More investment in midwifery could save many of the millions of babies and hundreds of thousands of women who still die every year because of a lack of skilled healthcare during childbirth, the United Nations said on Monday.
In the first global midwifery report for 35 years, the United Nations said as well as saving lives and preventing disability, good midwives can also help contribute to a country's human and economic development.
"If we want to stop these women and babies dying, we need to invest in skilled care," said Flavia Bustreo of the family and community health department at the World Health Organisation, one of around 30 organisations who compiled the report - the first systematic survey of midwifery worldwide since 1976.
"Midwives can provide such care in communities and primary health care services. They can also link women up with emergency obstetric care services if they need them."
Increasing access to midwives has become a focus of global health efforts since it is central to three of the Millennium Development Goals agreed by the international community to reduce child death, improve maternal health and step up the fight against AIDS, malaria and other diseases by 2015.
The report found that every year 358,000 women and 3.6 million newborns die due to largely preventable complications in pregnancy, childbirth and the postnatal period. Up to another 3 million babies are stillborn.
No comparative figures were available because the report was the first of its kind by the United Nations.
The report surveyed 58 countries representing just under 60 percent of all births worldwide but 91 percent of all maternal deaths. It estimated that countries need a minimum of six skilled birth attendants for every 1,000 births if they are to achieve 95 percent coverage.
It said that among the 38 countries most desperately in need of midwives, 22 needed to double their midwifery workforce by 2015 and seven needed to triple or quadruple it.
Nine countries -- Cameroon, Chad, Ethiopia, Guinea, Haiti, Niger, Sierra Leone, Somalia, Sudan - needed to scale up midwifery by a factor of between 6 and 15, it said.
"Ensuring that every woman and her newborn have access to quality midwifery services demands that we take bold steps," UN Secretary-General Ban Ki-moon wrote in the report's foreword. "Our responsibility is clear: we must safeguard each woman and child so they may live to their full potential."
The report, commissioned and coordinated by the United Nations Population Fund (UNFPA), was launched at an International Confederation of Midwives in Durban, South Africa.