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---
title: International Day of the Midwife: Why Midwives Matter
description: Midwives will have a crucial role to play in ensuring that women and babies have access to the high-quality, patient-centered care.
canonical: https://time.com/4318462/international-day-of-the-midwife/
author: Jerker Liljestrand
article:opinion: true
article:content_tier: free
article:published_time: 2016-05-05T14:28:39.000Z
article:modified_time: 2026-08-04T07:55:39.504Z
article:section: Ideas
og:title: Midwives Are Essential to Global Health
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![](https://static.time.com/v3/assets/bltea6093859af6183b/bltb0cef8b3f9f1b224/698891ed428a9e0019cd2818/midwife.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9)


# Midwives Are Essential to Global Health

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<!-- video src="https://cdn.jwplayer.com/manifests/iUUpW4Su.m3u8" -->
## Video: Outsourcing Surrogacy

[Watch (HLS stream): Outsourcing Surrogacy](https://cdn.jwplayer.com/manifests/iUUpW4Su.m3u8) (16:48)

![Outsourcing Surrogacy](https://cdn.jwplayer.com/v2/media/iUUpW4Su/poster.jpg?width=720)

_Published 2015-08-29. Outsourcing Surrogacy_


by 

[Jerker Liljestrand](https://time.com/author/jerker-liljestrand/)


## Jerker Liljestrand


May 5, 2016 2:28 PM UTC

![](https://static.time.com/v3/assets/bltea6093859af6183b/bltb0cef8b3f9f1b224/698891ed428a9e0019cd2818/midwife.jpg?branch=production&width=1200&quality=75&auto=webp&crop=3:2)

Getty Images

by 

[Jerker Liljestrand](https://time.com/author/jerker-liljestrand/)


## Jerker Liljestrand


May 5, 2016 2:28 PM UTC

Four babies are [born each second of every day](http://www.prb.org/pdf14/2014-world-population-data-sheet%5Feng.pdf). By the time you finish reading this sentence, eight children will have been born. Childbirth is among the most common, constant and natural of human experiences. 

Over the past 100 years, childbirth in much of the world has moved from the home to the health-care system. This has had both positive and negative effects. On the one hand, the increase in births taking place with skilled attendants in health facilities has helped to significantly reduce maternal mortality. On the other, it has also led to the medicalization of labor and delivery.

Increasingly, health providers are treating childbirth as a medical event and are often performing unnecessary interventions like too many cesarean sections[, which can cause severe infections, hemorrhaging and organ damage](https://www.ariadnelabs.org/childbirth-projects/). Despite the fact that cesarean section rates higher than 10% are not associated with reductions in maternal and newborn mortality, many countries across the world, including the [U.S.,](http://www.cdc.gov/nchs/fastats/delivery.htm) [Brazil](http://www.huffingtonpost.com/2014/04/16/c-section-rates%5Fn%5F5161162.html) and [even parts of India](http://www.healthreformasia.com/resources/downloads/presentations/Grace%5FP146.pdf), are seeing rates of cesarean section rise to over 30%.

So how do we continue to support women giving birth in health facilities, where providers are able to respond to potential complications, while also recognizing that the vast majority of births are normal, non-medical events? Midwives—a vastly underutilized segment of the health workforce—are an important part of the solution.


Midwives have supported women during childbirth since ancient Egyptian times, and today, in many parts of the world, they are providing a unique set of lifesaving services for mothers and babies. Midwives are trained with a focus on supporting natural births and thus are distinctively positioned to provide respectful, high-quality care that places women and newborns at the center. Research has shown that women who have access to a [midwife experience less preterm births, fewer interventions during labor and shorter hospital stays](http://internationalmidwives.org/assets/uploads/documents/IDM/IDM%202016/IDM2016-resourcepack-English-editurl.pdf). 

Over the next decade, the number of births at facilities is expected to [increase,](http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2814%2960919-3.pdf) placing significant strains not only on physical capacity of hospitals and clinics but also on the workload of physicians. As a part of a team of physicians, nurses and obstetricians, midwives can alleviate some of these pressures, providing woman-centered and supportive care that goes beyond childbirth to family planning, disease screenings and more.


