ICM Vice President Frances Day-Stirk describes recent action among midwives--and she urges them 'to believe'.
In many parts of the world the month of May holds significance--be it Mother's Day or, in temperate countries, the first signs of spring--signalling new life. May also holds significance for midwifery associations in membership of ICM and for midwives. The 5th day of May, the International Day of the Midwife, is marked out for celebration and commemoration: celebration of all that is good about midwives and midwifery and commemoration of the millions of lives of women and their children lost though childbirth related deaths. And it is almost one year since ICM Council last met in Glasgow in last May. It has been a year that has seen the profile of midwifery heightened significantly, as outlined by the ICM President in the previous issue of this journal (IM 2008; 21:51). This achievement results from a combination of the ICM's continuing strategy as well as global recognition of the significance of midwives in achieving Millennium Development Goal (MDG) 5. It is a huge privilege to be serving as ICM Vice-President at a most exciting time in the history of the globalisation of midwifery--a time when the lack of progress towards MDG5 has galvanised global leadership.
The 2009 theme for the Intemational Day of the Midwife (IDM), The Worm needs midwives now more than ever, and the poster illustration encompass the message that the ICM wants all governments, and international policy--and decision-makers to heed the call and take action: all Member Associations and midwives, in their turn, are needed to campaign and lobby in their own countries on behalf of the world's women. This was emphasised in the press release message that midwives are central to achieving the matemal and newborn specific MDG goals 4 and 5 and also key players in reaching the equally important MDG 6, relating to the fight against disease.
The ICM website demonstrates the unprecedented scale of activities around IDM 2009, inlcuding Mother Night in the Netherlands, the WHO postcard and UNICEF message (ICM 2009). Midwives and mothers figured strongly in the UK at the launch of a report from the All Party Parliamentary Group on Population Development and Reproductive Health, which focused on maternal morbidity with its stark message made clear in the title 'Better off Dead?" (APPG 2009). The high-profile launch by Sarah Brown was planned to coincide with the IDM and also with the 'From Pledges to Progress' event hosted by the Royal College of Midwives and Women and Children First UK.
What else has happened in May? In preparation for the G8 summit, the Maternal Mortality Campaign, chaired by Sarah Brown, moved on to meeting European Commissioners in Brussels. Again there was clear support for access to midwifery competency skilled health professionals to work in liaison with community health workers. This campaign was then profiled at the World Health Assembly in May www.number10.gov.uk/Page19362, which was attended by the ICM Secretary General and Treasurer.
MDG5--reducing maternal mortality--is at the heart of all the MDGs and yet it is the most under-funded with a paltry annual global expenditure of approximately 2.4 billion [pounds sterling]. Consider and compare this to the sums that governments can find when there is a will. Not very long ago, C17 billion was swiftly raised to bail out two Belgian banks; MDG 5 targets of universal access to family planning services and reduction of the maternal mortality rate by three-quarters by 2015 could be met if wealthy nations allocated an additional C 13bn in aid, according to the World Health Organization (Duff 2008). The stark differences are evident as the world becomes increasingly interconnected--where the impact of recession in the west reverberates in every comer of the globe. So too does the opportunity to influence and as innovative financing systems are considered this must be in the context of targeted accountable aid and tangible outcomes linked to indicators.
In an article in the UK's Guardian newspaper Romesh Gunesekera, writing on the military situation between the Sri Lankan army and the Tamil rebels, recalled a Bengali poet Sunil Gangoapdhyay's poem that made him think: what should I believe in now? What can I believe in? What must I believe in?
This made me think about maternal mortality and the issues around safe motherhood that tax and challenge us all: global, regional and national leaders, NGOs like the ICM, Midwifery Associations and midwives. What if his idea was borrowed and adapted to maternal mortality: What must we (midwives) believe in now? What can we believe in? What must we believe in?
* We must believe that maternal health will improve by 2015 and there will be significant reduction in preventable maternal death and disability.
* We must believe that those who have the power will ensure that the lives of future generations of women and infants will not be brought to this point of suffering again
* We must believe that everyone will acknowledge that women's reproductive rights matter and gender discrimination is wrong.
* We must believe that that aid will flow into countries in most need and that it will go directly to support universal free health access to women and children.
* We must believe that in-country leaders will commit to funding maternal and child health services and systems
* We must believe that sufficient ICM competent midwives will be trained and found gainful employment
* We must believe that the health and reproductive rights of women will be recognised and implemented globally
* We must believe that girl children will enjoy education opportunities equal to boys
* We must believe that that women will not be intimidated and their status seen not just as a women's matter but a matter for society
* We must believe that women will not have to cross the bridge alone.
Midwives, mothers and mortality appear to be reaching a tipping point. We must be prepared to believe 'we can'. We must keep up the momentum.
APPG (2009) Better off Dead? A report on Maternal Morbidity from the UK All Party Parliamentary Group on Population, Development and Reproductive Health (May 2009) www.appg-popdevrh.org.uk/accessed 10 May @22:30
Brown S. (2009) Speech on the Maternal Mortaliy Campaign to the World Health Assembly (Geneva) 19 May www.number10.gov.uk/Page19362 accessed 20 May @14:20
Duff E. (2009) Women 'have to cross that bridge alone MIDIRS Midwifery Digest, vol 18, no 4: 503-504.
Gunesekera R. (2009) A long, slow descent into hell The Guardian 30.04.09
ICM 2009 www.internationalmidwives.org/accessed 10 May 2009 @22:30