Why Investing in Midwives Is Key to Reducing Maternal and Infant Deaths

Midwives play an essential and lifesaving role in maternal and child healthcare systems worldwide. In South Africa, especially in Gauteng, one of the country’s most populous provinces, the importance of midwifery services has never been clearer. With maternal and infant mortality rates still presenting a significant public health challenge, investing in midwives is critical. It saves lives and improves health outcomes. As the World Health Organization (WHO) and experts elevate global awareness about maternal and child health, the expansion and support of midwifery services remain paramount.

The Crucial Role of Midwives

Midwives are typically the first point of contact for women during pregnancy, childbirth, and postpartum care. Their presence during delivery is vital in reducing risks and managing complications. These can threaten the lives of mothers and newborns. Research indicates that skilled midwifery care significantly lowers maternal complications, particularly in low-resource settings where access to doctors may be limited.

The Gauteng Department of Health (GDoH) acknowledges this vital role and has prioritized strengthening midwifery by enhancing training programs. They are also improving working conditions and increasing retention rates. These efforts align with broader national objectives to reduce maternal deaths. Many stem from complications like hypertensive disorders, bleeding, and infections-conditions manageable with competent midwifery interventions.

Maternal and Infant Health in South Africa: The Current Landscape

South Africa faces persistent challenges concerning maternal and infant mortality. According to WHO data, around 810 women die every day worldwide from preventable causes related to pregnancy and childbirth. Locally, the most recent national report reveals that South Africa’s institutional maternal mortality ratio (iMMR) stands at approximately 112 deaths per 100,000 live births. This figure has plateaued after pandemic-related surges. Gauteng province has seen some improvement in maternal outcomes, but challenges remain due to disparities in healthcare access, staffing shortages, and infrastructure gaps across regions.

Infant mortality remains high at an estimated 22.7 deaths per 1,000 live births in 2025, though this reflects gradual improvement. Neonatal and perinatal mortality are key concerns, with many deaths attributable to preventable conditions like birth complications and infections.

Supporting Midwives to Save Lives

Investing in midwives requires more than improving salaries or work environments. It calls for scaling up the workforce and expanding high-quality education. Additionally, midwives need the latest medical knowledge and tools. The GDoH’s ongoing investment in midwifery education and retention ensures midwives are capable of delivering safe, evidence-based care during emergencies and routine deliveries alike.

At the 19th Annual Congress of the Society of Midwives of South Africa (SOMSA), Gauteng’s MEC for Health and Wellness, Nomantu Nkomo-Ralehoko, lauded midwives as the “heartbeat of maternal and newborn care.” Her remarks resonate with global health authorities emphasizing midwives as frontline agents in reducing deaths and improving healthcare quality.

The Global Crisis of Midwifery Shortages

Worldwide, the midwifery profession faces a critical shortage. WHO projects a shortfall of nearly 900,000 midwives by 2035. Low- and middle-income countries like South Africa are disproportionately affected. To counter this, education institutions such as the Gauteng College of Nursing are vital in training cohorts of midwives. These efforts are supported by ongoing professional development and retention strategies.

Midwifery Training and Education: Building a Foundation for Better Outcomes

Midwifery training involves acquiring skills to handle pregnancy-related complications, emergencies, and newborn care while promoting holistic health. Early detection and management of conditions such as pre-eclampsia and gestational diabetes rely heavily on trained midwives.

The GDoH’s partnerships with universities and colleges facilitate continuous education programs. These include workshops and conferences, ensuring midwives stay current with global best practices.

Midwives Beyond Childbirth: A Holistic Role

Midwives contribute extensively beyond delivery rooms. They play pivotal roles in family planning, antenatal, and postnatal care, breastfeeding promotion, and educating mothers on infant nutrition. Timely vaccinations and preventive care overseen by midwives significantly reduce infant mortality and promote healthier families.

Economic Benefits of Investing in Midwives

Midwifery investment yields economic dividends by averting costly complications that lead to prolonged hospital stays and intensive care. Healthier mothers and babies translate into a stronger, more productive workforce. Supporting midwives reduces strain on health systems and fosters social stability.

The Path Forward: Strengthening Midwifery Services

Tackling maternal and infant mortality demands intensified commitment to midwifery services. This means scaling up education, enhancing working conditions, and equipping healthcare infrastructure to support growing patient needs. Gauteng’s strides are commendable but more concerted efforts are required nationwide.

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Midwives Are Key to Maternal and Infant Health

Midwives are indispensable in South Africa’s journey toward reducing maternal and infant deaths. They provide critical, life-saving care, promote healthier families, and strengthen health systems. Sustained investments in midwifery education, infrastructure, and workforce capacity will drive improved outcomes. This will help build a healthier, more prosperous South Africa.