Imagine trying to perform a C-section, or conduct a delivery, in a hospital with no light.

For hundreds of thousands of health workers, this is the reality they face each night. Close to 300,000 women and one million newborns (primarily in sub-Saharan Africa and Southeast Asia) die from complications of pregnancy and childbirth each year. Hemorrhage, infection, eclampsia, obstructed labor, and unsafe abortion cause the majority of obstetric deaths— many of which could be prevented with access to timely emergency obstetric care.

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.

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.

In 2022, the Dot-Mom column published several pieces from expert guest authors from the greater maternal and reproductive health community. In our top read guest contributor piece of the year, Susie Jolly examined the role of colonialism in sexuality education globally. Jolly highlighted examples where sexual health knowledge is built on unethical medical research carried out on racialized people, such as the study of untreated syphilis among Black men in the United States. Sexuality educators, especially those placed in the Global North, have a responsibility to work to decolonize their work. Jolly suggests supporting resources led by marginalized people, critically examining colonialism’s influence in the understanding of sexuality, and shifting the dynamics of who decides on content to lend more weight to non-Western expertise and young people learning from their own experiences.

More than 60 percent of preventable maternal deaths and 45 percent of newborn deaths take place in countries affected by recent conflict, natural disaster, or both. Yet as Sarah B. Barnes, Project Director of the Maternal Health Initiative, observed at a recent event hosted by the Wilson Center and UNFPA, in collaboration with the Inter-agency Working Group on Reproductive Health in Crisis (IAWG) and White Ribbon Alliance, “the leading causes of both maternal and newborn death occurring in humanitarian settings are considered to be preventable if managed by skilled providers and adequate resources.”

Reducing maternal mortality is key to promoting population health. It is also a main priority of the UN General Assembly’s Sustainable Development Goals. And the reasons for concern are clear. Globally, 800 women and 6,500 infants die during pregnancy and birth every day. More than 94 percent of these deaths occur in low-and-middle-income countries (LMICs).

“When women can decide on the timing and spacing of their births, are treated with respect, and offered quality of care across the life course—they are not only able to survive, they, their families, and their communities are able to thrive and flourish. By directly and indirectly contributing to women’s empowerment, midwives are contributing to strengthen economic and productive and equitable societies,” said Dr. Julitta Onabanjo, Director of the Technical Division at the United Nations Population Fund (UNFPA), New York, at a recent event hosted by UNFPA as part of the 66^th Session of the Commission on the Status of Women. Midwives and midwifery experts convened to discuss the important role that midwives play in the improvement of gender equality, women’s economic empowerment, and climate justice.

“Regardless of income level, regardless of education level, Black women, Native women, women who live in rural areas are more likely to die or be left scared or scarred from an experience that should be safe and should be a joyful one; and we know a primary reason why this is true – systemic inequities,” said Vice President Kamala Harris during her opening remarks at the first-ever White House Maternal Health Call to Action Summit on December 7, 2021. Members of Congress and maternal health advocates gathered to discuss the importance of addressing racial disparities and systemic challenges in maternal health through national policy.