Midwives Can Be the Voice Heard Around the World

By: Joy Marini, Director Corporate Contributions, Johnson & Johnson

At the opening ceremony of the International Confederation of Midwives 29th Triennial Conference in Durban, South Africa on Sunday, a hall full of midwives joined voices to sing “One Love,” Bob Marley’s anthem of compassion for humankind. As a witness, I can report that you have not heard the power of a collective voice until you’ve heard 3,000 midwives singing about their love and commitment to mothers and babies: “Hear the children crying… let's get together and feel all right.”

Today, women all over the world are giving birth and listening for the joyful squawk of their newborns crying for the first time. But many of these mothers will hear only heartbreaking silence – as many as one out of 10 babies may have difficulty breathing at birth, and asphyxia (or lack of oxygen) is responsible for more than 20 percent of newborn deaths. With their unique access to women and children at a critical moment, midwives may hold the key to ending this tragedy.

Interventions performed by a midwife, like stopping a hemorrhage and administering antibiotics to prevent infection during birth, can have an immediate impact on women's lives. But their role doesn’t end there. We have heard here at ICM about the importance of the Continuum of Care, a model that extends the reach of midwives to the health and survival of newborns. As midwives continue to gain recognition as a sustainable resource to support women’s health, they are also gaining the knowledge and skills to protect the lives they help bring into the world.

At a standing-room-only workshop for the Helping Babies Breathe program at the conference, I was reminded why it is so important to engage midwives in the Continuum of Care. As the presenters shared stories and best practices for combating newborn asphyxia – for example, an estimated 42,000 newborns a year could be saved simply by having a birth attendant dry the baby and stimulate it to breathe – the midwives in the packed room responded with gasps, vocal approval and excited murmurs. At a work station, crowds of midwives surrounded the infant-sized mannequins used for practicing newborn resuscitation.

In a partnership with Save the Children, the American Academy of Pediatrics and USAID, Johnson & Johnson is supporting Helping Babies Breathe training in Malawi and Uganda over the next five years. But there is more work to be done. In some countries, more than 80 percent of women still give birth without a skilled birth attendant, a number that is tied closely to rates of maternal and infant mortality. As part of the conference this week, The State of World's Midwifery 2011: Delivering Health, Saving Lives was released by UNFPA, providing the first comprehensive analysis of the role of midwives in the parts of the world with the greatest need. The report names nine countries that need to increase their midwifery workforce by 6 to 15 times, just to meet the current need.

This week, here in Durban, South Africa, those 3,000 midwives from more than 120 countries will again join voices to talk about how midwifery can change the way we address global maternal and child health. These women save lives, and as their role expands to take on more responsibility, midwives deserve the respect and support of health systems and local governments and the legitimacy of true health professionals. After all, they may be our best shot at giving more mothers a chance to hear that first beautiful cry.