Governments that have invested in midwives are seeing the benefits. Countries including Sri Lanka, Burkina Faso, Cambodia, Indonesia and Ethiopia have shown significant and sustained [reductions](http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2814%2960919-3.pdf) in maternal and newborn mortality as a result of including midwives as a core aspect of their health systems. Alongside efforts to improve access to health facilities, these countries established professional unions for midwives, expanded midwifery training programs and schools and created incentives for individuals to enter into the profession.

In Cambodia, where I’ve spent significant time working on maternal health programs, the government began to put an emphasis on midwife training in 2000\. Midwives are financially incentivized to assist deliveries at public-health facilities, and they are given priority when the government recruits civil servants for the Ministry of Health. Thanks in part to these efforts, the country has reduced the maternal mortality ratio by [two-thirds](http://www.wpro.who.int/about/administration%5Fstructure/dhs/story%5Fcambodia%5Freduces%5Fmaternal%5Fmortality/en/) since 1990.


If other countries hope to reduce their maternal and newborn mortality rates as well, they should prioritize deploying midwives and scaling up midwifery practices in their national health plans. It is also a smart economic decision. Investing in midwifery education and training programs and working to ensure midwives are reaching the communities most in need, has the potential to yield a [16-fold](https://www.unfpa.org/sites/default/files/resource-pdf/SOWMY-Factsheet-Key%20messages-English-web.pdf) return on investment in terms of lives saved and costs of non-emergency caesarean sections avoided. In order to make these policies successful though, countries must also better understand where midwives are working and what services they are providing.


Later this month, ahead of the [2016 Women Deliver Conference](http://wd2016.org/), midwives, women’s health experts and advocates will gather for the [2016 Midwifery Symposium](http://212.121.127.104/news/?nid=321) to explore new ways the global community can support midwives, especially young midwife leaders. These discussions and their outcomes will be critical over the next 20 years, as the [number of births taking place around the world increases ](http://www.un.org/en/development/desa/population/publications/pdf/trends/Population2030.pdf)and health facilities and the health workforce strain to provide adequate care for mothers and babies. 

Midwives will have a crucial role to play in ensuring that women and babies are supported during the natural birthing process and have access to the high-quality, patient-centered care they deserve. So today, on International Day of the Midwife, let’s recognize the incredible work of midwives and call on countries to invest in their potential.


## Transcript

He got married. But then again, that's the thing. Yes, I know, I know. My life I belong. Whatever. We help match up a surrogate with the infertile couple, do the IVF procedure over here. Once the surrogate gets pregnant, we take care of her for nine months. She stays in the clinic or the surrogate house. So in one place, everything right from starting the infertility treatment to the baby is delivered and the couple takes the baby back and we have delivered close to 290 surrogates so far. Since 2005, I've started. You can call this renting a room or selling a room. I would rather say donating a room for nine months and compensation for a child.

I think whatever the couple does, they are never going to monetarily compensate a surrogate. It is impossible for what she has that. It's been five years now since the first miscarriage. I look at my friend's children growing up. They are five, six, seven years old. So there is like in a sometimes an immediate reflection out of it. So from the start I went through a miscarriage, three insemination to IVF, all unsuccessful. And now I realized my body can't do it. I remember here reaching the fifth month and her stomach was round and beautiful. And no. I was happy and I was ecstatic. Never will we have consider that my water would break.

The for me to ask Melissa to keep trying is entering the threshold of abusing Melissa's body. So we decided to do an egg donor and it's going to be my sperm and it's going to be another woman's egg. And someone else wouldn't. This is the first one that we didn't really like it. She was a second shoe. The third one. Not a choice. Not a choice. And we chose her. I like the hood. Spraying her smile. Exactly. It's a surreal process. You choose your son or daughter by looks. By looks, by choosing a picture. I don't know if there is going to be some sort of continuous relationship with this lady or not.

Probably not. Probably not. Maybe take many paths that it's noted here or take two to build. Do you really like your jacket out? Me Then I guess you a little bit out or is Nina always been on some of the air? Give me the look in the day you miss me, that's empty. Your entire which is mechanized. The illegal You made me number television. You. I have so many concerns. The surrogate mother. How do I know that I She's not going to have sex with her husband for a few days after they transfer the embryos. How do I know eventually that the babies are worth? I love Drive safely home. I'm flying to India tonight without Melissa, which I find very interesting, to go somewhere without your wife to make babies.

