The noble profession of midwifery

Ntsoaki Motaung

“Hearing a baby’s cry and seeing the smile on the mother’s face is the most fulfilling moment to every midwife.”

This is how Lahlewe Kao, a midwife at Khabo Health Center in Leribe district summarises the essence of her daily job.

A prayer warrior who relies on the power of prayer as a weapon for successful deliveries, Kao uses her passion for midwifery as inspiration in her otherwise critical line of work.  

“When I started school, I wanted to become a nurse because I wanted to be part of people who save other people’s lives, but eventually I ended up a being a midwife, someone who assist in bringing people into this world,” she reminisced.

This paper met Kao during a recent visit to different health centres in remote areas of Leribe and Berea districts.

The visits were supported by the United Nations Population Fund (UNFPA) – a UN agency aimed at improving reproductive and maternal health.

UNFPA provided resources for journalists to go out in the remotest areas of Leribe and Berea to gather stories of midwives as part of the World Midwifery Day marked on May 5.

UNFPA views midwives and other people with midwifery skills as the main caregivers for women and their new-borns during pregnancy, labour, childbirth and in the post-delivery period.

The organisation therefore stands in solidarity with midwives worldwide appreciate the life-saving work they do.

This year’s theme was “Together again: from evidence to reality”.

It is explained to honour the efforts of midwives and their associations to action critical evidence like, the State of the World’s Midwifery (SoWMy) 2021, towards meaningful change for their profession, and the women and families they care for.

According to the 2016 national census, Lesotho has a high maternal mortality ratio of 618 deaths per 100,000 live births.

“Most of the maternal deaths are caused by, among others, long distances that women have to travel to access sexual and reproductive health services, haemorrhage (uncontrolled bleeding), infection (including HIV), hypertensive disorders (high blood pressure) and other causes,” the census report noted.

According to Kao, one has to be passionate about their work to be a good midwife, and they must have a lot of patience.

“To be a good midwife, one has to be passionate about their work and they have to have to be very much patient,” she said.

One must also have love for other people and most importantly, be someone who loves children.

Kao started practicing midwifery in 2019 at Tsatsane Health Center and moved to Khabo Health Center in March 2022.

She said since her arrival at Khabo Health Center, she has delivered between 15 and 20 babies, all of whom lived.

Kao noted that midwifery is one of the hardest jobs because they are entrusted with the lives of two people; being the baby and the mother, and if anything goes wrong, they are held responsible.

The day she will never forget in her job, she said was when a placenta got stuck inside a woman she had just successfully helped deliver a healthy and bouncy baby.

She said she called for an ambulance to come and transport the patient to the catchment hospital, Motebang Hospital, but was regrettably told an ambulance was not available.

“I was very scared of the worst case scenario, I was frustrated and started calling anyone I thought would be available to help me, but eventually I was told transport was on the way.”

“…It took longer than expected and I was not coping, but it eventually arrived and the mother was moved to a hospital and received help and by God’s grace, she was saved,” she recollected, saying that was her first traumatic encounter.

Hato Ramapepe, one of the male village health workers’ coordinator at Thaba Phatoa Health Center emphasised that midwives do an honourable job of bringing lives to the world amid many challenges.

“In this part of the country our real issue is women walking long distances to access clinics, a burden to their health and well-being, and that of the unborn babies they are carrying.

“One day an incident happened when a pregnant woman who was walking to the clinic needed urgent medical assistance, she was in the company of a village health worker. The reality they were both facing was that the clinic was too far and the baby was fact demanding to join the world. The village health worker called the clinic and midwives came with all their tools.

“The child was delivered right on the road. We saw dedication of health professionals who pitched a tent and created a mobile clinic just for the baby to be delivered, and indeed the child was born health with no complications.

“That incident confirmed that there are people who take their jobs seriously and Midwives in my view take the cake,” Ramapepe said.

According to the 2021 State of the World’s Midwifery report, by the World Health Organization (WHO), the International Confederation of Midwives (ICM) and the United Nations Population Fund (UNFPA), the global shortage of midwives stands at 900 000, and is particularly acute in Africa. With estimates that 75 percent of essential needs for maternal and reproductive health scare are met by midwives, it is concerning that the comparative figure for the WHO African Region is only 41 percent.

According to WHO, Midwives are central to the prevention of maternal and newborn deaths, and stillbirths. With adequate investment in midwifery, the report says that 4.3 million lives could be saved annually by 2035.

“Unfortunately, if current trends persist, only 300 000 midwifery jobs are likely to be created in low-income countries, with the shortage of midwives set to increase to 1 million by 2030. This has serious implications for the Sustainable Development Goal target of reducing the global maternal mortality ratio to less than 70 per 100 000 live deaths before 2030.”