A global shortage of nearly one million midwives is significantly impacting maternity care, leaving pregnant women vulnerable to inadequate treatment and increasing the risk of maternal and infant deaths. This alarming finding comes from a recent study published in the journal Women and Birth, which highlights that almost half of the global shortfall is concentrated in Africa, where 90% of women reside in countries without sufficient midwifery support.
According to Anna af Ugglas, chief executive of the International Confederation of Midwives (ICM) and a co-author of the report, the absence of nearly one million midwives leads to overstretched health systems, with many midwives facing excessive workloads and inadequate pay. As a result, the quality of care provided to mothers and babies diminishes, often resulting in higher intervention rates during childbirth. “This is not only a workforce issue; it is a quality and safety issue for women and babies,” af Ugglas stated.
The research indicates that an additional 980,000 midwives are needed across 181 countries to ensure all women receive safe, high-quality care before, during, and after pregnancy. Previous studies suggest that providing universal access to midwife-delivered care could prevent two-thirds of maternal and newborn deaths and stillbirths, potentially saving 4.3 million lives each year by 2035.
The ICM report points out that the crisis is not solely due to a lack of training opportunities for midwives. Many countries fail to employ trained midwives effectively or retain those already working in health services. Prof Jacqueline Dunkley-Bent, ICM’s chief midwife and another author of the report, commented, “In many settings, midwives are educated but not absorbed into the workforce or not enabled to practice fully.” This exacerbates the already severe shortage, leaving women without access to essential care.
The data reveals that over 90% of the midwife shortage affects low- and middle-income countries. Africa currently has only 40% of the midwives it needs, while the eastern Mediterranean region has 31% and the Americas just 15%. Shortfalls are less severe but still present in regions such as Southeast Asia and Europe.
To arrive at these conclusions, the study estimated the number of midwives required to perform a range of basic midwifery tasks, including contraception counseling, antenatal care, and childbirth assistance. Researchers compared this figure with the current workforce numbers, noting existing data gaps that create uncertainty. While the number of midwives is gradually increasing, the gap between required and available workforce appears to be a persistent issue that may last well into the next decade, surpassing the 2030 deadline set by global sustainable development goals to reduce maternal mortality and eliminate preventable deaths of newborns and young children.
In response to these findings, the ICM has urged governments to take immediate action to strengthen midwifery workforces. The organization has launched a global petition advocating for investment in the profession. “When midwifery is a respected and well-supported profession, more women are motivated to train and stay in the workforce,” af Ugglas emphasized. “That is how countries improve health outcomes and build stronger, more sustainable health systems.”
The implications of the midwife shortage are profound, affecting not only the health of mothers and infants but also the overall efficacy of health care systems worldwide. Addressing this issue is essential for safeguarding maternal and child health on a global scale.
