Midwives: Unique contributors to MDSR

Midwives are vital to ensuring women and their babies not only survive pregnancy and childbirth, but live healthy lives.

We know from the Lancet Midwifery series that:

What do we know about the role of midwives in maternal death surveillance and response (MDSR) systems?Image_Midwives_SL_Direct Relief
In 2016, we asked six experts in MDSR or similar models for their opinion. Experts agreed that midwives can make a unique contribution to MDSR being familiar with the medical and sociocultural factors relevant to each case. Their unique insights are meaningful in the investigation of and response to a maternal death. However, midwives are not always involved in the review of a maternal death and in some cases may have a low status within a health system.

In this blog, written for International Day of the Midwife on 5th May 2017, we turn our gaze to northern Syria where midwives are being trained in maternal and newborn care. We look at the challenges, benefits and opportunities in involving midwives in maternal care, in particular MDSR.

In March 2017, Nadine Cornier, a trained midwife and reproductive health Humanitarian Advisor at UNFPA in Turkey, gave a presentation at a seminar we co-organised at the London School of Hygiene and Tropical Medicine. She discussed her research and experience in measuring maternal mortality in humanitarian settings and responding to findings. Watch the live recording.

Her current work in Northern Syria involves re-training midwives in “life-saving capacities and competencies” as set out in the International Confederation of Midwives (ICM) Essential Competencies for Basic Midwifery Practice to raise their skill sets from an assistant midwife to a qualified midwife.

While Nadine Cornier describes this as a large task, maximising the competencies of midwives is invaluable in a setting where hundreds of health workers have been killed and numerous have fled the country. It is also important to note that accordingly assessments of maternal deaths have not been carried out in this area because of the security risks to health workers and health facilities.

For the panel discussion, Nadine Cornier was joined by Rajat Khosla, Human Rights Adviser in sexual and reproductive health and rights at the World Health Organization, and Eleanor Brown, Technical Specialist at Options.

When asked about the role of professional associations, especially professional midwifery associations, Eleanor Brown shared her work experience in Nigeria. She tells us that the Society for Obstetricians and Gynaecologists of Nigeria is integral to the maternal death review process and in instilling a culture of no blame. Eleanor Brown further states:

“The professional association for midwives plays quite an important role in other [Options] maternal health programmes as champions, particularly for getting people to have the political will to address maternal mortality”.

N.Cornier_presentation slideImage caption: Slide from Nadine Cornier’s seminar presentation

Let us celebrate the work of midwives as champions in maternal and newborn care around the world. Let us also reaffirm that midwives can play an important part in MDSR as they can uniquely contribute to making effective decisions to improve the quality of maternal and newborn care.

To watch the live stream of the seminar at LSHTM, Applying Maternal Death Surveillance and Response in Crisis Settings, click here.

To download Nadine Cornier’s presentation, click here.

This seminar is part of a series. To read about the seminar series including the first seminar which took place in January 2017, click here.

Read this blog by UNFPA to learn more about Nadine Cornier’s work with midwives in northern Syria.

Acknowledgements: This blog was written by Jenna de St. Jorre, Evidence for Action-MamaYe Technical Assistant at Options.

[1] Rounded from 83%