More midwives ‘a simple way to halve deaths in childbirth’

A series of papers in The Lancet journal also claim that women’s health is being increasingly threatened by the “over-medicalisation” of pregnancy such as Caesarean sections, with experts saying that natural birth reduces the likelihood of mental health problems, among other areas.

Each year an estimated 139 million births take place around the world, and almost 300,000 women die during pregnancy, say the experts.

They estimated that if midwifery coverage increased by just a quarter, the current rate of maternal deaths could be halved by 2030.

It also claims that routine use of what is described as “unnecessary interventions” including C-sections, cutting to facilitate childbirth and restrictions on movement during labour, can have lasting effects on both mothers and babies.

Professor Caroline Homer, one of the researchers from the University of Technology in Sydney, Australia, said: “Both under-use and over-use of medical interventions in pregnancy contribute to short and long-term illness for an estimated 20 million child-bearing women (worldwide).”

In high-income countries such as Britain, midwife-led units in or next to hospitals were better at generating natural births and lower levels of hormone treatment, assisted birth, Caesarean birth and vaginal cutting than conventional labour wards, evidence showed. There was no difference in infant outcomes between the two.

Independent “free-standing” midwife care also appeared to have important benefits, according to one Danish study, including reduced maternal ill-health and an increased likelihood of spontaneous natural birth.

Professor Mary Renfrew, an author from the School of Nursing and Midwifery at the University of Dundee in Scotland, said: “Many of the needs of childbearing women, their babies, and families across the world are still not being met, despite long-standing recognition that women and their babies need access to health care which provides more than just emergency interventions for acute medical problems.

“Although midwifery is already widely acknowledged as making a vital and cost-effective contribution to high-quality maternal and newborn care in many countries, its potential social, economic and health benefits are far from being realised on a global scale.”

Cathy Warwick, chief executive of the Royal College of Midwives (RCM), said: “We welcome this publication which has enormous significance for midwives and maternity services in the UK and worldwide.

“Most importantly the authors, having examined what women and babies need, conclude that we will not make enough progress in improving the care of women and babies if we continue to focus on one-off interventions to save lives. Instead, we must offer a package of midwifery care.

“This includes essential life-saving interventions but also focuses on the need to treat women with respect, to acknowledge their own preferences around childbirth and to ensure they have high quality information.

“The authors emphasise the need to avoid unnecessary interventions in childbirth, a position the RCM has been advocating and promoting for some time.”