Midwifery Voices: Key to Overcoming Maternal and Newborn Challenges

angelanguku·August 25, 2024·0 comments

Midwifery Voices: Key to Overcoming Maternal and Newborn Challenges

Stories

Perinatal health care is an important aspect of primary health care. According to an estimation by World Health Organization, a woman dies of pregnancy-related causes every two minutes most of which are preventable with the right care at the right time.

For instance, in 2020, there were maternal 287, 000 deaths which were noted to be largely concentrated in the poorest parts of the world and in countries affected by conflict, while in 2021, 2.3 million children died in the first month of life globally, which on average is 6,400 neonatal deaths every day.

Midwives are listed as among the maternal and newborn health (MNH) professionals alongside nurses, obstetricians, pediatricians, and anesthetists because they all support

the health and well-being of women and newborns by performing the primary functions of emergency maternal and newborn care. However, midwives are unique in that they

are able to provide women and newborns with most of the essential services in even the most difficult humanitarian, fragile, and conflict-affected settings.

Midwifery- which the WHO defines as skilled, knowledgeable, and compassionate care for childbearing women, newborn infants, and families across the continuum from pre-pregnancy, pregnancy, birth, postpartum, and the early weeks of life- plays a central role in perinatal health care. From prenatal counseling, antenatal care, childbirth, and postnatal care, midwives are depended on in various capacities to provide reproductive healthcare throughout pregnancy and childbirth.

However, despite the vital role they play, midwives are still barely recognized and appreciated in most regions across the globes.

2021 State of the World Midwifery

Despite being able to provide about 90% of the Sexual Reproductive Maternal Newborn and Adolescent Health (SRMNAH) care needed, midwives account for less than 10% of the global SRMNAH workforce. The 2021 State of the World Midwifery Report (SowMY2021) approximated that the world needs 900,000 more midwives especially in low-income countries and in Africa.

Other than preventing maternal and newborn deaths, quality midwifery renders diverse services by improving other health-related outcomes across the perinatal continuum.

What Women Want: Midwives’ Voices, Midwives’ Demands

In 2021, White Ribbon Alliance Kenya commissioned a listening exercise with midwives to document their challenges, aspirations, and recommendations for the delivery of quality, equitable, and dignified Reproductive, Maternal, and Newborn Health (RMNH) care which then was compiled into a report titled

‘What Women Want: Midwives’ Voices, Midwives’ Demands Kenya Report 2021’.

The report which presented the lived experiences, challenges and self-expressed priorities made by midwives working in various sectors in Kenya, highlighted the biggest challenges midwives face including weak health systems, lack of adequate space, beds, ambulances, weak referral systems, coupled with understaffing and shortage of trained midwives to render services. Career problems included midwives’ quest to develop their professional careers appeared to be disillusioned by non-responsive recruitment, promotion, and remuneration policies.

Midwives have spoken; its now time to deliver forthem.

71.9% of midwives in Kenya cite the heavy workload and shortage of midwives as a great impediment to the provision of quality and dignified care to women, girls, and newborns. Often, when midwives’ voices are missing from global health leadership, decisions and policies don’t always reflect the diverse concerns and needs of women. The lack of women’s leadership in the global health workforce has led to the deprioritisation of women’s health issues.

The State of the World’s Midwifery 2021 estimates a global shortage of 900,000 midwives, projected to fall to 750,000 by 2030 if all countries continue on their current trajectory. The Lancet estimates that expanding midwifery care by 25% over 5 years would result in a 41% reduction in maternal deaths and a 39% reduction in infant mortality. This equates to 170,000 women’s lives saved and 1.2 million infants per year, by 2035.

Therefore, there’s an urgent need to strengthen the midwifery funding mechanisms to improve midwifery pay and conditions. Investing in improving the working conditions of midwives will be critical to improving the well-being of mothers and their newborns during the critical times of pregnancy and childbirth. There is need to address harassment in the workplace and improve workplace safety thus ensuring they deliver quality care to pregnant women and their newborns. Further, the scope of practice needs to be expanded to strengthen midwifery education and training at all levels. Addressing the gender pay gap in midwifery will be key thus ensuring there is equal pay for work done. These will not be possible without working to strengthen leadership within midwifery to ensure that midwives remain key in decision making tables for mothers, their newborns, and the midwifery profession at large. The data is available, midwives have voiced their realities, and mothers, and newborns have voiced their realities too, too many lives are at stake. What is lacking is the will and action of every actor responsible. The talk needs to stop! It is time to Act for good!

The time is now!

angelanguku

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Wra Kenya

White Ribbon Alliance Kenya (WRA Kenya) is a people-led movement for reproductive, maternal, and newborn health and rights. We advocate for women’s and girls’ voices and demands to lead change at the local, national, and regional levels and contribute to shaping the global reproductive, maternal, and newborn health (RMNH) agenda.

 

Re-Igniting the Inherent Power in Women and Girls through Advocacy and Action

We deeply believe in advancing the self-articulated needs of women and girls through advocacy to shape policies, programming approaches and strategies. This is aimed at amplifying women, girls and newborn’s voices, and agency, to actively participate in decision-making processes in public, private and civic spheres. We provide our action networks with the right tools, and trainings, to broaden the reach and efforts and realize a lasting change.

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Portfolio

I am Angela Nguku, a midwife, an ICF certified leadership and mindset coach, an advocate, an author, and a movement builder who turned silence into action.

I founded White Ribbon Alliance Kenya to center the voices of over 3.5 million women and girls who have boldly told us what they need for quality reproductive, maternal, and newborn health and wellbeing. We are not just documenting their needs. We are acting with them to address the intersecting issues that go beyond health. These include access to economic power, education, information, clean water, sanitation, dignity in care, among others.

I also founded AudaciousHer, a coaching and leadership platform for women and girls who are done shrinking to fit into broken systems. Through mindset coaching, storytelling, and bold spaces, we support them to reclaim voice, unlearn silence, and lead from a place of truth.

A powerful part of this work is coaching African frontliners — the community midwives, justice defenders, grassroots organizers, and policy disruptors who carry entire systems on their backs while navigating burnout, backlash, and broken institutions. They are the shiftmakers. AudaciousHer provides them with space to breathe, reflect, and lead differently, not just as responders, but as visionaries shaping new futures.

I’ve stood in delivery rooms where dignity was missing. I’ve sat with mothers who’ve buried their dreams and their children. I’ve walked into rooms where inclusion was just performance, not power-sharing. But I also do this work because I’ve seen what happens when a woman is truly listened to. She doesn’t just speak. She moves systems.

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I know what it feels like to grow up silenced, taught to keep quiet, defer, and disappear. But silence doesn’t keep us safe. It keeps us small. Across Kenya and Africa, too many women and girls are still raised in that silence. Only 15 percent of girls in Kenya feel confident speaking in public or participating in decisions that shape their lives. This trend mirrors a wider pattern across the continent, where cultural norms and systemic barriers continue to stifle voice and power.

I founded AudaciousHer in 2024 as a bold, African rooted coaching and leadership platform. We walk with women and girls reclaiming their voices. From adolescent mothers to midwives, movement builders to market women. Whether you’re restarting, reinventing, or rising, you’ll find truth, strategy, and sisterhood here.

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We do not moderate to keep the peace. We moderate to move the room. These are not polite panels. They are bold, truth filled sessions where power is questioned, silence is named, and clarity becomes action.
Whether it is in a boardroom, a village hall, or a global summit, we hold space for what matters. We convene with purpose, ask the uncomfortable questions, and turn conversations into strategy.

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