The World Health Organization reports that most maternal deaths are preventable; yet, preterm birth complications rank among the top 10 causes of death in low- and lower-middle-income countries. Two recent studies from the Johns Hopkins Bloomberg School of Public Health have explored the role skilled midwives may play in saving the lives of women and their babies in poor counties.
In one study, published in The Lancet, researchers found that deploying a small number of midwives – 10 percent more every five years through 2025 – in the world's 26 poorest countries could stave off a quarter of the maternal, fetal and infant deaths there.
From a release:
The estimates were done using the Lives Saved Tool (LiST), a computer-based tool developed by Johns Hopkins Bloomberg School of Public Health researchers that allows users to set up and run multiple scenarios to look at the estimated impact of different maternal, child and neonatal interventions for countries, states or districts. For this analysis, the tool compared the effectiveness of several different alternatives including increasing the number of midwives by varying degrees, increasing the number of obstetricians, and a combination of the two.
In the other study, published in PLOS One, researchers used the LiST tool in the world's 58 poorest countries, where they found that 7 million maternal, fetal and newborn deaths will occur between 2012 and 2015. The release continues:
If a country’s midwife access were to increase to cover 60 percent of the population by 2015, 34 percent of deaths could be prevented, saving the lives of nearly 2.3 million mothers and babies.
The researchers say boosting coverage of midwives who provide family planning as well as pregnancy care to 60 percent of women would cost roughly $2,200 per death averted as compared to $4,400 for a similar increase in obstetricians. Midwives are cheaper to train and can handle interventions needed during uncomplicated deliveries, while obstetricians are needed when surgical interventions such as cesarean sections are necessary, [lead author Linda Bartlett, MD] says. Midwives can administer antibiotics for infections and medications to stimulate or strengthen labor, remove the placenta from a patient having a hemorrhage as well as handle many other complications that may occur in the mother or her baby.
Previously: Indonesia’s cash transfer programs are valuable, Stanford health fellow finds, Study cautions babies born at home may be at increased risk for health problems, Simple program shown to reduce infant mortality in African country and Should midwives take on risky deliveries?
Photo by Vinoth Chandar