The world’s midwifery report 2011 was launched recently by the minister of Health and Social Welfare, Fatim Badjie. It is considered the first report of its kind. It is not only timely but is long overdue.

Nurses and midwives in the developing world play significant and pivotal roles in the health delivery services of the countries because from time immemorial babies are being born as a sequel to pregnancy and an act ordained by God, the creator. Midwives have played an active role in the delivery of babies from early times.

The process of a small female cell, the ovum and the male spermatozoa fusing together to form one single cell which becomes embedded in the uterus (the female organ of reproduction) where it matures for nine months into a male or female embryo or multiple embryos, is a very unique and extraordinary phenomena of nature.

The report therefore raises issues of the availability of the service of midwives, which are fundamental in the reduction of maternal, neonatal morbidity and mortality.

In the animal world, female animal normally produce their young puppies, kittens, lambs etc. on their own as the case may be, they are endowed with natural instincts and ability to feed and care for their young.

In the case of humans the situation is different - once the pregnancy is at term or attained nine months in utero and the gestation has been without complications, labour will automatically commence.

Under normal circumstances at the end of labour a stressful and painful ordeal, an infant is born. This is where the services of a midwife comes into play due to the many complication which can occur during labour, such as hemorrhage, delay in the expulsion of the placenta, rupture of the tissues of the Birth Carnal among others and stress of the infant which can also occur if labour has been prolonged or the presentation of the infant is abnormal instead of the normal presentation of its head presenting first. Animal on the other hand will remove the Amniotic around their young and devour the placenta themselves.
According to the report, the availability of an adequate number of well-educated and motivated midwifery workers are a pre-requisite for an efficient health care system and to achieve the MDG’s of the millennium targets requires full commitment at global and national levels with the involvement of individual families, communities and civil societies.

The report indicates that many countries are yet to attain the WHO recommended threshold of 6 midwives per 1, 000 live births in order to ensure full coverage and quality services.

According to the visiting UNFPA regional director for Africa, Bunmi Makinwe who also stated that the state of the world’s midwifery 2011 is a result of the collaborative efforts of 30 partners with common goals to strengthen midwifery and to promote maternal and newborn health.

Also, he noted that The Gambia has done well in this regard, as the country has a ratio of 5 midwives per 1, 000 live births.

This sounds good on paper. Permit me to describe the cramped and chaotic situation viewed at one of our maternity units in the country sometime ago.
I went round the Serrekunda maternity unit sometime ago and was surprised and horrified at the state of the labour ward.

There was only one midwife on duty and a few nurses who were very busy and rushed off their feet. All the labour wards were occupied and there were more women in labour awaiting admission.

In this kind of situation some patients may have had to deliver their babies on the labour ward floor since the beds were all occupied. The groans of women in pain and infants letting out their first breath after delivery filled the atmosphere.

It was utter confusion as the nurses dashed from one patient to the other as each patient yelled for their attention. As an ex-nurse midwife I wondered how these nurses coped with the heavy work load.

I did not think that I could work efficiently under those difficult circumstances. According to the staff, the labour ward was always that busy and they were obviously overworked.

The report focuses on the availability of adequate number of a well-educated midwifery work force as a prerequisite for a well-functioning health care system.

It is recognised that most of our midwives are overworked because the number of deliveries they have to deal with daily are far too many for the staff available on duty at each shift of the day. This was the situation at the Serrekunda health center at the time I paid a visit there.

The minister in her launching statement indicated that the attaining of the millennium development goals, particularly MDG’s goals 4 and 5 relating to health issues and the improvement of maternal health and reduction of child mortality, cannot reach without the services of the required numbers of midwives distributed equitably around the world and especially in the developing world.