EVERY YEAR, NEARLY 300,000 women are thought to die during pregnancy across the world and millions suffer stillbirths.
In countries with the highest burden of infant and maternal deaths, over three quarters of stillbirths and maternal newborn deaths could be prevented in the next 15 years if effective midwifery is available to all women, according to a researchers.
A new series, published in the academic journal The Lancet, examines the role of midwives and shows the scale of the positive impact that can be achieved when high-quality midwifery is available to all women and their babies.
Caesarean sections
The authors also produce evidence of a trend towards the overmedicalisation of pregnancy, and the use of unnecessary interventions such as caesarean sections, in high-income and lower-income countries, with consequent hazards and costs.
Professor Caroline Homer, of the Faculty of Health at the University of Sydney, said both underuse and overuse of medical interventions in pregnancy can contribute to short and long-term illness for an estimated 20 million childbearing women.
“This not only effects their health and wellbeing, but may also result in their needing to pay for ongoing health-care costs, and on the ability of their families to escape poverty,” she said.
Mental health
The authors point out that apart from saving lives, midwifery also improves the continuing health and wellbeing of women and has other long-lasting benefits. Millions of women and their families suffer long-term health, financial, and emotional problems, simply because they have not received adequate health care before, during, or immediately after pregnancy.
A study last month found that mothers were more likely to suffer depression four years after childbirth than in the first 12 months afterwards. At the time, Dr Patricia Leahy-Warren of the School of Nursing and Midwifery at University College Cork told TheJournal.ie that this is a big problem here and that public health nurses in Ireland are the key in helping these women.
“The evidence shows that if intervention is by a healthcare profession who has a relationship with the mother, it is more likely to work,” she said. “These people have worked in the community for years, they’d often know the grandmother and the family, especially if the woman had more than one child so they need to be given the training and the time.”
Barriers
Barriers to wider uptake of the effective midwifery practices include a lack of understanding about what midwifery can do, low status of women in society, interprofessional rivalries, and unregulated private sector care for mothers’ and infants’ health.
To address the barriers, the series outlines a new framework describing the characteristics of care that women, babies and families need – before, during and after pregnancy. The authors of this new series hope that the framework will be used to evaluate success in midwifery and help build capacity in countries most affected by maternal and infant deaths.
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