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One million lives lost to midwife shortage - report

Source: Thomson Reuters Foundation - Fri, 1 Apr 2011 13:23 GMT
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LONDON (AlertNet) - Liknesh was in labour for five days before her baby was delivered stillborn in Ethiopia. "The child came out of my womb dead. I didn't have the assistance of a birth attendant - only my family helped me," she said.

Ninety-four percent of women in the Horn of Africa country give birth without trained help, compared to only 1 percent in Britain, Save the Children said in a report released on Friday.

Up to 1.3 million babies could be saved each year if a global shortage of 350,000 midwives was met, according to the charity, which estimates that 48 million - or one in three - women give birth without expert help every year.

More than 2 million women give birth completely alone, without even a friend or relative to help them, "making these some of the most dangerous moments of their lives".

It said 1,000 women and 2,000 babies die every day from birth complications which could easily be prevented - with women in the poorest countries the least likely to have a skilled attendant at delivery, much more likely to lose their newborn and most likely to die during childbirth.

"No mother should face giving birth without help," said Save the Children Chief Executive Justin Forsyth in a statement. "It doesn't have to be complicated: someone who knows how to dry a baby properly and rub its back to help it breathe can make the difference between life and death. No child is born to die."

Some women giving birth at home without a midwife have only a razor blade to cut the umbilical cord and herbs from a traditional healer to combat infection, the aid group said.

"...the reality of childbirth for many women means delivering their babies at home with no midwife, lying on a dirty bed or dirt floor in a house without running water, electricity or light," the report said.


In Rwanda there are 46 public midwives for 400,000 babies born every year, while neighbouring Uganda has 15,000 trained for 1.5 million women giving birth a year. Women living in rural areas have even less chance of getting help from a midwife.

In some cases, women give birth alone because custom dictates they are unable to leave the house to seek help when they go into labour, in others because they have not secured permission from a male relative to leave their home.

The report found that in Nigeria, one in five women deliver their babies alone. A third of women in the West African country said one reason for not going to a health facility was that their husbands said it was unnecessary.

Afghanistan is one of the riskiest places for mothers and babies. It has the highest newborn mortality rate with 52 in every 1,000 births ending in death while Afghan women face a one in 11 lifetime risk of maternal mortality.

Save the Children called on donor countries especially in the European Union, G8 and G20 to put health workers at the centre of their development agenda.

 It also urged heads of state meeting at a U.N. summit in September to make concrete commitments to tackle a global shortage of 3.5 million health workers, while asking the International Monetary Fund (IMF) to be more flexible about allowing more public sector spending in the countries it lends to.

Without recruiting and training midwives, it will be harder for world leaders to meet their target of reducing child deaths by two-thirds and maternal mortality by three-quarters by 2015 as part of the Millennium Development Goals, Save the Children said.



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