The Role of Midwifery in Maternal and Perinatal Health

The important requirement of child bearing women in every country and of their families and babies is the concentration of the concept of initiating a series of international studies on midwifery. In many cases these requirements are not yet met despite of the fact that they were recognized about a decade ago. Establishment of midwifery ensures that there is quality maternal as well as newborn care and this firmly positions the need of women and the newborn babies at its core. Midwifery put into consideration of attitudes, skills and behaviors instead of specific professional roles.The prevalence of the series reinforce a shift from segmented maternal and newborn care provision which concentrate on identification and treatment of pathology to a whole-system approach that give everyone skilled care.It calls for efficient multidisciplinary teamwork as well as integration across hospital and society.

Requirements for Women from Maternal and Newborn Services

The quality maternal and newborn care (QMNC) framework was used to analyze the evidence on the things that mothers and their newborns need from maternal and newborn services. This analysis indicated that there is a need to educate people so that women can learn by themselves to enable them build their own strength as well as access services at the right time (Human Resources for Health, 2015).The analysis indicated that mothers required services to be provided in such a way that it shows some respect from the staff.Mothers preferred the medical attendants who integrated clinical with interpersonal as well as cultural knowledge and skills.

Effectiveness of Maternal and Newborn Care Practices

The examination of the evidence above implies that midwifery is positioned in a unique way to make contribution to the QMNC framework as well as to provide the combination of skills and relationship based care which aligns with the context and condition.

Scope of Practice of Midwifes

Midwives who are educated, licensed, trained and regulated can assist in full scope elaboration of midwifery as indicated in the series. Many providers are active in the provision of midwifery care although there exist limited benefits since there is dependency on only the health workers who have less skill. The care which is offered by midwives who are well educated, regulated, licensed, integrated in the health system and operating in interdisciplinary groups had beneficial impacts in maternal and perinatal health across many levels of the framework (Ten et al., 2014).This is even after a comparison with care led by other professionals in the field of health in combination with the midwives. In the settings of high income in which analysis about the use of resources has been done there is evidence that midwife-led care is a better option interms of cost efficiency when compared medically-led care. Situations where the midwives operates in collaboration as part of the multidisciplinary groups offering care that is integrated across societal and hospital settings; they can as well provide efficient midwifery care for both mothers and the newborns when complications arises.

The Effects of Increasing Midwifery

The series display health as well as the well-being advantages for mothers and their newborns and also their families when there is delivery of high quality midwifery care by midwives and other individuals who possess skills on midwifery. The lives saved tools (LiST)was applied to model the possibilityof the significant interventions for maternal, reproductive and newborn health (RMNH) that revolve around the context of competencies of the midwives. It was indicated from the modeling that increasing midwifery could assist in minimizing mortality even in the contexts where resources are constrained. Midwifery could be established with successful outcomes at any level of the country’s evolution to minimize maternal and newborn mortality rates. The universal overview on specific significant interventions for RMNH that are in the context of competencies of the midwives will result to lowering of maternal deaths, death of infants and stillbirths.

In the setting of low resource, the model suggests that in comparison to the current baseline estimates that have persisted over 15 years, the newborn and maternal mortality as well as stillbirths could be lowered by a range of 27% and 82% (Human Resources for Health, 2015). There was also an estimation of the value of additional of a specialist care to midwifery on maternal, neonatal and fetal care to save more lives. The impacts accompanied by adding specialist medical services to midwifery care was examined to be bring less impact as compared to the impact created when the activities were considered to be part of the midwifery. Scaling up of midwifery in the nations that have high income has a possibility to impact more on morbidity that mortality. The excessive use of technical interventions is a challenge to many nations at all stages of income but the relative undesirable contribution excessive use and under-use has a possibility of being larger in nations whose incomes are high. There is need for development of distinct approaches to model the effects of midwife led care in nations whose incomes are at different levels.

Reinforcing Healthcare Systems and the Recruitment of the Midwives in Nations where the Rate of Mortality is high

The series provides a case study from various nations that intended to improve the health of mothers and children as well as the health(Schneider & Whitehead, 2013).  In Cambodia, Burkina Faso, Morocco and Indonesia a combination of change of system as well as staffing and provision of services initiatives was applied to attain sustained lowering of maternal and death of newborns. The four nations had opted efficiently for a massive scale up of their teams of midwives where their experience draws concern on two major issues. One of the issues provoked is that a method for enhancing the health of mothers and infants cannot be minimized to an option of the professional category to be raised but instead it relies on the model as well as the investment in the entire network of service delivery. The recruitment of the teams within this framework is a question of controlling pace, quality and cost.

The second issue raised is a confirmation that where systems are reinforced consistently throughout a long duration, investment in midwives becomes realistic and an efficient method of minimizing the maternal mortality even in the contexts where resources are constrained. Establishment of a network facility from the ground as in the case of Burkina Faso and Cambodia will consume time but once it is established recruiting a team can proceed in a massive way(Jirojwong, Johnson & Welch, 2014).  In Morocco, Burkina Faso as well as Cambodia, a long duration of time was consumed between development of infrastructure and recruitment of the midwifery taskforce. Considering Indonesia, the fresh taskforce had diverse roles where apart from the staff facilities it was also intended for village-level maternal healthcare services alongside with the facilities. The performance of the taskforce was restrained to the figures of expectant mothers in a village where they work as single clinician. This indicates that majority of the advantages in the minimization of deaths of expectant mothers originated from improved access to formal facility where an additional number of midwives were recruited.

Policy Implication for better Maternal and Newborn Health through Midwifery

The displayed facts in this series is an indication that raising the services covered alone is not a confirmation of care which is of high quality or a decrease in the deaths of mothers who are bearing children and the recently born babies (Renfrew et al., 2014).There is need for policies to address both improving coverage as well as quality at the same time since they have an equal significance. It is the idea of proper way of coverage which means that the fraction of the population who have a requirement of an intervention and receive the intended intervention with enough quality to be effective. This suggests that facilitating women’s use of services related to midwifery, putting an extra effort to align with women’s requirements and enhancing a better quality of the care received by women as well as newborn infants.

Raising the support of midwives to the extension of prevailing RMNH care entails a tactical choice of relevant appeal by the current makers of policies (McMurray &Clendon, 2014).  The efficiency of midwives is clear from the practices of the four nations and the modeling of the possible consequences of technical interaction involved in the field of midwife practices. There is a possibility indicating both health and social consequence of raising the number of contribution of midwives would be enhanced through focusing on other perspectives of QMNC framework.

Conclusion

In conclusion, the role of midwives in regards to the five major strategies for health promotion identified in the Ottawa Charter for Health Promotion make a great contribution to the reduction of maternal as well as newborn mortality. Midwifery is an essential solution to the problems of offering improved quality care for expectant mothers as well as the newborn across the world. The scaling up the services of midwives ensures that childbearing women have delivered safely and both the mother and the child are in safe condition of health. Midwives who are educated, licensed and supported possess great skills of competencies and deliver services that are of high quality.

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