One in every 23 people is expected to need humanitarian assistance in 2023. That is a record 339 million this year alone. During such humanitarian crises, the needs of women, newborns and adolescents are often unmet, with devastating consequences. In fact, in 2023, 58 percent of global maternal deaths, 50 percent of newborn deaths, and 51 percent of stillbirths worldwide occur in the 29 countries with a UN humanitarian response plan or regional response plan.

Four months ago, the resident medical officer at the HIV and AIDS clinic in Kampala, Uganda reported that the clinic treated up to 50 patients a day. Now, the clinic is relatively empty, and supplies of antiretroviral therapy (ART) pile up, unused.

It is a sign of enormous progress that vaccines are currently available to prevent more than 20 life-threatening diseases. And health and economic data supports the widespread benefits of regular access to vaccination in public health. Yet it is estimated that 20 million infants or so each year do not have access to vaccination for a number of diseases, including varicella (also known as “chickenpox”).

In 2021, 1.9 million stillbirths occurred globally. A baby who dies at or after 28 weeks of pregnancy,* and is born with no sign of life is classified as a stillbirth. Stillbirths can be caused by pregnancy and childbirth-related complications, like hemorrhage, placental abruption, and pre-eclampsia; maternal infections during pregnancy, including malaria and sexually transmitted infections; prolonged pregnancy to 42 weeks or more; and pre-existing health conditions. Other risk factors include maternal age and smoking during pregnancy.

Midwives play a central role in maternal and newborn health. So, it is fitting that their efforts took the spotlight at a two-day event – The 5^th Global Midwifery Symposium – held during the first ever International Maternal and Newborn Health Conference (IMNHC) in May 2023 in Cape Town, South Africa.

Women who are treated with respect and dignity during childbirth are more likely to have positive birth experiences, feel empowered to make informed decisions about their care, and have better health outcomes for themselves and their newborns. 

A recent report on global maternal mortality by the World Health Organization (WHO) reveals a hard truth: the world has been ignoring the needs of pregnant women. While there have been substantial reductions in maternal death rates since 2000, progress has stalled or been reversed in some countries after 2015, even before COVID-19 exacerbated the situation. Nations affected by humanitarian emergencies, conflicts, and other crises fared the worst.

Of the more than 4 million pregnant people in the United States annually, 90 percent report taking at least one medicine during pregnancy, and about 50 percent receive the influenza or tetanus toxoid/reduced diphtheria toxoid/acellular pertussis (Tdap) vaccines. Yet 69 percent of clinical trials conducted in the United States explicitly exclude enrollment of pregnant people.