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For Immediate Release

Contact: Damaris Hay
Email:[email protected]
Office: (240) 485-1856

Download the PDF here.

Midwifery matters "more than ever"

Experts urge global leaders to recognise midwifery's
"vital potential" to save lives of women and infants worldwide

has a crucial part to play in saving the lives of millions of women and
children who die during and around the time of pregnancy, according to a major new
Series, published in The Lancet.

Series, produced by an international group of academics, clinicians, professional
midwives, policymakers and advocates for women and children, is the most
critical, wide-reaching examination of midwifery ever conducted. It shows the
scale of the positive impact that can be achieved when effective, high-quality
midwifery is available to all women and their babies. Apart from saving lives, it also improves
their continuing health and wellbeing and has other long-lasting benefits.

authors also produce evidence of a trend towards the overmedicalisation of
pregnancy, and the use of unnecessary interventions such as caesarean sections,
in high-income and lower-income countries, with consequent hazards and costs.

to Professor Mary Renfrew of the Mother and Infant Research Unit, School of
Nursing and Midwifery, at Dundee University, Scotland, one of the Series
authors, "Many of the needs of childbearing women, their babies, and families
across the world are still not being met, despite long-standing recognition
that women and their babies need access to health care which provides more than
just emergency interventions for acute medical problems. Although midwifery is already widely
acknowledged as making a vital and cost-effective contribution to high-quality
maternal and newborn care in many countries, its potential social, economic and
health benefits are far from being realised on a global scale." 

year, nearly 300 000 women are thought to die during pregnancy, childbirth or
soon after. About 2-6 million women suffer stillbirths, and 2-9 million infants
die in the first month of life. Millions
more women and their families suffer long-term health, financial, and emotional
problems, simply because they have not received adequate health care before,
during, or immediately after pregnancy.

estimates produced for the Series suggest that in the countries with the
highest burden of infant and maternal deaths, over three quarters of
stillbirths and maternal and newborn deaths could be prevented in the next 15 years
if effective midwifery was available to all women. Even if improvements in the coverage of
midwifery services were much more modest, the potential for saving lives is
huge - if coverage of midwifery services
increased from current levels by just a quarter, the authors estimate that the
current rate of maternal deaths could be halved by 2030.

most maternal and child deaths occur in low-income and middle-income countries,
where lack of access to effective midwifery is the primary obstacle to
improving mothers' and infants' health, the Series also says that
overmedicalisation of pregnancy is increasingly threatening the health and
wellbeing of women and their families in both high-income and lower-income
countries. The Series authors argue that
routine use of unnecessary interventions, including caesarean sections, limited
mobility in labour, and episiotomy can have a lasting effect on mothers' and
infants' health and wellbeing.

to another of the authors, Professor Caroline Homer, of the Faculty of Health
at the University ofTechnology,Sydney,
Australia, "Both underuse and overuse of medical interventions in pregnancy contribute
to short- and long-term illness for an estimated 20 million childbearing women. This not only effects their health and
wellbeing, but may also result in their needing to pay for ongoing health-care
costs, and on the ability of their families to escape poverty." 

return on investment from the education and deployment of community-based
midwives is thought to be similar to vaccination in terms of the cost per life
saved. However, according to the Series
authors, the scale of the potential effect that increasing access to effective
midwifery could have is yet to receive adequate international recognition. Barriers to wider uptake of the effective
midwifery practices include a lack of understanding about what midwifery can
do, low status of women in society, interprofessional rivalries, and
unregulated private sector care for mothers' and infants' health.

address these barriers, the Series outlines a new framework describing the
characteristics of care that women, babies and families need, before, during,
and after pregnancy. For the first time,
the framework addresses not just what must
be done for women and their families during this period, but how it must be done, where, and by whom. The authors hope that
as well as providing a blueprint for progress in improving midwifery care
worldwide, the framework will also be used to evaluate success, and to help
build capacity in the countries most affected by maternal and infant deaths.

to another of the Series authors, Professor Petra ten Hoope-Bender, of the Instituto
do Cooperacion Social Integrare, Barcelona, Spain: Although the level and type
of risks related to pregnancy, birth, postpartum and the early weeks of life
differ between countries and settings, the need to implement effective,
sustainable, and affordable improvements in the quality of care is common to
all, and midwifery is pivotal to this approach.

it is important to understand that to be most effective, a midwife must have
access to a functioning health-care service, and for her work to be respected,
and integrated with other health-care professionals; the provision of health
care and midwifery services must be effectively connected across communities
and health- care facilities. 


The Series will be launched on Monday 23
June, 2014, at a special event held at the London School of Hygiene &
Tropical Medicine, London, UK. For more
details, and to register, please see:

To learn
more about the Lancet Series or to set up an interview with an ACNM
spokesperson, please contact Damaris Hay, ACNM Media Relations Specialist at
(240) 485-1856 or via e-mail at
[email protected].

For other interview requests, please
contact Thomson Prentice, Series media consultant, France. E)
[email protected] T) +33 631 86 39 30

The Series Twitter
feed is @MidwiferyAction, with the hashtag #LancetMidwifery

To learn more: www.thelancet.com/series/midwifery

The launch event started
at 10.00 UK time on Monday Jun 23 and can be viewed on this webstream address:
http://www.livestream.com/lshtm. To
receive the event programme schedule, please click here.

The American
College of Nurse-Midwives (ACNM) is the professional association that
represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the
United States. With roots dating to 1929, ACNM sets the standard for excellence
in midwifery education and practice in the United States and strengthens the
capacity of midwives in developing countries. Our members are primary care
providers for women throughout the lifespan, with a special emphasis on
pregnancy, childbirth, and gynecologic and reproductive health. ACNM reviews
research, administers and promotes continuing education programs, and works
with organizations, state and federal agencies, and members of Congress to
advance the well-being of women and infants through the practice of midwifery.
More information about ACNM can be found at www.midwife.org

8403 Colesville Road, Ste. 1550, Silver Spring,
MD 20910-6374 * Phone: (240) 485-1800 * Fax: (240) 485-1818 * www.midwife.org

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