On the other hand, I take 100% responsibility. For the he With that, keep in mind that. Hello, how are you, Dr. Patel? Finally, finally you get. To meet you, Dr. Patel. I want to make. Sure that. The egg donor is the one that we chose. Yes, he told me. Yes, I am ready for dishes. Very nice. Yes. She looks amazing. And very cute. She the one, right? Yes. Okay, good. I really, really think that you are doing an amazing thing. I really do. Really. It's a it's a beautiful story by only. I'll see you tomorrow at 1030. Okay? Okay. Thank you so much. Pleasure to meet you. Thank you. Samia, we get a this kind of love.

And make with that. She was very, very nice going over the whole process. Very pleasant person. Going to meet with surrogate mothers in the slums. Actually, yes, though most of them live on premises and yes, she's going to stay there during the whole nine months. Yeah, guys stay there. I'm happy. Oh. This is the area where some of my surrogates come from. These are her children and that has. Had my name in metallic I that you age. I mean, they must've known that I'm from my name. Exactly. Video They'll take you when they may. The infants. Yeah, well, they're not like that with this family. She's saying that she had absolutely nothing.

This is a good house, as far as the saying goes, thing in India. You know, there are so many you as a start criticizing. But why don't they come and help such people? They should come to the slum everyday and help the people if they want to help, you know, and don't blame the surrogate that she's trying to sell her body. There's competitive prostitution out of the boards, out of which they don't know anything and they're being exploited. The money is being used like a machine for surrogacy. It's not something that they need. They should not be ashamed of what they do. They should be proud of what they're doing.

We have come out in the open rather than get scared of this society and do it behind closed doors, not letting anyone know hush hush. We have come out in the open and said, Yes, we do surrogacy. These are the surrogate. They are getting pressure babies for foreign couples. She could not have earned this kind of money. If you are talking about 300,000, ₹400,000, even if she works 24 over seven throughout her life, in the beginning this start for money, even in the end, money is a criteria all said and done. The world is like that, you know. But she has that feeling, the positive attitude in her that, look, I am going to be of some use to somebody.

Have invested so. You need the central to bring the in intent. To proceed to this and this is. Why we have this need is to us for surrogacy program. Her name is Jack Ruby. She's was married, but she's now divorced. She is titular 11, eight and five. So she's staying by herself with her own children and she's supporting them. I again, would like to thank her and I respect very much the service that she is performing. And I would like her to know that that's a blessing that we can interaction. Then it would be done was provided the money in the bank when they get away. I thank you very much and thank you.

Now, the other thing we became supposed to explain is regarding the monetary aspect of the world, right? A surrogate for tool for delivering a child successfully to you will receive $7,500, 75% of majority of dishonesty received after delivery. So this is for your understanding. Thank you. And this is the surrogate here. And you kind of got to be me locally. Be very merry. Do not like to be water to you. So could you be me not quite obese. Okay, But my neighbor like you made him a chocolate. Or I could come. I can walk. He's Illumina May is a coconut out you get me could get my Can we raise a cupcake can Malik or this one local value medical baloney miracle clinical you see let me what can banana do Merry Merry Quixote You banana.

Jesse Ventura and this kind of. I found. A lot. Of, like, real. Bruises. They look good. This is amazing. This is also I thought that. This is also. One very good. So basically all three are good. Okay. Okay. So I will see you, I think, in nine months. No difference in eight months. Okay. You work for me? Yes, I hope so. Thank you very much for everything. Okay. We're going to be in touch via email and I love you. Thank you so. So this is the email that we've got yesterday morning around 8 a.m.. Subject is urgent. Dear Melissa. Hello, Geeta The surrogate mother has developed abdominal pain. Scan shows sudden liver problem.

So we will induce her for abortion of this baby. Doctor Mina Patel. Because we must have we Hopefully that's. All just about for now. You which is like an extra stab in my heart because I was almost five so around this time is when you know my workbook. So it's like damn sorry. One thing is for sure, Geeta is a person, she's an individual and she matters. So if it is a matter of her life, she has to terminate, you know? I mean, she's helping us. We don't want to hurt her in the process. So I think you make a great that not just I just want it to be it makes to one of us, even if it has his temperament.

There are questions in life. Let's take the question, if the boat is sinking, whom would you save first, your father or your mother? This kind of question that it's just more comfortable not to deal with them, Which one is more important to you, your woman, your partner, or your family? Expansion? For me, as harsh as it sounds, if I have to choose your woman or your children and choose children, creation.

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