Analysis: Maternal, newborn deaths could decrease by 60% with more midwife care

Dec. 1 (UPI) -- Making midwife services more widely available worldwide could reduce maternal deaths, newborn deaths and stillbirths by as much as two-thirds, particularly in developing countries, according to an analysis published Tuesday by The Lancet Global Health.

If countries allow midwives to provide a range of services, from family planning to post-natal care, their work could save the lives of up to 4.3 million mothers and newborns annually by 2035, the researchers said.

Midwives are trained health professionals who help women during labor, delivery and after the birth of their babies. They attend about 8% of births in the United States, but that percentage is much higher in many European nations, the World Health Organization estimates.

"Supported by appropriate professional education, regulation and improved working environments, it is possible to achieve a substantial increase in the level of provision of essential interventions delivered by midwives -- [and] this could save millions of lives," study co-author Andrea Nove said in a press release.

"However, there are numerous barriers to fulfilling this level of scale-up, particularly in low to middle income countries," said Nove, technical director at England-based data analytics firm Novametrics.

These barriers include inequitable distribution of qualified midwives, poor transportation links, lack of supplies and equipment and, in some countries, a lack of trust from the public, she said.

For this analysis, Nove and her team used the Lives Saved Tool, which models avoidable deaths assuming use, effectiveness and impact of a range of care services provided by midwives.

These services include family planning, hypertension screening, induction of labor and the use of antibiotics for newborn sepsis, caused by the body's response to a blood infection in infants younger than three months old.

The researchers modeled the effect of changes in the level of healthcare interventions delivered by midwives for 88 countries and analyzed the results.

If current mortality rates persist in these 88 countries, the analysis more than 3 million stillbirths, 3 million newborn deaths and more than 400,000 maternal deaths annually by 2035, the data showed.

If, however, use of midwife services in these countries increased by 25% every five years, maternal deaths could drop by 41%, stillbirths by 26% and deaths of newborn babies by 39%, the researchers estimated.

Providing midwife-delivered care to up to 95% of mothers and newborns in these countries could result in a 67% reduction in maternal deaths, a 65% reduction in stillbirths and a 64% reduction in deaths of newborn babies, the researchers estimated.

And the "universal scale-up" would have the potential to avert 280,000 maternal deaths, 2.1 million stillbirths and 2 million neonatal deaths annually by 2035.

While the number of women who die during childbirth and newborn have both dropped by about 30% globally since 2000, the figures remain high in countries where access to quality care is an issue, according to the United Nations.

"Midwives, especially in developing countries, are at the core of primary healthcare," study co-author Maria Najjemba said.

"Scaling up midwife delivered interventions can be a game changer that will give midwives the much-needed confidence to reach everyone and provide quality care to reduce maternal and neonatal [deaths]," said Najjemba, a country midwifery adviser for the United Nations Population Office in Uganda.