The state of the world’s midwifery 2011

Increasing women’s access to quality midwifery services has become a focus of global efforts. This report presents a body of knowledge to inform and accelerate the availability of quality midwifery services for women and newborns.

Every year approximately 350,000 women die while pregnant or giving birth, up to 2 million newborns die within the first 24 hours of life. The document notes that the overwhelming majority of these deaths occur in low-income countries and most of them could have been prevented.

The authors find a triple gap, consisting of competencies, coverage and access. In addition, there are significant gaps in data and strategic intelligence, which limits the availability of strategic intelligence to inform policy improvements.

Recommendations include:

• midwifery should be recognised as a distinct profession, core to the provision of maternal and newborn health services, and promoted as a career with posts at the national policy level
• governments are urged to ensure adequate availability and distribution of emergency obstetric and newborn care facilities, including midwife-led units of care and improve data on the practicing midwifery workforce
• the role of schools and training institutions in educating more midwives and improving the skills and other competencies of graduates should be activated 
• professional midwifery associations are encouraged to collaborate with other health care professional associations, with regional and international federations, and with women and communities
• international organisations, global partnerships and donor agencies should encourage the establishment of a global agenda for midwifery research and support its implementation at country level
• international organisations, global partnerships and donor agencies should also provide financial and in-kind support to build capacity of midwifery associations, and facilitating exchanges of knowledge, good practices and innovation.