More Midwives Needed to Reduce Maternal Deaths

They call it The Stealer. It comes to claim the lives of women during childbirth in a remote region of northern Ethiopia. It took Asmer Geremew's mother and two sisters. Then it came for her.

After Asmer gave birth to a healthy baby, she began to bleed profusely. "I delivered, and then the Stealer came," she said. In the village of Tebabari, where Asmer lives, there were no ambulances. So relatives and neighbours carried her to the nearest clinic, shouting, beating frying pans and shooting guns to scare The Stealer away.

Asmer survived. She was lucky. Globally, some 300,000 women die every year from complications of pregnancy and childbirth, mostly of causes that could be easily averted with access to quality health care. For every woman who dies in childbirth, some 20 more suffer birth-related diseases, infections or appalling injuries, such as obstetric fistula--a condition that leaves a woman leaking urine, and ostracized.

Fifteen years ago, world leaders agreed on a global target to reduce maternal deaths by three quarters by 2015. Although significant progress has been made, we will not achieve the target. Of the eight Millennium Development Goals launched in 2000, progress on the goal for maternal health lags farthest behind.

While Eastern and South-East Asian countries reduced maternal death by more than 60 per cent, the gains made in sub-Saharan Africa stand at less than 50 per cent. Today, 6 in 10 maternal deaths occur in Africa.

As the world moves to the Sustainable Development Goals, the unfinished business of improving maternal health must continue to be a priority. To make greater progress in the years to come, we must understand the reasons why we failed to reach the Millennium target on maternal deaths and take urgent corrective action.

We know that safe birth for every woman requires strong health systems. All countries that have achieved dramatic improvements in maternal health share one thing in common: they have greatly improved the provision of professionally trained midwives and skilled birth attendants.

We also know that providing women access to voluntary family planning can prevent more than a third of maternal deaths.

Countries with the highest maternal deaths typically have the weakest health information and health systems. They lack the capacity to deal with the major causes of such deaths, which include excessive bleeding, obstructed labour, seizures, infections and ruptured uterus. The availability - and use - of emergency obstetric and newborn-care services, including Caesarean sections, are essential for the survival of women and their babies.

UNFPA, the United Nations Population Fund, has supported 36 countries to assess their needs and 27 countries to develop monitoring systems that would allow midwives and doctors to better provide timely and accurate emergency care to women and newborns.

Over the past six years, UNFPA has also supported the training of 35,000 midwives - with 14,000 trained in 2014 alone. Since 2007, UNFPA has contributed to efforts to save 774,000 lives through the provision of drugs and reproductive health services, and potentially averted an estimated 47 million unintended pregnancies and 18 million abortions.

And with UNFPA's support, ambulances are now available in Asmer's home region.

But much more needs to be done. The good news is that investments bring high returns for generations for years to come.

Investing in maternal health yields a triple return on investment as it not only eliminates preventable maternal deaths, but also stillbirths and newborn deaths. Investments also reduce maternal diseases and injuries. This benefits families and communities that have healthy and productive women and mothers.

However, many countries with high maternal death rates will make little progress, or will even fall behind over the next 15 years, if we don't improve the current trajectory of available midwives and other health workers with midwifery skills. According to estimates, developing nations require 350,000 more midwives. If we don't make a big push now, in 2030 we'll be faced, once again, with a missed target for reducing maternal deaths.

With the Sustainable Development Goals enshrined by world leaders and the United Nations Secretary-General's updated Global Strategy for Every Woman, Every Child launched last month, we can make maternal deaths a thing of the past. By joining forces, we can make The Stealer fade out of memory.