Midwives in Focus: Moving from Problems to Solutions

The author of this week’s blog is Dr Sally Pezaro (@SallyPezaro), Fellow of the Royal College of Midwives (@MidwivesRCM), Adjunct Associate Professor of midwifery at the University of Notre Damme (@notredameaus) and Assistant Professor at Coventry University (@covcampus).

Despite evidence demonstrating how the scaling up of midwives could avert the majority of maternal and neonatal deaths, the midwifery profession has faced both historical and present-day challenges, whereby their expertise has been questioned and devalued in many areas. As midwives remain focused on being experts in physiological birth, targets, agendas, and societal push back have now left the profession in much need of attention.  The serious and longstanding under-investment in midwives can largely be attributed to gender, social and professional related factors along with the economic disempowerment of midwives and the women and childbearing people they care for.

However, societal attention given to midwives is challenging, as in many areas, the midwifery profession is often conflated with nursing, thus challenging their creation of a distinctive professional identity and status. As an example of how nurses are drawn upon to represent midwives, the international year of the Nurse and Midwife was celebrated on Florence Nightingale’s (a nurse’s) bicentenary. Yet in an effort to move from problems to solutions in this area, our recent article in the Lancet argued how  midwives now need a useable past that is authentic and empowering for midwives in the face of a crisis in maternal and neonatal mortality. We also partnered with Coventry University and Jhpiego to establish ‘Midwives in Focus’.

Our ‘Midwives in Focus’ steering committee has been working over the last few months to build up networks and relationships with key stakeholders all over the world to devise a fundable project using applied research to get midwives where they need to be and meet the challenges set out in the  State of the World’s Midwifery report 2021 (SoWMy2021) and the WHO Global Strategic Directions for Nursing and Midwifery (2021-2025). As many midwives around the world are also nurses or nurse-midwives, we have also enlisted the support of the ‘Nursing Now Challenge’,  who engage thousands of midwives and nurse-midwives worldwide. So far, ‘Midwives in Focus’ have engaged with 1000’s of midwives and nurse-midwives in a multitude of countries such as the UK, Oman, Tanzania, Pakistan, Qatar, Rwanda, South Africa, Mozambique, Uganda, Guinea, Australia, Republic of Korea, Grenada, Malaysia, Kenya, Barbados, Cameroon, Ghana, India, Somalia, Israel, Saudi Arabia, Brazil, Spain, United Arab Emirates. This engagement has been invaluable in the shaping of our work going forward, and we thank everyone who has participated thus far.

Reflecting on the importance of professional identity, one of our first tasks has been focussed on collecting data in relation to midwives’ licensure around the world, and mapping that with a measurement of their professional identity. Will midwives or nurse-midwives have higher or lower measurements of professional identity?

We are also conducting an appreciative inquiry into Strong Midwifery Leadership. This should enable us to identify some themes as to what it is that makes midwifery leadership strong. What does it look like? How do you know is it strong?

Moreover, we are also exploring representations of midwifery around the world to gain some perspectives prior to the next phase of our work. If you would like to complete and/or share this survey, please see details below. There is much work still to do with ‘Midwives in Focus’ and a multitude of ways in which to approach the challenges ahead. We urge you all to follow our progress as we move forward in this venture together.

The best is yet to come.

Survey link: https://bit.ly/3uERMmZ

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