility; and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care, or other appropriate assistance and the carrying out of emergency measures.
(2) Important tasks in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women's health, sexual or reproductive health, and childcare.
(3) Practising in any setting including the home, community, hospitals, clinics or health units (ICM, 2021).
Midwives have pivotal roles to play in ending preventable maternal and newborn deaths, thereby achieving UN Sustainable Development Goal (SDG) 3.1, which is reducing global maternal mortality ratio to less than 70 per 100 000 live births by 2030. Equally important is the role midwives are expected to play in achieving universal coverage of midwife-delivered interventions by 2035. It is important to realise that these midwife-delivered interventions can avert 67 per cent of maternal deaths, 64 per cent of newborn deaths, and 65 per cent of stillbirths, ultimately saving 4.3 million lives per year, by 2035 (ICM, 2021). A point that cannot be overlooked is that there is a global shortage of 900,000 midwives, and locally there is shortage of approximately 6,000 midwives and nurses.
Midwives have proven how critical their work and worth, even during the novel coronavirus pandemic. Generally, COVID-19 has negatively impacted health-care service delivery locally, including sexual, reproductive, maternal, newborn, and adolescent health care. One cannot deny the fact that the pandemic threatens the gains made in health outcomes, with a possible increase in unplanned pregnancies, sexually transmitted infections, unsafe abortions, and increased health risks for mothers, newborns and adolescents.
Despite the pandemic and worsening shortage of practitioners, midwives have proven that:
(i) they can provide care for women, children and adolescents outside of health facilities and near where they live, which can result in preventing medical services from being overrun;
(ii) working in communities, they can provide care to women where they live. By and large, home births protect women and families from exposure to COVID-19 that is quite pervasive in health facilities;
(iii) they should not be deployed to secondary and tertiary health facilities in response to COVID-19. Providing nursing services to general patients with COVID-19 detracts from their core function and the services they offer to communities (ICM, 2021).
A point worth emphasising here is that midwives must be involved at the level of the Ministry of Health and Wellness and at the policy-making level generally. Midwives are essential in the narrative on the rights of women, children, and communities. However, they are often deprived of their own rights; for example, to rest and self-care, to decent work and pay, and protection from discrimination (ICM, 2021). On the whole, midwives are key to achieving many of the SDGs, and the provision of respectful, quality care, essential to meeting the sexual and reproductive health needs of women and adolescents.
Most importantly, midwives are fundamental to saving the lives of women and newborns, and as such it is important that the Government, decision-makers, and policymakers are held accountable as we attempt to invest in them. Investment in midwives must be done to achieve a well-educated, adequately trained, and appropriately regulated midwifery workforce, with enabling work environments that promote efficient, effective and safe delivery of midwifery services.
Adella Campbell, PhD, is an associate professor and head of the Caribbean School of Nursing at the University of Technology, Jamaica.
Now you can read the Jamaica Observer ePaper anytime, anywhere. The Jamaica Observer ePaper is available to you at home or at work, and is the same edition as the printed copy available at https://bit.ly/epaper-login