With this briefing, the HPC commemorates the International Day of the Midwife, which falls on May 5, under the theme "Midwives: A Crucial Role in Every Crisis". This day represents an opportunity to highlight the key role midwives play in providing maternal, newborn, and child health care, as well as counselling, information, and services on pregnancy, family planning and breastfeeding, particularly in times of humanitarian crises.
Midwives are on the front lines of primary health care, the cornerstone of healthcare. They provide comprehensive support before, during, and after childbirth. As part of this year's activities, the United Nations launched a global initiative to strengthen the role of midwives at the 58th session of the Commission on Population and Development. The initiative aims to reduce pregnancy and childbirth-related deaths by expanding the scope of quality care provided by midwives.
United Nations data indicates that approximately 260,000 women will die in 2023 due to complications from pregnancy and childbirth, or one death every two minutes. Despite a 40% decrease since 2000, the pace of progress remains slow and uneven, especially in fragile and conflict-affected areas [1] .
Midwives: The Backbone of Maternal and Child Health
Midwives' responsibilities extend to all stages of motherhood, from pregnancy planning, through pregnancy and childbirth, and even after birth. They provide regular checkups and health advice, monitor fetal growth, and detect complications early. They also contribute to the management of natural births and provide emotional and physical support during labor and delivery. They also monitor the health of the mother and newborn after birth, support breastfeeding, and educate on family planning, nutrition, hygiene, and mental health.
Midwives play a pivotal role in remote areas, where they are often the sole providers of care, making them a key component in improving community health indicators. Research indicates that good midwifery care contributes to improvements in more than 50 health indicators and reduces unnecessary interventions such as cesarean sections (unlike in Jordan, where midwives contribute to an increase in cesarean births), making it one of the most cost-effective and quality-driven health interventions.
Midwives in Jordan: A Model of Excellence
In Jordan, midwives play a pivotal role in providing reproductive health services. They provide family planning advice, monitor women's health during pregnancy, supervise child vaccinations, and provide support and care during childbirth in both the public and private sectors. According to the Ministry of Health's 2023 report, the number of midwives in the Kingdom reached 4,984, distributed across various sectors, including 1,630 in the Ministry of Health, 495 in the Royal Medical Services, 35 in university hospitals, and 2,824 in the private sector. This reflects the vital role this group plays in strengthening the healthcare system in the Kingdom.
Every year, the General Secretariat of the HPC receives groups of midwives enrolled in the RMS College for Allied Professions. The HPC organizes a scientific day for them, which includes presentations on their role in implementing the National Reproductive Health Strategy 2020-2030 and their contribution to providing services related to reproductive health components such as marriage preparation, adolescence, safe motherhood, family planning, reproductive system cancers and sexually transmitted diseases, menopause, violence, and gender. These efforts come within the framework of the keenness to raise community awareness and improve the quality of life for individuals at various age levels.
It's worth noting that since the adoption of the Nursing and Midwifery Licensing System in 2019, the profession has witnessed a qualitative shift in ensuring competency and quality through licensing exams, updated curricula, and the creation of question banks, in addition to the launch of an electronic platform to facilitate procedures.
Estimates of future needs for midwives in Jordan
As part of planning efforts to meet reproductive health needs, the HPC has prepared estimates of the Kingdom's need for midwives for the period 2025–2035, based on a scenario where the use of modern family planning methods remains constant at 2023 levels. These estimates calculate the number of pregnancies and births per year for both Jordanians and Syrians. The estimates assumed that the rate of midwives per 10,000 pregnancies (184 midwives) and the rate of midwives per 10,000 births (271 midwives) remain the same as in 2023, taking into account that maternity care sites differ from delivery sites. Estimates indicate that the need for midwives will gradually increase, from 5,147 midwives in 2025 to 5,701 midwives in 2030, reaching 6,201 midwives in 2035, with additional numbers needed to replace midwives who retire or die.
Midwives in Crises: A Critical Humanitarian Response
During conflicts, natural disasters, and public health emergencies, reproductive health needs are often neglected, with dire consequences. Pregnant women are at risk of life-threatening complications if they lack access to childbirth and emergency obstetric care. Women and girls may lose access to family planning services, exposing them to unintended pregnancies in risky circumstances.
The importance of midwives is particularly highlighted in emergencies and humanitarian disasters, where they are at the forefront of health responses, essential for saving lives and reducing suffering. The World Health Organization confirms that skilled midwives mean the difference between life and death for hundreds of thousands of mothers and newborns annually. Pregnant women living in humanitarian emergencies face some of the highest risks globally. Nearly two-thirds of maternal deaths worldwide occur in countries affected by fragility or conflict. For women in these settings, the risks are enormous, and the Arab region in general is facing a challenge in this regard due to conflict and instability in some Arab countries.
In this context, it is noteworthy that Jordan provides excellent medical services to both citizens and refugees. Hosting large numbers of Syrian and other refugees has placed significant pressure on its health facilities, but it has succeeded in providing care through field hospitals, mobile clinics, and cooperation with international organizations. The Jordanian health system is also working hard to meet the healthcare needs of mothers and children, at a time when family pressure is increasing on the midwifery profession and healthcare workers.
The need for continued support for the midwifery profession
The HPC emphasizes the key role played by qualified midwives. Global studies indicate that trained midwives can contribute to reducing maternal and neonatal mortality, as well as reducing premature births and the likelihood of stillbirth. The HPC recommends recognizing the humanitarian role of midwives and honoring their efforts in saving lives. It also recommends working to promote investment in the midwifery profession by expanding training and continuing education programs. This will improve working conditions and wages, ensuring a safe and stimulating environment for midwives, as well as ensuring the availability of basic medical supplies and appropriate health facilities, especially in remote areas. It also recommends increasing community awareness programs about the role of midwives in integrated healthcare and the need to enhance the participation of midwives in health policies to ensure their voice is represented in decision-making.
