Midwives, Mothers and Partners; a partnership for life

  • Picture of midwives
Building a strong partnership among midwives, mothers and partners in maternal and newborn health builds a healthy community and nation.

Esther Mphazi is a Nurse and Midwife Technician working in Lilongwe, Malawi. She has spent over 10 years working at both government and private hospitals making sure that pregnant mothers and newborn babies are getting the best care from her. I sat down with her to find out more about her work as a midwife as we join the rest of the world to commemorate the International Day of the Midwife. This is a day celebrated every year to appreciate the work the midwives play in our health sector and the tremendous contribution towards health of our nations.

Being a midwife means being there for a pregnant woman throughout her pregnancy, labour and delivery and during her early days after the birth helping her and her newborn baby.

According to Esther, in many ways, this means making sure that the pregnant woman gets the best care during antenatal visits by being told on what to eat for the good health of both the mother and baby. Nutrition is an important topic during antenatal clinics in order to avoid pregnant mothers from suffering from lack of iron in the blood and malnutrition for the baby.   

According to the 2015 Countdown Maternal, Newborn and Child Survival Report, newborn and child nutrition still remains a key challenge which must be addressed as they account for 45% of deaths in children under the age of 5. 

As for this year’s theme being about partnership between midwives and mothers, Esther points out that this is important for the wellbeing of the mother, baby and for the nursing profession.

To ensure a safe birth it is important that there is good communication and a strong partnership between midwife and pregnant mother.

  • International day of the midwife
    Esther Mphazi, Nurse/Midwife Technician

What needs to be done

But in a country where there is a shortage of midwives (48 auxiliary midwives, 3,037 nurse-midwives) according to National Statistical Office report of 2017), this puts a lot of burden on the work of the midwives in performing their tasks.

Nancy Kamwendo, a community health midwife specialist and National Coordinator for White Ribbon Alliance in Malawi echoes the plight of the working conditions for midwives in the country, she says;

White Ribbon Alliance did a survey and discovered that one midwife is looking after a thousand women which is a very challenging thing. So a midwife can be at a health facility alone looking after the labouring woman, the postnatal woman and the newborn. And this woman is expected to perform wonders alone

She further says the World Health Organization (WHO) recommends one midwife per 175 childbearing women. Malawi falls far short of reaching this figure.

However, the country has made a great progress in ensuring that mothers are assisted by skilled providers. According to the latest DHS, over 90% of mothers are assisted by skilled providers. But still there is a gap between the urban and rural areas where in the urban, 95% are assisted by skilled providers while in the rural 89% are assisted by skilled providers.

Partnership in health sector is about trust where the pregnant woman has to have trust in the midwife. In a county where HIV/AIDS is very high, issues of patient/doctor confidentiality is of utter most importance and this is what builds partnership between midwives, mothers and families. According to the UNAIDS report on global AIDS epidemic 2013, 64% of pregnant women living with HIV in sub-Saharan Africa were receiving antiretrovirals in 2012, out of which 90% of women in Malawi were on ARS. 

Mary Goba Phiri, a nurse and midwife technician working in Lilongwe narrates how she was able to build trust between herself, an HIV positive mother and her partner.

I had a patient who was diagnosed to be HIV patient during her earlier visit. When she had given birth, and was taking medication together with her child, we also discovered that the partner was also positive. So, we called them and counselled them. We encourage both partners to come for counselling together to avoid stigma and mistrust between partners 

In conclusion, as we celebrated this day by focusing at this year’s theme, it is worth reflecting on the importance of building a strong partnership through trust and respect among midwives, mothers and partners in maternal and newborn health.

A healthy community and nation begins when there is a good partnership between the midwife, mother and her partner.

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