The vital role of midwives in saving the lives of pregnant women and newborns is increasingly under threat due to severe funding cuts, particularly affecting the United Nations Population Fund (UNFPA). Despite midwives being the first responders in many crisis settings, delivering life-saving care to mothers and babies, these funding reductions are putting lives at risk, especially in conflict zones and fragile states.
According to the UN reproductive health agency, UNFPA, three-quarters of all maternal deaths occur in just 25 countries, most of which are located in sub-Saharan Africa and South Asia. Midwives, often the only healthcare providers in these regions, play a crucial role in preventing maternal and neonatal deaths, particularly in crisis settings where the risk of mortality during pregnancy and childbirth is significantly higher.
However, severe funding cuts are forcing the UNFPA to scale back its support for midwifery services. In 2025, the agency will only be able to fund 47% of the 3,521 midwives it had initially planned to support in eight of the most affected countries. These cuts threaten to undermine decades of progress in improving maternal and neonatal health.
Midwives are often the first and only line of defense in crisis settings, where women frequently lose access to critical maternity services. In these dire situations, midwives are instrumental in saving lives. As UNFPA Executive Director Natalia Kanem put it, “Midwives save lives.”
In humanitarian settings, UN support for midwives includes essential services such as training, providing medical supplies and equipment, and, in some cases, offering transportation for mobile health clinics. These critical supports are now being reduced as funding decreases, leaving midwives without the necessary tools to provide life-saving care.
“When crises strike and systems break down, midwives step up,” said UNFPA, highlighting the indispensable role midwives play in maintaining maternal and newborn health during emergencies.
The global shortage of nearly one million midwives, coupled with rising maternal and newborn death rates in fragile contexts, is further exacerbating the crisis. The lack of essential medical supplies, including blood bags and medicines, is a significant challenge. Fabrice Bishenge, Director of Kyeshero General Hospital in eastern Democratic Republic of Congo, stated, “We’re lacking everything, from blood bags to medicines. With the support of UNFPA and other partners, we can still provide services—but for how long?”
In conflict-affected regions, maternal deaths now account for 60% of all maternal fatalities globally, and these rates continue to rise as funding cuts deepen. In Yemen, for example, more than 590,000 women of childbearing age are expected to lose access to midwifery care in the wake of funding reductions.
To address the growing crisis, UNFPA and its partners have launched the Global Midwifery Accelerator—a coordinated initiative designed to scale up midwife-led care in countries with the highest maternal mortality rates. The initiative aims to create a cost-effective roadmap for strengthening health systems, even in the most fragile and conflict-affected contexts.
The initiative emphasizes the critical need for increased funding, training, and advocacy for midwifery. UNFPA stresses that universal access to midwife-led health coverage could avert up to two-thirds of maternal and newborn deaths, reduce healthcare costs, and contribute to the development of more productive workforces.
The ongoing funding crisis calls for urgent action to protect midwifery services and the lives of pregnant women and newborns. UNFPA’s appeal for increased investment in midwifery care is crucial for improving maternal and neonatal health outcomes, particularly in the world’s most vulnerable regions.
Without adequate funding and support for midwives, the future of maternal and newborn health in crisis settings looks increasingly uncertain. The global community must act now to ensure that midwives continue to have the resources they need to save lives, especially in the most challenging environments.
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