Midwives save lives. Well-trained midwives working in a fully functional environment could help avert roughly two thirds of all maternal and newborn deaths, according to the most recent State of the World’s Midwifery report. They could also deliver 90 per cent of all essential sexual, reproductive, maternal and newborn health services, yet because they are both underutilised and in short supply, they account for only 10 per cent of those currently providing these services. 

Since 2008, UNFPA has worked with partners, governments and policymakers to help build a competent, well-trained and well-supported midwifery workforce in low-resource settings. UNFPA focuses on four key areas: strengthening competency-based midwifery training; developing strong regulatory mechanisms to ensure quality services; raising the voices of midwives by establishing and strengthening midwifery associations; and advocating for increased investments in midwifery services. UNFPA also works to create a supportive environment for midwives by advocating for adequate workforce policies for midwives.

Topic summary

Why are midwives needed?

Around the world, in most regions, rates of maternal deaths have either stagnated or worsened. Every year, 287,000 women globally lose their lives giving birth, 2.4 million newborns die and an additional 2.2 million are stillborn. Many lose their lives to complications and illnesses that could have been prevented with proper antenatal, delivery and post-natal care – services provided by midwives.

The World Health Organization advocates for “skilled care at every birth” by an accredited health professional, such as a midwife, doctor or nurse who has been trained to manage uncomplicated pregnancies, deliveries and the immediate post-natal period. Skilled birth attendants also need to be able to identify complications and secure timely emergency assistance. Midwives provide all these services, and more.

What midwives do

Midwives and people with midwifery skills are the main caregivers for women and their newborns during pregnancy, labour, childbirth and in the post-delivery period. Yet they do not just deliver babies: Well-trained midwives can provide comprehensive sexual and reproductive health information and services, and play a critical role in promoting health within their communities. As members of their community, they can ensure culturally sensitive care that is more likely to have a lasting impact.

Midwives also provide family planning counselling and services, and perform breast and cervical cancer screenings. If authorised by their countries, they can provide basic emergency obstetric care, and in humanitarian crises, midwives can help implement the Minimum Initial Services Package for reproductive health care services.

Midwives also do much to advance women’s and girls’ rights. By providing information and counselling, they can help prevent female genital mutilation; offer support and assistance to survivors of gender-based violence; and provide reproductive health services to adolescents, who are often denied access to these services at great cost to their health and rights.

The midwife shortage

Midwives, when properly trained and supported, offer one of the most cost-effective and culturally sensitive paths to achieving universal health care. Yet midwives are in short supply in many developing countries, and they often lack the skills and supportive environment to perform their jobs well. In fact, the world is short of 900,000 midwives. The deficits are highest in the areas where needs are greatest.

There are many challenges to increasing the availability of midwifery services. Despite the enormous responsibilities they bear, midwives – who are overwhelmingly women – frequently endure poor pay, low status and a lack of support. Gender biases also play a role in the problems midwives experience.

By closing the deficit in the number of midwives, we could prevent two thirds of maternal and newborn deaths, saving more than 4.3 million lives a year by 2035.

What is UNFPA doing?

Together with its partners, UNFPA works to scale up quality midwifery education, policies and services around the world, in addition to strengthening midwifery institutions, associations and regulations. UNFPA’s support for midwifery now spans some 125 countries, including the countries with the highest rates of maternal mortality, which receive targeted support through the Maternal Health Thematic Fund.

For instance, UNFPA helped train more than 105,000 midwives between 2009 and 2018, while also providing books, equipment and training materials to more than 650 midwifery schools; training more than 8,500 midwifery tutors; and supporting more than 250 national and sub-national midwifery associations and their branches. UNFPA also works closely with national governments to ensure that midwifery is a well-regulated, autonomous profession with midwives enjoying a clear title and properly defined scope of practice. Many countries now follow a competency-based midwifery curriculum that is aligned to global standards. In addition, UNFPA has been supporting higher education programmes for midwives. Bachelor’s degree programmes have been launched in Afghanistan, Cambodia, Ghana, Haiti, the Lao People's Democratic Republic, Pakistan, Somalia and Zambia, and midwifery master’s degree programmes have been introduced in Bangladesh, Benin, Burkina Faso, Ethiopia, Nigeria, Uganda and Zambia.

UNFPA also focuses on deploying midwives following the completion of their education and training. For example, UNFPA recently supported the deployment of more than 4,400 midwives in Ethiopia.

Today, support for midwifery services is growing. Midwifery is strongly emphasized in the UN Secretary-General’s Global Strategy for Women’s, Children’s and Adolescent’s Health, as well as in the Africa Health Strategy, and an increasing number of governments have committed to investing in midwifery care. Each year, UNFPA works with ministries of health and national midwifery associations to celebrate the International Day of the Midwife on 5 May, highlighting the importance of midwives everywhere.

The State of the World’s Midwifery

In 2011, UNFPA and 30 partners published the first-ever State of the World’s Midwifery report, with data from 58 developing countries. The report called for bold initiatives by governments, regulatory bodies, training institutions and others to scale up investments in midwifery services. The second State of the World’s Midwifery report was published in June 2014, offering data from 73 low- and middle- income countries, and highlighting the acute shortage of midwives in the places where there the needs are greatest. In May 2021, UNFPA and partners published the third iteration of the State of the World’s Midwifery report, with a number of new findings, including the current lack of 900,000 midwives. 

“Every woman has the right to lifesaving healthcare,” UNFPA Executive Director Dr. Natalia Kanem has said. “Midwives are critical to help make that happen.”

Updated 4 May 2023

Explore Country Data
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Midwives per 10,000 population

Colour indicates the number of midwives per 10,000 population. "Midwives" includes midwifery professionals, midwifery associate professionals, midwives not further defined, nursing professionals with midwifery training and nursing associate professionals with midwifery training

Click on a country to view key data and access the SoWMy 2021 country profile

  • 10+
  • 4 - 9.99
  • 3 - 3.99
  • 2 - 2.99
  • 1 - 1.99
  • 0 - 0.99
  • not reported

The designations employed and the presentation of material on the map do not imply the expression of any opinion whatsoever on the part of UNFPA concerning the legal status of any country, territory, city or area or its authorities, or concerning the delimitation of its frontiers or boundaries. The dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties.