A recent study highlights a pressing global shortage of nearly 1 million midwives, which is jeopardizing essential care for pregnant women and increasing the risk of maternal and infant mortality. This critical shortfall is particularly pronounced in Africa, where approximately 90% of women reside in countries lacking sufficient midwifery support. The findings, published in the journal Women and Birth, underscore the urgent need for action to address this growing crisis.
According to Anna af Ugglas, chief executive of the International Confederation of Midwives (ICM) and co-author of the study, the absence of nearly 1 million midwives places immense strain on health systems. “Midwives are overworked and underpaid, and care becomes rushed and fragmented,” she stated. This situation results in increased rates of medical interventions and a higher likelihood of women receiving inadequate care or facing mistreatment during pregnancy and childbirth.
To ensure that every woman has access to safe and quality care before, during, and after pregnancy, the research indicates that an additional 980,000 midwives are needed across 181 countries. Previous studies suggest that universal access to midwife-delivered care could prevent two-thirds of maternal and newborn deaths, potentially saving 4.3 million lives annually by 2035.
The ICM report identifies not only a shortage of training opportunities for aspiring midwives but also systemic failures in hiring and retaining qualified professionals. Prof. Jacqueline Dunkley-Bent, ICM’s chief midwife and another author of the report, emphasized that many trained midwives are not integrated into the workforce or are unable to practice fully. This exacerbates the existing shortage and leaves women without the necessary care.
The report further reveals that over 90% of the global midwife shortage is concentrated in low- and middle-income countries. For example, Africa currently possesses only 40% of the midwives it requires, while the Eastern Mediterranean region has 31% and the Americas just 15%. Although regions like South-East Asia and Europe face fewer challenges, they still experience significant shortfalls.
To arrive at their conclusions, the researchers estimated the number of midwives needed to perform basic midwifery tasks, such as contraception counselling, antenatal care, and childbirth assistance, for all eligible women and babies. They compared this estimate with existing workforce data, although they noted some uncertainties due to inadequate data collection.
Despite a gradual increase in the number of midwives, the gap between the workforce demand and supply is likely to persist into the next decade, surpassing the 2030 deadline set by global sustainable development goals aimed at reducing maternal mortality and preventing deaths among newborns and young children.
In response to the findings, the ICM has called on governments worldwide to take immediate action to bolster midwifery workforces. The organization is launching a global petition urging investments in the midwifery profession. “When midwifery is a respected and well-supported profession, more women are motivated to train and remain in the workforce,” said af Ugglas. “This is how countries can improve health outcomes and build stronger, more sustainable health systems.”
As the world grapples with the implications of this shortage, the findings serve as a stark reminder of the critical role midwives play in safeguarding maternal and infant health. The call for comprehensive strategies to recruit, train, and retain midwives has never been more urgent.
