Image: Professor Mary Renfrew, School of Nursing and Health Sciences
Proper access to good quality midwifery care is something that many of us may take for granted but it is a highly contentious global issue. The same applies to breastfeeding and the risks of using breastmilk substitutes, with national and international battles involving big business, public attitudes, and public health agencies.
When we look at global health it is often the major diseases or sudden outbreaks of possible pandemics that grab the headlines, but what may be seen as more prosaic issues are having a drastic effect worldwide. Every year, nearly 300,000 women die during pregnancy, childbirth, or soon after. About 2.6 million women suffer stillbirths, and 2.9 million infants die in the first month of life. What makes these statistics even more staggering is the knowledge that the great majority of these deaths could be prevented by proper care – millions more women and their families suffer long-term problems simply because they have not received adequate health care before, during, or immediately after pregnancy.
It is estimated that increasing breastfeeding to near-universal levels for infants and young children could save over 800,000 children’s lives a year worldwide. These are issues where the University, and in particular the School of Nursing and Health Sciences, is making a significant impact.
“The essential needs of childbearing women in all countries, and of their babies and families, have been our focus, because many of those needs are still not being met, decades after they have been recognised,” said Mary Renfrew, Professor of Mother and Infant Health and Director of the Mother and Infant Research Unit.
“That needs to change. We are involved at many levels in working with international agencies to make that happen. We have seen tremendous developments this year which have been influenced by a series of articles we led for The Lancet on midwifery, and our work with Save the Children on breastfeeding, led by colleagues including Dr Alison McFadden, is having a similar impact.
“The hugely encouraging thing is that for the first time I can recall, the major global agencies are really collaborating on the implementation of midwifery. That is particularly important when we look at consistent messaging around what are complex issues.
“Countries are now putting new training in place for midwives. Education is changing and improving in many places. Individuals involved in healthcare around the world have picked up the key messages from The Lancet series and started putting them in to action. Dundee has played a key role in all of this.
“A key point that is now being widely recognised is that the core issue is not only about midwifery, or not only about breastfeeding. It is about bringing essential care to women and babies, which impacts on their survival, their long-term physical and mental health and even the economic prospects for their families and communities.”
Engendering major change across different countries and cultures is a mammoth task, but Mary sees reasons for hope.
“I am far more optimistic now about where things are going than I would have been if you’d asked me the same question even just two or three years ago. From where I am standing there really has been a complete sea change in attitude and approach to global co-ordination for midwifery, and The Lancet series on Midwifery and our follow-up work has been instrumental in that. We are already having a big impact on the implementation of midwifery and improvement of health services for women and children.”