The decade of the midwife!

In 2019 the World Health Organization nominated 2020 to be the International Year of the Nurse and the Midwife. This was not a surprising choice because the 2 million midwives and 22 million nurses make up half the world's health workforce and are at the heart of healthcare everywhere. For the International Confederation of Midwives (ICM) and the International Council of Nurses (ICN) this is a great opportunity to showcase our professions. The crucial role of nurses and midwives during the Covid-19 pandemic has only strengthened the world’s realisation that this predominantly women’s workforce is fundamental to our global healthcare systems in general and midwives are key to maternity care systems in particular. In fact, without midwives and nurses, most countries will neither be able to achieve the sustainable development goals nor reach Universal Health Coverage.

It is important to see midwifery and nursing as the two distinctly different professions that they are. Conflation of our professions can endanger women’s rights to receive skilled reproductive and sexual healthcare by the appropriate care-provider, a midwife. Unfortunately, across the globe many believe that midwifery is simply another branch of nursing, like intensive care nursing or geriatric nursing. This risk for midwifery, as the smaller of the two profession, is that its unique life course continuity of care approach, gets overlooked by that of nursing.

Midwives deal specifically with sexual and reproductive health and rights including pregnancy and childbirth. In most women’s lives these are normal life events. Midwifery is based on a psychosocial model of childbirth rather than the bio-medical nursing model. Midwifery has a strong advocating role as midwives advocate for women and their needs in both extremes of under-resourced and over-medicalised maternity care systems [2]. Inappropriate reallocation of midwives is common and recent alarming figures from the Guttmacher Institute show the devastating effect of the global response to the Covid-19 pandemic, as women experience less quality midwifery care, especially in the area of antenatal care, contraceptives and abortion services with disastrous consequences for women, new-borns, adolescents and their families [1]. For this reason we have focussed our editorial on midwives even though 2020 is also the year of our respected colleagues, nurses.

With only ten years until the Sustainable Development Goals (SDG) deadline, the International Confederation of Midwives (ICM) see 2020 as a springboard for the decade of the midwife. ICM advocates for national governments to scale up their investment in midwives so as not to leave anyone behind. Investing in midwives is key, not only for the health and wellbeing of all but also for the economic and social prosperity of every nation. In 2020, ICM and her 142 midwifery associations celebrate midwives globally through many different activities including profiling the first babies born in January 2020 into the hands of a midwife and identifying midwives and friends of midwives who have contributed significantly to the development of the midwifery profession and the advancement of Global and National women’s rights and gender equality.

ICM will build on the global momentum and spotlight on the profession to drive policy change and public action to achieve increased commitments to building a sustainable workforce of qualified midwives and thereby increase women’s access to quality midwifery care. ICM will also further ignite pertinent discussion about the relationships between midwives and women as advocates for each other. One of many focuses will be to highlight the role of midwives as gender champions in their communities and to tackle the challenges and barriers midwives face globally by disseminating evidence about the vital need for midwives to transform quality sexual and reproductive healthcare for a sustainable future.

ICM works with global partners and contributes relevant, midwife expertise at different events throughout the year to highlight progress, disseminate evidence and build the investment case for midwifery. After all, midwifery is widely recognised as the world’s oldest profession, midwives have gone through many challenges and changes and have transformed to survive to lead the way to 2030.

“Wherever women and babies are, whatever their circumstances or the health system in place, their survival, health, and wellbeing can be improved by midwifery care” [3]. The time has come to recognize the profession of midwives as the life-savers and life-changers who have always and will carry on standing side by side with women to achieve sexual and reproductive health and rights for all.