Midwifery: An executive summary for the Lancet’s series

Each year an estimated 289,000 women die from pregnancy related causes, 2.6 million women will have stillbirths, and 2.9 million children will die in the first month of life. Providing quality maternal and newborn care is vital in reducing these deaths and strengthening midwifery is pivotal in doing so. The Lancet Midwifery series, together with The State of the World’s Midwifery Report 2014, is the most important and wide-reaching engagement with midwifery to date, bringing together a range of clinical, health system and policy perspectives. This series consists of four articles developed by a multidisciplinary team of academics, researchers, women and children advocates, clinicians, and policy-makers. It addresses the contribution of midwifery and challenges current thinking held by health professionals, decision-makers, and the public.This executive summary introduces a framework for quality maternal and newborn care (QMNC). This framework describes the characteristics of care needed for women, their newborn babies and families across the continuum of care. It sees quality of care not only in terms of its technical components of what is done, but also includes how, where, and by whom this care is provided. Central to this framework is placing the needs of women and their newborns at the centre of care. It can be used to assess quality of care, plan the development of an education curriculum, the allocation of resources or of the workforce, and identify evidence gaps to prioritise for future research. This framework underpins all the articles in this series and has been used to:

• Review the evidence on what women and newborns need from maternal and newborn services
• Describe the scope of midwifery practice
• Identify parts of quality of care that need to be strengthened based on country specific examples.

The series concludes by recommending that health professionals and policy-makers should develop and implement policies that simultaneously address the need to increase coverage and to improve the quality of maternal and newborn care, thereby ensuring “effective coverage”. In doing so, they need to develop an environment where effective midwifery practices can be implemented according to the women-centred values of the QMNC framework.The four papers in this series include:1)     Midwifery 1: introduces the quality of maternal and newborn care framework.2)     Midwifery 2: models the life-saving impact of scaling up midwifery interventions on women and babies.3)     Midwifery 3: reviews four countries’ efforts to improve maternal and newborn survival through investments in midwifery.4)     Midwifery 4: summarises the key messages of the previous papers and shows how investing in midwives can make a crucial contribution to reaching universal and effective coverage of woman-centred care.To read the articles in the series click here. Free registration is required.To watch the video, click here. Renfrew, J. M., Homer, C. S. E., Downe, S., McFadden, A., Muir, N., Prentice, T., & ten Hoope-Bender, P. (2014). Midwifery: An executive summary for the Lancet’s series. The Lancet, (Early online publication).