Midwifery care not enough: We need more women at the decision-making table

Worldwide, there is overwhelming evidence from policy, research, and training institutions that the care of a midwife can mitigate the risk of harm to women and their newborns dramatically. There is even consensus that if midwives stand with women, and women stand with midwives, we can turn around this unacceptable situation.

Despite the magnitude of women working in healthcare, the essential role of midwives for women has endured immense pressure within the biomedical model, which is still predominantly male-dominated.

The current medical status quo tends to perceive childbirth not as a natural and normal life experience, but as a medical procedure that warrants intervention. This does not always rhyme with what a woman wants or needs, which can lead to a situation in which a woman can feel violated or traumatised by her medical care. 

International Women’s Day is celebrated on the 8^th of March each year to celebrate the achievements of women worldwide, but also to highlight the fact that we still live in a male-dominated society, and as such, women continue to strive for gender equality. Maternity care is certainly still a place where women’s choices can be decided for them and where we can still lack aspects of control over our reproductive rights.

As midwives, we believe it is the right of all women to decide what happens to their own bodies, to decide their own future, to decide what is best for their baby and to decide to have their own midwife by their side.

Well, midwives across the world understand that over and under-medicalisation (‘Too Much, Too Soon’ and ‘Too Little, Too Late’) in their countries are indicative of one and the same issue: That women worldwide are being disempowered in asserting their rights to respectful quality care, appropriate to their context. 

These midwives know that they can make a difference for and with women and are ready to support them, but inclusion can be a key barrier for midwives who advocate for women.

A common issue always said by midwives is that at the decision-making table, midwifery care is on the menu, but women and their midwives are not permitted to sit at that same table! 

So, the question is, “How are we supposed to represent the interests of women if we cannot partake in the conversations that impact us?” As with the miracle of childbirth itself, midwives are patient when necessary. But it is also an inherent skill of midwives to know when we have waited long enough.

We therefore call upon the decision-makers in our key health-related ministries to ensure that women and midwives are seated at the table when it comes to conversations around sexual, reproductive, maternal newborn care child and adolescent health. Let’s see more women and midwives sitting at the table.

The authors are; Namakula Ritah; a registered graduate Midwife working with Mulago Specialised Women and Neonatal Hospital and Lilian Nuwabaine; MSN-Midwife and Women’s’ Health Specialist