Among 73 lower and middle income nations, just four - Armenia,
Colombia, Dominican Republic and Jordan - have adequate resources in
place, according to a review led by the United Nations Populations
Fund and the World Health Organization.
"More than three-quarters face serious shortages that will result in
unnecessary deaths of women and babies," Frances Day-Stirk,
president of the International Confederation of Midwives, told
reporters on a conference call.
Midwives, who are trained to deliver babies and provide medical care
before and after pregnancy, can provide most of the services needed
for women and newborns, experts said. That is critical to relieve
pressure on doctors, especially in areas where medical resources are
scarce or difficult to access.
In 2013, there were an estimated 2.6 million stillbirths, 3 million
newborn deaths and 289,000 maternal deaths. More than 92 percent of
those deaths occurred in the countries reviewed, the groups said in
their "State of the World’s Midwifery" report.
The countries included in the review range from China, India,
Pakistan and Afghanistan to Central African Republic, Chad,
Guatemala and Mexico, among others.
Many lack the infrastructure necessary to allow for quality care
from midwives, and often don't have regulatory systems in place to
adequately train them, according to the report. Collecting necessary
data is also a problem.
"Women and girls' right to maternal and reproductive health are
essential," Babatunde Osotimehin, a physician and executive director
of the UN's Populations Fund, told reporters. They "need and deserve
respectful, compassionate care before, during and after pregnancy
and birth ... This is not the case in many countries. This needs to
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The crisis is also an economic one, experts said. For example,
boosting midwifery services can reduce costly cesarean births,
saving up to $128.5 million over three decades, Day-Stirk said.
One country that has shown some gains is Bangladesh, where the
government in 2010 launched an effort to train 3,000 midwives,
helping reach key health goals even though birth-related mortality
remains high, experts highlighted.
The report, funded by the UN along with the U.S. and Canadian
governments, the Bill and Melinda Gates Foundation and other groups,
and Johnson & Johnson, is part of the UN and WHO's larger effort to
boost access to midwives by 2030.
(Reporting by Susan Heavey; Editing by Michele Gershberg and Andrew
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