Globaldev careers: The midwife

BARCELONA — The work of a midwife is not limited to labor wards and deliveries. These health professionals also play a critical role in reducing child and maternal mortality through community education, family planning services, and advocating for women’s reproductive rights. There can be many misconceptions about the role and expertise of midwives, and this is one of the challenges of the job, said Olajumoke Adebayo, who works in a midwife-led health center in Nigeria, where the rate of maternal deaths is particularly high. Adebayo, who is also a member of the Young Midwifery Leaders program at the International Confederation of Midwives, spoke to Devex about what her daily work looks like, the different ways that midwives are contributing to global health, and how the role is evolving. The conversation has been edited for length and clarity. What does your day-to-day look like? In the morning, we have women coming for immunizations because the government covers free immunization for children 0-5 years. So we use this as an opportunity to educate [the women] on different health topics, from breastfeeding to the importance of immunization, family planning, contraception. In the afternoon we provide family planning services, and then when we have labor cases during the day or in the night, we attend to [those]. It’s a midwife-led [center], so usually you don’t have doctors around. If I’m not on my day-to-day job, I volunteer for a nongovernmental organization where we go into slum communities in Lagos, Nigeria, and provide free antenatal services to the women in these communities, because it’s really difficult for them to reach primary health care services. Then I also run an organization where I provide sexual health education to young people and women. [This] actually started as a blog when I was a student. I was in class one day and [thinking about how] women were dying from causes that were preventable and if they had information they could prevent this. What skill sets have you found to be most valuable and focused on building to progress in your career? Apart from clinical skills, I’ve learned empathy and listening to women — which might seem like a small skill but means a lot. We have a lot of women coming in for different services, and it’s easy to get carried away and not listen [to what they’re saying] and just do your task. … But I’ve learned that you have to always listen to their concerns and be able to alleviate their fears. … Then you see that women are able to stay on their family planning methods longer than when they do not have that support. Sometimes it’s not about providing the services; it’s about just listening to them. [I’ve] also learned more about design thinking and using [this] approach to help solve problems in women’s health and midwifery. With design thinking, it’s about reimagining what the deliverable should be and what the approach should be. For example, by teaming up with the user of your service, you might understand that some women like to stand during birth. … And you are able to redesign and reimagine everything from the labor wards to health systems. How have you seen the scope of your work change over recent years as the sector has changed? I’ve had to work in different areas, from the clinical setting to the nonclinical. As a clinical midwife, I’m there taking births, providing family planning services, but then I’ve also had to start providing health education through content development. [This] is another skill that can be developed as a midwife to educate women online so that they don’t always have to walk into the health center or the hospital. “I wake up every day knowing that I am going to make an impact.” --— Olajumoke Adebayo, midwife and Young Midwifery Leaders member I’ve also seen myself working with startups to design maternal health solutions and programs. There are a lot of health startups and innovations around reducing maternal mortality and improving health for women, but sometimes they might not have the health personnel to guide them. I’ve also had to work with nongovernmental organizations on their programs and to provide services … and with adolescents in providing youth-friendly services to them. The work of a midwife goes on the continuum from adolescents to their childbearing years, so your role doesn’t just stop at delivering babies. What should people know before pursuing this career path? The most important thing is that you have to have the rights [and interests] of women in your heart. … You also have to be a resilient person, be very empathetic and patient. If you are going [into this career] for the money, sadly, I cannot promise there is a lot of income, which is something we are hoping to advocate for because we deserve to be paid well. But if you want to impact and change lives, then it is [a good fit] because midwives are important in reducing maternal and child mortality. What advice would you have for other professionals interested in a career in midwifery? They should not be limited in their understanding of what midwifery is, because I know that a lot of times, people think about midwifery as just delivering babies. But there are different areas that you can work in: midwifery education, research, then there’s a lot of work in regulation and policy. Be empathetic, have respect for women, and be very resilient … because midwifery [can be] a very emotional profession, and there are times that you have losses or you are not able to achieve what you want to achieve. … So you have to understand and be prepared for that. But it’s a very fulfilling career; I wake up every day knowing that I am going to make an impact.