A staggering global shortage of nearly one million midwives is leaving pregnant women without the basic care needed to prevent harm, including the deaths of mothers and babies, according to new research. This crisis is particularly acute in Africa, where nine in 10 women live in a country without enough midwives.
The study, published in the journal Women and Birth, found that for all women to receive safe, quality care before, during and after pregnancy, an additional 980,000 midwives would be needed across 181 countries. This shortage is not only a workforce issue, but a matter of quality and safety for women and babies.
“Nearly 1 million missing midwives means health systems are stretched beyond capacity, midwives are overworked and underpaid, and care becomes rushed and fragmented,” said Anna af Ugglas, chief executive of the International Confederation of Midwives (ICM) and one of the study’s authors.
According to previous research, universal access to midwife-delivered care could prevent two-thirds of maternal and newborn deaths and stillbirths, saving 4.3 million lives annually by 2035. However, the current shortage is likely to “persist well into the next decade,” the researchers warned.
The crisis is particularly acute in low- and middle-income countries, which account for more than 90% of the global midwife shortage. Africa has only 40% of the midwives it needs, the eastern Mediterranean only 31%, and the Americas just 15%, the researchers found.
“In many settings, midwives are educated but not absorbed into the workforce or not enabled to practise fully, compounding this already serious and universal shortage of midwives, and still leaving women without access to the care that midwives are trained to provide,” said Prof Jacqueline Dunkley-Bent, ICM’s chief midwife and another of the report’s authors.
The ICM is calling on governments to take urgent action to strengthen midwifery workforces in their countries, including signing a global petition urging investment in the profession. “When midwifery is a respected and well-supported profession, more women are motivated to train and stay in the workforce,” said af Ugglas. “That is how countries improve health outcomes and build stronger, more sustainable health systems.”
