A recent study highlights a significant global shortage of midwives, with nearly 1 million positions unfilled. This deficit is severely impacting maternal care, particularly in developing regions, where pregnant women lack essential support to prevent complications and fatalities. The study reveals that almost half of this shortage is concentrated in Africa, where 90% of women reside in countries lacking adequate midwifery services.
According to the report published in the journal Women and Birth, the International Confederation of Midwives (ICM) estimates that an additional 980,000 midwives are required across 181 countries to ensure all women receive safe and quality care before, during, and after childbirth. The chief executive of the ICM, Anna af Ugglas, emphasized the gravity of the situation, stating, “Nearly 1 million missing midwives means health systems are stretched beyond capacity, midwives are overworked and underpaid, and care becomes rushed and fragmented.”
The report outlines a correlation between the midwife shortage and rising rates of maternity interventions, which often lead to poor-quality care. Prof Jacqueline Dunkley-Bent, ICM’s chief midwife and a co-author of the study, noted that despite the education of midwives, many are not integrated into the workforce or are unable to practice fully. “This compounds the already serious and universal shortage of midwives, leaving women without access to the care that midwives are trained to provide,” she added.
The implications of this shortage are dire; previous research indicates that universal access to midwife-led care could prevent two-thirds of maternal and newborn deaths, potentially saving 4.3 million lives annually by 2035. The ICM pointed out that the workforce gaps are particularly acute in low- and middle-income countries, with Africa possessing only 40% of the midwives needed, the Eastern Mediterranean at 31%, and the Americas at just 15%.
While some regions, such as Southeast Asia and Europe, experience smaller shortfalls, the overall picture remains concerning. The researchers conducted a comprehensive assessment of the number of midwives required to deliver essential midwifery services, including antenatal care, childbirth assistance, and postnatal support. They found that the current workforce falls significantly short of these needs.
Despite a gradual increase in the number of midwives, the gap between required and available personnel is expected to persist into the next decade, notably beyond the 2030 deadline set by the global sustainable development goals aimed at reducing maternal mortality and ending preventable deaths of newborns and children under five.
In light of these findings, the ICM is urging governments to take immediate action to strengthen midwifery workforces. The organization has initiated a global petition advocating for increased investment in the midwifery profession. “When midwifery is a respected and well-supported profession, more women are motivated to train and stay in the workforce,” said af Ugglas. “That is how countries improve health outcomes and build stronger, more sustainable health systems.”
The urgent need for midwives and the impact of their absence cannot be overstated. As health systems around the world grapple with this challenge, the focus must turn to effective strategies for training, deploying, and retaining qualified midwives to ensure the safety and wellbeing of mothers and infants alike.
