Access to the life-saving services of a midwife is a gender rights issue
Opinion piece by the Minister for International Development Cooperation, Isabella Lövin in The Guardian on the International Day of the Midwife, May 5, 2016.
In the mid-18th century, the maternal mortality rate in Sweden approached 900 deaths for every 100,000 births. A hundred years later, the introduction of professional midwives had contributed to the rate being pushed down to 230. Today, four women die per 100,000 live births.
This goes to show that the midwifery profession and workforce have the power to save thousands of lives each year. Unfortunately, not everyone gets to enjoy the benefits of that power. Although global maternal and infant mortality rates have dropped by half since 1990, about 800 women and girls worldwide still die from pregnancy- or childbirth-related complications each day. Almost all of them, 99%, die in developing countries. Every day there are more than 8,200 stillbirths and, each year, 2.8 million babies die within the first six weeks of life.
These figures are troubling in themselves, but the fact that the majority of these deaths could have been prevented with the help of qualified midwives and doctors makes the situation even more frustrating. Added to that is a persistent and – in some places – growing resistance to the human rights of women, not least among violent extremist groups, who make the control of women's lives, bodies and reproduction a central part of their ideology and rhetoric. Women's human rights can never be taken for granted.
To help spread the word about the major part played by midwives in sexual and reproductive health, the Swedish foreign ministry teamed up with the International Confederation of Midwives to launch the Midwives4All initiative. Our aim is to strengthen women's human rights, improve access to health services and resources for women, and increase female representation. This year we're celebrating the heroism of midwives by acknowledging those whose efforts make a real difference. Our excellence in midwifery award is open to healthcare workers in 14 countries around the world.
Midwives not only improve the chance of a safe pregnancy and delivery, but also provide the full continuum of care throughout a woman's life. By doing so, they play a key role in the empowerment of women and building sustainable societies. Access to a midwife is a big and important step in achieving sexual and reproductive health and rights for all. These rights are crucial for gender equality and are not merely a health issue.
Sweden has a feminist government and sexual and reproductive health and rights are seen as central to the struggle for women's human rights. If women and girls can't control their own bodies, decide whether or not to have sex with someone, and choose who to marry and when to have children, how can they participate on equal terms as men in society?
Sweden has a long tradition of being at the forefront on these matters, and up to 60% of Swedish development cooperation for health goes to promoting sexual and reproductive health and rights. In 2014, it amounted to 2.3bn Swedish kronor (£197m).
We promote more and better midwife training, strengthened legislation, increased recognition of the profession, and better information on the role midwives play. Swedish aid helps women and girls in countries where maternal mortality is highest. During my trips as a minister in Afghanistan, Somalia and South Sudan, I have seen how this work saves lives and build better capacity for the future. In Bangladesh, Swedish midwives, in close cooperation with local authorities, have helped to build up a new profession from the ground.
We have the policy and the mindset to drive change for the better, but first and foremost we have the opportunity. Through the ambitious goals of the 2030 agenda, two of which explicitly relate to sexual and reproductive health and rights, world leaders have already agreed to invest in gender equality. Partly because it is the right thing to do, but also because, when women and girls can educate themselves and find a job they like, they bring economic development. This pays off: if every country matched the most gender-equal country in its region in terms of access to the labour market, the global GDP would increase by 11%.
Gender equality can truly be the key to ending poverty.