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At the Women Deliver conference held this week in Kuala Lumpur, Malaysia, sexual and reproductive rights advocates have convened to present strategies on how to expand access to contraception and abortion to poor women and girls in developing countries.

One such strategy is incorporating family planning and abortion as essential competencies provided by midwives. A full day symposium hosted by UNFPA and a subsequent follow-up meeting discussed how to help governments scale up midwifery programs.

However, during a breakout session some attendees expressed concern over the “continuum of care” being proposed. “If you want to reduce maternal mortality,” a woman from Malawi said, “then let’s look at morbidity.”

“Women are dying from lack of skilled birth attendants — this is the service they need to provide,” she continued.
One of her colleagues added that additional midwives were needed but the country lacked the funding to train them.

Countries that have made significant progress in lowering maternal mortality have done so by scaling up midwives.

A health care stakeholder from Ghana said that midwives in his country were already providing comprehensive abortion services.

While most maternal deaths occur from childbirth complications, family planning advocates primarily focus on increasing contraception prevalence to lower fertility rates and expanding access to abortion to reduce maternal mortality.

By supporting the scale-up of midwives, family planning advocates know modern contraceptive methods and abortion services will be more accessible and it allows them to tap into funding previously designated to maternal and child health services.

Because the Helms amendment prohibits U.S. funds from being used to perform or promote abortion, this new continuum of care should disqualify midwifery programs from receiving USAID funding.

[30 May 13, Lisa Correnti, KUALA LUMPUR,, ]