A severe worldwide shortage of midwives is forcing health systems to breaking point, leading to increased medical interventions and poorer care for mothers and newborns, a major new report has warned.
A Workforce Stretched Beyond Capacity
The research, published in the journal Women and Birth, reveals the planet is short of an estimated 980,000 midwives. This gap means that in 181 countries, women are not receiving the fundamental care required before, during, and after pregnancy to prevent harm and death.
"Nearly 1 million missing midwives means health systems are stretched beyond capacity, midwives are overworked and underpaid, and care becomes rushed and fragmented," said Anna af Ugglas, Chief Executive of the International Confederation of Midwives (ICM) and a study author. She stressed that this is not merely a staffing crisis but a critical quality and safety issue for women and babies.
Regional Disparities and Systemic Failures
The deficit is not evenly spread. The most acute shortages are concentrated in low and middle-income nations. Africa has only 40% of the midwives it requires, with nine in ten women on the continent living in an understaffed country. The Eastern Mediterranean region has just 31%, and the Americas only 15% of its needed workforce.
The ICM highlights that the problem extends beyond training. In many countries, there is a systemic failure to employ qualified midwives where they are most needed and to retain those already in the health service. Professor Jacqueline Dunkley-Bent, ICM's Chief Midwife and co-author, explained that midwives are often "educated but not absorbed into the workforce or not enabled to practise fully," which worsens the shortage.
The Staggering Human Cost
The human impact of this shortfall is devastating. Previous studies indicate that universal access to midwife-led care could avert two-thirds of all maternal and newborn deaths and stillbirths. By 2035, this could save an astonishing 4.3 million lives every year.
Without this care, intervention rates rise, and women face a higher likelihood of receiving poor-quality treatment or even mistreatment during childbirth. Despite a gradual increase in midwife numbers globally, researchers warn the gap will persist well beyond the 2030 deadline set by international sustainable development goals to reduce maternal and child mortality.
The ICM is urging governments to take immediate action, calling for signatures on a global petition to boost investment in the profession. "When midwifery is a respected and well-supported profession, more women are motivated to train and stay in the workforce," said af Ugglas. "That is how countries improve health outcomes and build stronger, more sustainable health systems."
