WHO: Expand Midwifery Care Globally
Reclaiming Childbirth: Why Investing in Midwifery Models of Care is a Global Imperative
For generations, childbirth has been increasingly medicalized, often at the expense of a woman’s autonomy and well-being. Now, a new push from the world Health Institution (WHO) and the International Confederation of Midwives (ICM) is advocating for a return to, and expansion of, midwifery models of care - a move poised to empower women, reduce unnecessary interventions, and revitalize maternity care worldwide.
The Rise of Over-Medicalization and the Power of Midwifery
While medical interventions like Cesarean sections, inductions, and forceps are undeniably life-saving when clinically indicated, their overuse presents significant risks to both mothers and babies. Alarmingly, C-section rates in some countries now surpass 50%, raising concerns about medically unnecessary procedures.
Midwifery care offers a powerful alternative. It centers on providing individualized, respectful care that empowers women to trust their bodies and abilities. “Skilled midwives help women trust in their bodies, their abilities, and their care,” explains Ulrika rehnstrom Loi, Midwifery expert at WHO and technical lead for the new guidance. “This is why investing in midwifery models of care is so important – it not only improves health but builds a cadre of experts equipped to provide individualized, respectful care, ensuring women are consistently part of decision making and have access to the facts they need as well as vital emotional support.”
A Practical Roadmap for Change
The WHO’s new guidance doesn’t just highlight the why of midwifery care; it provides a practical roadmap for implementation. It emphasizes the need for strong political commitment, strategic planning, and dedicated, long-term financing.Crucially, the guidance stresses high-quality midwifery regulation and education aligned with international standards, fostering autonomous, evidence-based practice.
Successful integration requires collaboration. Midwives should be empowered to practice independently,yet seamlessly integrated into broader healthcare teams alongside doctors and nurses. This collaborative approach ensures that in the event of complications, women receive quality multidisciplinary care.
Addressing a Global Crisis in Maternal Health
The need for this shift is urgent. Millions of women globally still give birth without a skilled health worker present, and one-third don’t receive the recommended eight pregnancy checks. Worryingly, progress in reducing maternal and newborn mortality has largely stalled as 2016.
“Midwifery models of care are not just smart solutions – they are a necessity,” states Anna Ugglas, Chief executive of the ICM.”In a world where childbirth is increasingly medicalized, they offer a person-centred, evidence-based approach that respects the physiological process of birth, restores dignity and autonomy to maternity care, and helps ensure safety for women and newborns everywhere.”
Adaptable Models for Diverse Settings
The guidance outlines several adaptable models of midwifery care, recognizing that a one-size-fits-all approach won’t work. These include:
Continuity of care: Women are supported by a consistent midwife,or small team,throughout their entire maternity journey – pregnancy,birth,and the postnatal period.
Midwife-led birth centres: Dedicated facilities offering intrapartum care for low-risk pregnancies, frequently enough alongside antenatal, postnatal, and family planning services.
Community-based approaches: Midwives delivering care directly within communities, utilizing mobile units or local health centres to reach underserved populations. Private practice: Independent or organization-based private midwives, operating under robust regulation and integrated within national health systems.
Investing in midwifery isn’t simply about improving healthcare statistics; it’s about recognizing the fundamental right of every woman to a safe, respectful, and empowering childbirth experience. It’s a global imperative that demands immediate attention and sustained commitment.