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The Lancet: Midwifery matters 'more than ever'
Date:6/22/2014

adequate health care before, during, or immediately after pregnancy.

New estimates produced for the Series suggest that in the countries with the highest burden of infant and maternal deaths, over three quarters of stillbirths and maternal and newborn deaths could be prevented in the next 15 years if effective midwifery was available to all women. Even if improvements in the coverage of midwifery services were much more modest, the potential for saving lives is huge if coverage of midwifery services increased from current levels by just a quarter, the authors estimate that the current rate of maternal deaths could be halved by 2030.

While most maternal and child deaths occur in low-income and middle-income countries, where lack of access to effective midwifery is the primary obstacle to improving mothers' and infants' health, the Series also says that overmedicalisation of pregnancy is increasingly threatening the health and wellbeing of women and their families in both high-income and lower-income countries. The Series authors argue that routine use of unnecessary interventions, including caesarean sections, limited mobility in labour, and episiotomy can have a lasting effect on mothers' and infants' health and wellbeing.

According to another of the authors, Professor Caroline Homer, of the Faculty of Health at the University of Technology, Sydney, Australia, "Both underuse and overuse of medical interventions in pregnancy contribute to short- and long-term illness for an estimated 20 million childbearing women. This not only effects their health and wellbeing, but may also result in their needing to pay for ongoing health-care costs, and on the ability of their families to escape poverty."

The return on investment from the education and deployment of community-based midwives is thought to be similar to vaccination in terms of the cost per life saved. However, according to the Series authors, the scale of the potential effect that increas
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Contact: Thomson Prentice
t.prentice@orange.fr
33-631-863-930
The Lancet
Source:Eurekalert

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