Every birth marks a beginning. But behind every safe beginning stands a trained midwife.
This year’s International Day of the Midwife (May 5) carries a powerful and urgent message: ‘One Million More Midwives’. It is not simply a slogan. It is a global call to action. A recognition that the health of women, babies, families and entire communities depends on whether we invest in the professionals who stand at life’s first and most vulnerable moments.
Midwives are not simply present at birth; they are central to safe, respectful and evidence-based maternity care. They monitor pregnancies, detect complications, support informed decision-making and provide care that recognises childbirth as a profound human transition. They are trained professionals working at the intersection of science, skill and compassion.
Yet worldwide, there is a critical shortage of midwives, one million to be exact.
The call for “one million more” is rooted in a simple truth: without enough midwives, maternal and newborn health suffers. When maternity services are overstretched, the quality of care is harder to sustain. Continuity of care declines. Emotional support becomes limited. Prevention gives way to reaction. And the burden on already strained healthcare systems grows heavier.
This is not only a challenge for large or low-resource countries; it is a conversation that matters for Malta too.
As our population evolves and healthcare demands increase, maternity services must keep pace, not only in technology and facilities, but in human resources. Midwifery is a highly skilled profession that requires years of education, clinical training and ongoing development. It cannot be scaled overnight. Planning for the future must begin now.
Investing in more midwives is not a luxury; it is one of the most effective ways to strengthen healthcare systems. International evidence consistently shows that care models in which midwives play a leading role for women with uncomplicated pregnancies are associated with excellent safety outcomes, fewer unnecessary interventions, greater maternal satisfaction and improved emotional well-being.
Midwife-led care is often misunderstood. It does not mean care without doctors, nor does it exclude obstetric expertise. Rather, it is a model in which midwives are the primary caregivers for low-risk women, while working within a system where obstetricians are readily available if complications arise. It is about using the right professional, at the right time, for the right level of need.
In Malta, maternity care within the hospital setting is primarily obstetrician-led, reflecting a system designed to ensure immediate access to specialist medical intervention. This has clear strengths, particularly for high-risk pregnancies and emergencies. However, strengthening the role of midwives within this framework offers an opportunity to enhance care, not compete with it.
In Malta’s close-knit society, the impact of midwifery is deeply personal
When midwives are empowered to practise to the full extent of their training, leading care for low-risk women, providing continuity across pregnancy, birth and the postnatal period, obstetricians can focus their expertise where it is most needed. This makes the entire system more efficient, responsive and person-centred. It also reduces pressure on specialist services while maintaining safety.
Midwifery-led approaches place strong emphasis on continuity. This means being cared for by a known professional or small team throughout the maternity journey. This continuity builds trust, improves communication, and allows early identification of physical or emotional concerns. For women, this can transform childbirth from a fragmented medical process into a supported life transition.
But numbers alone are not enough. Retention matters as much as recruitment. Midwives work in emotionally intense environments. They witness joy and relief, but also anxiety, loss, and high-stakes decision-making. They carry responsibility not only for clinical outcomes but for the emotional experience of families at a defining life moment.
Supporting midwives means ensuring safe staffing levels, professional recognition, opportunities for advancement and working conditions that allow them to practise at the full scope of their expertise.
Midwives do far more than assist at birth. Their role spans pregnancy education, post-natal care, breastfeeding support, reproductive health and early parenting guidance. Their work strengthens families at the very beginning, laying foundations that affect health, development, and wellbeing for years to come. When we invest in midwives, we invest in prevention, resilience, and community health.
In Malta’s close-knit society, the impact of midwifery is deeply personal. A midwife may care for a woman during her first pregnancy, later support her daughter, and then guide the next generation. Their work becomes woven into family histories, often remembered not only for clinical competence but for calm reassurance, advocacy and humanity.
The call for one million more midwives is ultimately a call to value care and to use it wisely. It asks governments and institutions not only to train more professionals, but to create systems where their skills can be fully used.
For Malta, the conversation is not about choosing between obstetric or midwifery models. It is about evolving
towards a collaborative approach where both professions work to their strengths for the benefit of mothers and babies.
On this International Day of the Midwife, gratitude is important, but action is essential. Expanding and strengthening the midwifery workforce is one of the clearest steps we can take towards safer births, healthier women and stronger communities.
Because when we ensure there is a midwife for every mother, we are protecting not just a moment, but a lifetime that begins with it.
Georgette Spiteri is an education officer, Malta Midwives Association; senior lecturer, Department of Midwifery, University of Malta; and senior midwife, Gozo General Hospital.