The world urgently needs 900,000 more midwives, report says

An acute shortage of midwives is leading to a “terrible toll” in the form of preventable deaths, according to a new report.

Across the globe, 900,000 midwives are needed by 2035 to save an estimated 4.3 million lives a year, The State of the World’s Midwifery 2021 report finds.

Produced by partners including the United Nations Population Fund (UNFPA) – the UN’s sexual and reproductive health agency – the World Health Organization and the International Confederation of Midwives, the report evaluates the midwifery workforce and related health resources in 194 countries.

The impact of midwives

The identified shortfall represents a third of the required global midwifery workforce, the report finds. They are needed mostly in low-income countries and in Africa. Fully investing in midwives by 2035 would avert roughly two-thirds (67%) of maternal deaths, 64% of newborn deaths and 65% of stillbirths.

“The State of the World’s Midwifery report sounds the alarm that currently the world urgently needs 1.1 million more essential health workers to deliver sexual, reproductive, maternal, newborn and adolescent health care, and 80% of these missing essential health workers are midwives,” says UNFPA executive director Dr Natalia Kanem.

“A capable, well-trained midwife can have an enormous impact on childbearing women and their families – an impact often passed on from one generation to the next.”

The role of gender inequality

The COVID-19 crisis has worsened the problem, the partners warn, with the health needs of women and newborns being overshadowed, midwifery services being disrupted and midwives being deployed to other health services.

Gender inequality is a key, but unacknowledged, driver in this massive shortage.

“The continued under-resourcing of the midwifery workforce is a symptom of health systems not prioritizing the sexual and reproductive health needs of women and girls, and not recognizing the role of midwives – most of whom are women – to meet these needs,” the partners say.

Women account for 93% of midwives and 89% of nurses. As well as attending births, midwives provide antenatal and postnatal care and a range of sexual and reproductive health services. This includes family planning, detecting and treating sexually transmitted infections and sexual and reproductive health services for adolescents.

The report calls on governments to prioritize funding and support for midwifery and take concrete steps to include midwives in determining health policies.

The global gender gap

Similar gender inequality themes emerge in the World Economic Forum’s Global Gender Gap Report 2021, which analyzes gender gaps across 156 countries.

It finds that COVID-19 has lengthened women’s global journey to equality by a generation, from almost 100 years to 136 years.

“There are still too many parts of the world where the fundamentals like health and education still have massive gender gaps,” says Forum managing director Saadia Zahidi.