Around the world midwives face challenges in implementing the lifesaving care they’re needed to provide. Ensuring that midwives can lead the way to strengthening maternal and newborn health, including sexual and reproductive health and rights, is an essential step in reaching global and national goals. Seven midwives from the International Confederation of Midwives’ (ICM) Young Midwife Leaders (YML) Programme reflect on why midwifery leadership needs to be strengthened.
The Young Midwife Leaders (YML) programme is a part-time, two-year learning and professional development experience for 15 early-career midwives and 5 executive midwives from the International Confederation of Midwives’ member associations.
Anitah Kusaasira, Midwife, Uganda
I have been a midwife for over ten years, and as I grow in this profession, I have come to learn that it is beyond labour suit (or just the delivery of the baby). I have come to realize that it about mothers, babies, families and communities. And for anyone to be able to handle all this at a time, it important to learn how to lead.
We would say this is a noble profession – which indeed it is – because you’re able to offer services to everyone around you. However, there is a lot that still needs to be done in the midwifery profession to make it better.
Before I joined the YML program, I was at the verge of leaving the profession because I felt overwhelmed and tired of the challenges both mothers and midwives go through in my country.
This is because in my country there are only a few midwives who are involved in leadership, making our voices hard to hear.
It’s important to strengthen midwifery leadership because it increases visibility of the profession and its role in the health care system. Strengthening midwifery leadership will help in having more midwives at tables where decisions are made, thus influence policy changes about the profession. With this we will have better health outcomes for our mothers and improved working conditions for midwives.
The YML program has helped me to understand that I have a leadership role to play and I am getting strengthened to be a better leader instead of running away from the profession.
Ashu Martha Agbornyenty, Midwife, Cameroon
I love to refer to Midwives as Innovators. This is because in many ways, they are constantly on a quest to find ways to simplify knowledge and provide substantial help to women and their families.
It is often said that ‘Every rose has its thorn’. No matter how much good and help midwives render to the community, they still encounter challenges. A typical example of one such challenge is a terrible experience I had during one of my internship as a second year midwifery student.
A lady came for her antenatal checks and I was asked to take her vital signs. Once I approached her, she turned away from me speaking loudly and rudely saying ‘How can a very little girl, someone who knows nothing about a woman’s body during pregnancy want to touch me’. I felt demoralised! I wondered how I was going to get past this particular day, but eventually I did. This is one of the major challenges that young midwives face in the communities.
Young midwives are minimised, which restricts their career growth as it tends to discourage them from ever wanting to practice.
Midwifery leadership needs to be strengthened because they are key to improving health outcomes for women and their newborns during childbirth. Also, because they help navigate the constant evolution of health care. The YML program has groomed the leader in me and it is evident in my YML project execution. I am now determined to pass on these leadership skills to many other young midwives in Cameroon. One more thing, remember to encourage any midwife you encounter. They are doing a great job!
Doreen Mwazani, Midwife, Malawi
Midwifery as a profession is very vital, yet midwives face a lot of challenges. In a community, resistance in responding to new ideas – adaptability – is a major challenge. As I started my project as a YML, a good number of people could not agree to the interventions that I proposed and it took a while for them to realise how perfect the ideas were.
Being questioned by a lot of people, is not easy to deal with. Fear of failure when you have convinced your boss that your idea will work is also a challenge. Opposition from forces in the community, lack of funding and other resources are also challenges I face as a midwife.
With that being said, leadership needs to be strengthened. Successful leaders are able to transform communities and create better results.
Successful leaders will be able to create a vision for the community and inspire others to achieve it.
Leadership training helps one to prepare for responsibilities and challenges that can be faced in due course and it helps to build trust and inspires confidence. Because of leadership, people come together to make things happen.
Jeffthanie Mathurin, Midwife, Haiti
Haiti is a country that for several years, has been facing various crises that are increasingly jeopardizing the well-being of the population, as well as its health. And maternal, sexual and reproductive health is becoming more and more affected.
Unfortunately, the insecurity situation that is currently raging is at a level where even health workers no longer feel safe.
From January 2023 to April 2023, almost half of Haiti’s health workers have left the country in search of a place where they would feel safer, torn between the love of their profession, the love of their country, and the instinct to survive.
Haiti is the country with the highest maternal mortality rate in the Caribbean. Can we imagine it losing its midwives on a daily basis when the number of midwives was not sufficient to meet the needs of maternal, sexual and reproductive health?
I think it is time to put our feet on the ground, a time when the main stakeholders are obliged to take the lead in advocating for a new Haiti where all rights are respected. Both those of the beneficiaries and those of the providers.
At a time when it is obvious that no one will ever be able to leave the country, when young midwives in the making are without hope, when women and girls need assistance the most, it is more than important that the midwifery profession be strengthened in leadership to help lead this struggle in Haiti and even throughout the world by advocating for better living conditions for women and midwives!
Zakia Abdullahi, Midwife, Somalia
I believe that the effective leadership of midwives will promote high quality maternal and newborn health. When midwives are in position to lead the care of women and their families they will reduce the risk of getting unnecessary procedures for the women and their families.
One of the challenges every young midwife encounters is to showcase their talents either from the community they work in or from senior professionals.
The YML program has sharpened my leadership skills, built my capacity and given me strength to lead. I am dedicated to proceed my skills and knowledge into young midwifes in my country.
Feri Anita Wijayanti, Midwife, Indonesia
Someone told me something that I would never forget: skills do not appear instantly but require time and practice to understand and master them. Leadership is no exception.
As a midwifery lecturer, one of my tasks is to nurture a leadership culture for my students at the roots. This should continue to be fostered throughout their careers after graduation. Implementing and educating my students is not an easy job. I face many challenges, such as the lack of knowledge about leadership among students and midwife preceptors, the lack of empowerment, limited role models for leaders in clinical practices, and communication difficulties.
In the second year of work as a midwifery lecturer, I was assigned for the first time as a clinical instructor for midwifery students who undertook a leadership rotation within their clinical placements. I went to the private midwifery clinic to evaluate their learning activities. I asked my students while reviewing their logbooks and reports. Surprisingly, most of them did not understand much about the concept and implementation of leadership, although they got a lecture class in leadership. They were unable to use clinical placements to develop leadership skills.
It has been suggested that forces are in place in clinical practice settings that encourage midwives to follow; instead of lead.
It is crucial to strengthen leadership among preceptor midwives in clinical practice settings to equip them to become role models and educate their pupils during clinical placements. Creating a leadership environment from diverse insights, including midwife educators, students, and midwives’ preceptors, will be better to ensure the sustainability of leadership education.
Rose-Cardelle B. Riche, Midwife, Haiti
The midwife has an essential role for quality care all over the world. To achieve this, midwives must rely on technical training, midwifery skills and leadership. By strengthening the leadership of midwives, it allows them to develop creativity and create change with a significant impact, through which they evolve.
Let us take the case of our situation in Haiti where we face different kinds of problems, the most important of which is the recognition of the profession of midwife. We need real leaders to achieve this goal.
Through the YML and EML program, which is training a young midwife and strengthening a midwife of the association, this important pairing will allow us to work, create, make arrangements that will lead us to our greatest objective. Leaders mainly talk about why and what they want for the world of tomorrow.