A recent study highlights a serious global shortage of midwives, with nearly 1 million positions unfilled, jeopardizing maternal and neonatal health. The research reveals that almost half of this deficit exists in Africa, where an alarming 90% of women live in countries lacking adequate midwifery support. According to the study, this shortage leads to increased rates of maternity interventions and poor-quality care for mothers and their newborns.
Anna af Ugglas, chief executive of the International Confederation of Midwives (ICM) and co-author of the study, emphasized the urgent need for action. “Nearly 1 million missing midwives means health systems are stretched beyond capacity,” she stated. “Midwives are overworked and underpaid, and care becomes rushed and fragmented.” The consequences are dire; as intervention rates rise, women face a higher likelihood of receiving inadequate care or experiencing mistreatment during childbirth.
To ensure that all women receive safe and high-quality care throughout pregnancy, an additional 980,000 midwives are required across 181 countries. Previous research has shown that universal access to midwife-led care could prevent approximately two-thirds of maternal and newborn deaths, potentially saving 4.3 million lives annually by 2035.
The ICM report identifies not only a lack of training opportunities but also systemic failures in employing and retaining qualified midwives in the regions that need them most. Prof Jacqueline Dunkley-Bent, chief midwife at ICM and another author of the report, noted, “In many settings, midwives are educated but not absorbed into the workforce or not enabled to practice fully.” This situation exacerbates the existing global shortage of midwives, leaving many women without the care they require.
The findings indicate that over 90% of the midwife deficit is concentrated in low- and middle-income countries. For instance, Africa currently has only 40% of the midwives it needs, while the Eastern Mediterranean region has just 31%. In the Americas, the number is even lower at 15%. Although regions such as South-East Asia and Europe have smaller shortfalls, they still face challenges in meeting demand.
The study, published in the journal Women and Birth, calculated the number of midwives necessary to perform essential midwifery tasks, including counseling on contraception, antenatal care, and support during childbirth. Researchers compared this requirement with current workforce data and noted some uncertainty due to inadequate data collection in many regions. While the number of midwives is gradually increasing, the gap between need and availability is expected to persist well into the next decade, beyond the 2030 target set by global sustainable development goals aimed at reducing maternal mortality and preventing deaths of newborns and young children.
In light of these findings, the ICM is urging governments to take decisive action to bolster their midwifery workforces. They have launched a global petition advocating for increased investment in the profession. “When midwifery is a respected and well-supported profession, more women are motivated to train and remain in the workforce,” stated af Ugglas. By strengthening midwifery services, countries can improve health outcomes and develop more sustainable healthcare systems.
The implications of this research are profound, highlighting the urgent need for systemic changes in healthcare policies worldwide to ensure that women receive the care they need during one of the most critical times in their lives.
