Improving the plight of midwives to lessen maternal deaths
Last week’s passage on third and final reading of House Bill (HB) 10079 authored by Bulacan Representative Salvador Pleyto is a welcome development that has long been awaited. It’s a step closer to improving the midwifery profession in the country which, in turn, would hopefully lead to a sizeable reduction of maternal deaths which reaches a yearly total of around 2,600 Filipino women dying due to complications from pregnancy or childbirth.
“Many of these deaths are preventable if only there were accessible proper medical interventions and adequate healthcare systems that are also resilient to emergencies,” according to Dr. Leila Saiji Joudane, country representative of the United Nations Population Fund (UNFPA) Philippines.
“For every 1,300 women and girls in reproductive age, there is only one public health midwife. In the Philippines, 14 percent of pregnant women do not get regular check-ups and the other necessary medical care that they need during their pregnancy,” she said last year.
Thus, Rep. Pleyto’s bill to strengthen the state of midwifery in the Philippines and encourage more people to serve as professional midwives is of extreme urgency and importance. Coauthors of HB 10079 include Reps. Ron Salo, Kristine Alexie Tutor, Ciriaco Gato, Margarita Nograles, Elizaldy Co, Stella Quimbo, Maty Cajayonuy, Luis Campos, Emigdio Tanjuatco, Mario Mariño, Loreto Acharon Jr., Zaldy Villa, and Geraldine Roman.
“This bill is equipped with provisions that will help midwives gain more knowledge in the practice of their profession,” Rep. Pleyto said. “This is a tribute to our midwives who have been serving our country for almost all their lives.”
The bill certainly seeks to strengthen the vital role of midwives in the front lines of healthcare, as well as improve the regulation and education of midwives in line with global standards.
And, equally important, HB 10079 seeks to upgrade pay benefits and working conditions. It ensures that the compensation of entry level positions in public health facilities are not lower than Salary Grade 11, while those in private facilities have salaries and benefits not lower than the minimum wage set by the DOLE.
It seeks to ensure quality midwifery education, with support of the Commission on Higher Education and Profession Regulatory Board of Midwifery, by establishing education standards, including minimum qualifications of faculty and facility requirements for training.
It also lists the scope of the midwives’ work in managing pregnancies and deliveries, identifying pregnancy complications, caring for the newborn, carrying out the written order of physicians on natal, ante-natal, intra-natal and post-natal care of pregnant mothers, among other functions.
It’s well known that for the longest time, our midwives belong to the most neglected and marginalized licensed professional health workers in the country. They continue to face many challenges pertaining to how they are treated, their onerous work load, and meager pay, among many others.
Tasked primarily to assist and care for mother and child during pregnancy, birth and postnatal period, the midwife, commonly known as komadrona, are compelled to perform other functions – from attending to kids getting immunized and circumcised, to providing post mortem care for the dead.
The komadrona is hero in the remotest areas of the archipelago, a lifeline to people in dire need. It is common knowledge that six to seven out of every 10 impoverished Filipinos still die without ever seeing a doctor or nurse, and the only healthcare professional poor people ever see throughout their lives is the komadrona.
From start of life to the end of life, the komadrona is usually relied upon amid the oppressive situation plaguing the noble profession – particularly the low pay, slow promotion, and the arduous work load that can be outside the work scope.
The plight of midwives certainly needs to be improved to reduce maternal deaths. Around 4.3 million lives per year worldwide could be saved by investing in midwife-led interventions, says a 2020 study by the UN Population Fund, World Health Organization (WHO), and International Confederation of Midwives.
“About two-thirds of maternal deaths, newborn deaths and stillbirths could be prevented by 2035 if the current level of care by professional midwives educated and regulated to international standards was scaled up to provide universal access,” the WHO said about the study. “These findings should leave no doubt in the minds of ministers of health, education and finance that midwife-led interventions have the potential to save the lives of women and their newborns at a vast scale.”
Thus, the significance of HB 10079 cannot be overstated. Now, it’s up to the Senate to pass its counterpart bill so a law can be enacted to improve the plight of the komadrona and reduce maternal deaths.