In a study that should surprise few in the women's health advocacy community, the United Nations called for "more and better trained" midwives to address the maternal and infant mortality crisis that affects many developing countries, particularly those in Africa.
"We have now realized that there is a huge potential in the hands of the midwives that was not being exploited. They can do much more than deliver babies. They can deliver health services," said Vincent Fauveau, the doctor who coordinated the United Nations Population Fund's study of 58 countries.
The midwives who do work in developing countries often have an enormous workload, sometimes handling 10 to 15 deliveries a day. Midwives should really only tackle 1 to 2 deliveries in a day, according to the UN, both to ensure that midwives don't suffer from extreme overwork and to make sure that mothers and infants are receiving an adequate level of care.
"There are insufficient midwives, so staff work long hours and have few breaks. In addition, they deal with death after death of mothers and babies – a highly emotional experience. Hospital staff report they suffer stress and fatigue from such a relentless workload, which has increased over the last two to three years since government policy began to push for all women to give birth in health facilities, although the supply of hospital beds, drugs and staff has not kept pace."
These conditions clearly need to change if midwives are going to seek out jobs in the developing world and if their attempts to bring down rates of maternal and infant mortality are to be at all successful. As the United Nations said, this means recruiting and supporting midwives more effectively, making sure that they're not exhausted and depressed, and also that they have the tools they need to perform their jobs adequately. Although, as Fauveau pointed out, this is a "long-term strategy," not a quick revolution, it's encouraging to see the UN so explicitly recognizing midwives' value.
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