Midwifery: a tool for caring for and empowering women

mujer embarazada acompañada

Montevideo, May 5, 2023. Jovita had no intention of becoming a midwife when she was growing up, in fact, she didn't even really know what that meant. She started medical school and, as she learned more about midwifery, she fell in love with the profession and its potential. "Working for and with women is super powerful in terms of everything you can do, not only for health, but for women's lives," says Jovita Ortiz, director of the Department of Women's and Newborn Health Promotion at the School of Obstetrics, Faculty of Medicine, University of Chile. She adds that even today she continues to teach students and her own daughter that midwifery goes beyond childbirth care.

Daniela Poblete, one of Ortiz's students at the School of Midwifery, hopes to become a midwife next year. Although she graduated with a degree in Phonoaudiology, she found that she was very attracted to midwifery and decided to start studying again. She says that she comes from a family of many women and listening to their stories as they were having children influenced her decision and her desire to become more involved in these processes. "I believe that the way we are born marks our whole life, from the biological to the emotional. The moment of birth is very important for the woman, for the newborn, and also for her family. Being able to contribute to making the experience better is my great motivation. In addition to the accompaniment, which is fundamental, I feel that midwives are really prepared to attend to emergencies and contribute to the health teams," she said. 

Education, regulation and partnership

Regarding the impact of the profession on society, Ortiz says that, despite the existence of scientific evidence on the importance of the work of midwives in both maternal and newborn health, it is a profession that has not had the impact it deserves to be implemented on a massive scale in the region.  

She also says that favourable results are associated with solid training. "It is necessary to have trained and motivated staff, working together with health teams.... We must be able to transmit the midwifery approach from a preventive, health-promoting perspective. And we must be trained to diagnose complications, to know how to treat them and refer them in time," she said. 

It is also necessary for countries to have regulatory frameworks so that midwives can practise professionally and be protected by law. In addition, she pointed out that for this to happen, there is a need for association between professionals, so that they can continue to position themselves and claim spaces.

While there were challenges prior to the Covid 19 pandemic, there are new challenges now. "The people most affected during the pandemic were women, not with the virus, but with what was generated by the pandemic. And among them, the most vulnerable are always the most affected," said Jovita Ortiz. "That's why we need to recover what we have achieved and move forward".

A cutting-edge school collaborating with PAHO 

The Department of Women's and Newborn Health Promotion of the School of Midwifery has been a Collaborating Centre of the Pan American Health Organization (PAHO/WHO) since 2008 and works with the Latin American Centre for Perinatology - Women's and Reproductive Health (CLAP/WR) for the development of midwifery in Latin America and the Caribbean.

It is worth remembering that the University of Chile began training midwives 189 years ago. "It is one of the oldest schools in Latin America," says Pablo Gálvez, Director of the School of Midwifery. "As a career we have a very long trajectory. This allowed us to develop a comprehensive career for the midwife and midwife, who was originally dedicated only to midwifery and who gradually took on other roles and became a fundamental part of the health system". 

Gálvez says that the career emerged as a response to the number of maternal deaths in the country and had a great impact on reversing that situation. Over the years, other health professions emerged and midwifery was also linked to other areas. Unlike in other countries in the region, midwives in Chile are closely linked to areas such as sexual and reproductive health and neonatal health. Gálvez comments that, in addition, the curriculum has been adapted according to the needs of the country.

Regarding the department's role as a PAHO Collaborating Centre, he says, "For us it is a great recognition of our profession and its value. It has positioned us nationally and internationally and, also, in front of other health professionals". 

On the challenges facing the centre and the profession in general, Ortiz said it is necessary to continue advancing in research. "We do a lot for women's health but we show little evidence, we report little of our experiences, at least in Latin America". In this sense, she said it is important to develop research that "not only covers biological health outcomes but also experience, understanding that experience is one of the great dimensions of quality".