Building Midwifery – For and With the Next Generation

Dr. Vanessa Kerry, CEO, and Linda Jacobsen, CNM, Chief Midwifery Officer, Seed Global HealthBlog, Midwifery

No woman should die during pregnancy or childbirth. Period. How to prevent this? Midwives.

As midwives converge on Toronto for the 31st International Confederation of Midwives Triennial, we are reminded just how essential midwives are to the care of mothers, babies, families, and communities around the world. From antenatal care to labor and delivery and nutrition counseling, the work of midwives ensures that mom and baby have the best chance to survive birth and thrive as a new family.

When properly trained, midwives are able to provide 87 percent of essential maternal care, helping share the burden with doctors and other health professionals so that mothers receive quality, confident care from midwives. Yet the world sits on the precipice of a midwifery crisis, because there simply aren’t enough of these heroes in communities around the world.

Today, only 22 percent of countries have enough adequately educated midwives to meet the needs of women and newborns. While all women are vulnerable during the period of pregnancy and birth, 99% of maternal deaths occur in low income countries, which have some of the lowest numbers of midwives, nurses, and doctors in the world. In a country like Tanzania, where one woman dies every hour from a complication of pregnancy or childbirth, there are only 24 nurses and/or midwives for every 100,000 people – one hundred fold less than recommended by the World Health Organization.

To help address the unwavering demand, Seed Global Health is committed to working alongside midwives and midwifery educators and build the next generation of midwives. Our cornerstone program, the Global Health Service Partnership (GHSP), has been placing Certified Nurse Midwives in sub-Saharan Africa since the 2013-14 academic year. Volunteer faculty are placed for one year teaching assignments within schools of nursing, in five countries – Liberia, Malawi, Swaziland, Tanzania and Uganda – with input from Ministries of Health, nursing leadership and the Peace Corps.

It was wonderful during Sunday’s parade of flags to see midwifery colleagues from the countries where GHSP volunteers proudly serve. During their tenure, GHSP volunteers work alongside faculty colleagues to support efforts to

From our volunteer Olivia: “Midwives proudly teaching other midwives creative and hands on approaches to help train midwifery students to become competent midwives themselves.”

increase the number of trained midwives and help meet the need for midwifery in areas of dire shortages. These efforts have included the introduction of simulation for normal and emergency childbirth, expanded Helping Babies Breathe training for nursing students and clinical staff, and support for clinical education and work with faculty colleagues to improve implementation of core competencies.

The GHSP experience can be transformative not only for the local midwives, and for volunteer faculty as well. As Olivia, a GHSP volunteer midwifery educator placed in Tanzania recalled, “In January I was asked to advise a group of nursing, midwifery, and medical students who were planning to put on a seminar in March about postpartum hemorrhage. I gladly agreed despite having no idea what this seminar would look like. Over the course of a few months, I had the opportunity to act as a consultant to the students. They led, planned, organized and executed the seminar that was intended to reach over 200 students. I was there, along with a few Tanzanian faculty, to offer input on how to teach hands on skills like suturing, knot tying, running childbirth simulations, making fake blood, and performing manual vacuum aspirations on papaya. But the seminar was theirs.”

Student-led learning in skills lab.

Olivia continued. “The work was their own. As they each led their own skills lab station during the seminar, I walked around the room with pride and admired the creative ways they had chosen to teach each skill. They had taken empty plastic water bottles to demonstrate an empty uterus, made posters to show the likeness of a papaya to a uterus, used cardboard to make their own knot-tying stations and sutured through foam as they demonstrated a locked and unlocked stitch.”

Working in partnership with host institutions, Seed volunteers are helping educate the next generation of midwives and meet the needs of our growing world. We’ve seen first-hand just how much midwives have to give – and how eager people are to learn, especially in settings where resources and training opportunities can be scarce.

We welcome all midwives at the ICM Triennial to join us. Learn more. If you’re a U.S. midwife, find out how you can volunteer alongside your international colleagues as a visiting faculty member. If you work outside of the U.S., join our online community and make your voice heard. Every midwife matters – the lives you save and shape will transform communities for generations. We’re eager to know you and to support you, as together we can strengthen the next generation of midwifery.