Midwives and Safer Motherhood

Midwives and Safer Motherhood

Midwives and Safer Motherhood

Midwives and Safer Motherhood


MIDWIVES AND SAFER MOTHERHOOD draws its title from the Safe Motherhood Initiative (WHO, UNFPA, World Bank, 1987). This book provides a unique insight into the ways in which midwives may be involved in the achievement of safer motherhood, especially a reduction in maternal mortality and morbidity. Divided into four key areas, it explores: Research for Safer Motherhood, Midwives' Changing Roles, Midwifery Education, and The Midwifery Profession Internationally. The international team of contributors offers a rich and varied perspective on the changing role of midwives worldwide.


About 10 years ago the world began to wake up to a 'forgotten tragedy' - the knowledge that at the end of the twentieth century women were still dying or having their lives permanently ruined by the simple, everyday experience of childbirth. The world - or at least, the industrialized world -learned with disbelief that there were places where women ran a risk of death in childbirth that was more than a hundred times that of their Western sisters.

The Safe Motherhood Initiative, launched with the support of WHO and many other agencies at the 1987 Nairobi Conference, challenged the world to halve the maternal mortality figures by the year 2000. WHO and the International Confederation of Midwives (ICM), together with UNICEF, picked up the challenge immediately, with a series of meetings focused on what midwives needed to do to bring their education and practice into line with the demands of safe motherhood programmes. The iniative was given new impetus in the World Summit for Children in 1990, the Cairo International Conference on Population and Development in 1994, and the Fourth International Women's Conference in Beijing in 1995. Also, by 1995, 90 of the 182 member states of WHO had some form of safe motherhood action plan. It was clear that in spite of the steadily worsening economic situation in the worst affected countries there was a very real commitment to action to save women's lives.

Lasting improvement in maternal health means involving much more than the health sector. Childbearing will only gradually become safe as women gain access to better education, better status, some economic independence, and a greater degree of control over their own reproductive lives. Universal access to essential services which are acceptable, appropriate, and welcoming, and improvements in the scope and quality of education for those who have the privilege of caring for childbearing women are essential goals. One of the strengths of this book is that it covers a wide range of issues which midwives must address if they are to meet the safe motherhood challenge effectively.

WHO's practical guide to safe motherhood programming, the Mother Baby Package, states:

The person best equipped to provide community-based, technologically appropriate and cost-effective care to women during their reproductive lives is the person with midwifery skills who lives in the community alongside the women she treats. Midwives understand women's concerns and preoccupations. They accompany women through their reproductive life-span, providing assistance at birth, then during adolescence, pregnancy and delivery. Most interventions related to the care of the mother and the newborn are within the capacity of the person with midwifery...

Midwives are often described as strong women, both individually and as a profession. It is probably truer to say that they are tenacious. What gives them strength, keeps them tenacious - and what shines through this book - is their conviction that childbearing women deserve a very special kind of service. This book is not just for midwives. It is for all decision makers, planners, campaigners, who work to make sure that each year fewer women die or are damaged in childbirth.

Dr Tomris Türmen
Executive Director, Family and Reproductive Health, WHO

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