May 5, 2025 -  The International Day for the Midwife event, themed "Midwife in Every Crisis," was held by the Ministry of Health of Oman and UNFPA GCC Office to address the critical role of midwives in maternity care, particularly during crises. The event convened healthcare professionals, experts, and leaders to discuss challenges faced by midwives and strategies to improve maternal care, focusing on professional recognition, midwife shortages, and service preparedness. This report details the discussions and recommendations for strengthening maternity care during emergencies.  

The event was designed to achieve several key objectives. It aimed to highlight the critical role of midwives in providing essential maternal care during crises, focusing on the unique challenges they face in both natural and non-natural emergencies. A core emphasis was placed on the importance of midwives in ensuring the continuity of care for pregnant women during such disruptive times. Furthermore, the event sought to address the significant challenges related to midwifery recruitment, recognition, and retention. Panel discussions — featuring representatives from the Ministry of Health, UNFPA, midwives, and health professionals working in academia — covered the shortage of midwives, particularly during emergencies, and the necessity of achieving professional recognition for midwifery as a distinct healthcare specialty. The lack of incentives, limited training opportunities, and the difficulties in retaining midwives were also thoroughly examined.  

Moreover, the event aimed to explore strategies for strengthening maternity care by identifying key solutions to the challenges faced by midwives. These solutions included the need for specialized crisis training, improvements in governance structures, and the development of integrated crisis preparedness plans that specifically include midwives and other maternal healthcare professionals in emergency response systems. Additionally, a significant objective was to promote midwifery as a recognized profession by advocating for its formal recognition within the broader healthcare system. This advocacy included calling for the independent licensing of midwives, separate from general nursing licenses, the provision of professional incentives, and the creation of career advancement opportunities to enhance recruitment and retention rates. Finally, the event sought to encourage the adoption of technology in maternal healthcare during crises. This was to be achieved by promoting the use of mobile units and telemedicine solutions to maintain access to maternal healthcare, especially in remote or isolated areas where physical access to healthcare facilities may be limited.  

Discussion

The event facilitated discussions around several key themes. The recognition and professional identity of midwives was a central theme, with discussions focusing on establishing midwifery as a distinct profession from general nursing. Participants emphasized the need for official recognition and licensing of midwives and proposed the creation of a Coalition of Midwives to advocate for this cause. The introduction of a dedicated license for midwives, to clearly distinguish their role from that of nursing, and the provision of incentives for midwives working in high-risk areas, similar to those offered in other specialties like mental health, were among the key recommendations.

Crisis governance and preparedness was another critical area of focus. Discussions addressed the adequacy of current preparedness plans and maternity services, the need for maternity care representation in national crisis committees, and the importance of effective governance from top-level authorities. Recommendations included ensuring midwifery representation in national crisis management committees to prioritize maternity care during emergencies, reviewing and updating national preparedness plans to include maternity services in crisis protocols, and strengthening governance at all levels, from national to regional, facility, and even village levels.

The training of midwives during crises was also extensively discussed. Participants highlighted the necessity of specialized crisis management training for midwives, focusing on the specific skills needed to handle emergencies and provide psychosocial support. Recommendations in this area included implementing specialized training programs for midwives on crisis response and psychosocial support, collaborating with international agencies to integrate best practices into training programs, and providing ongoing education on crisis management as part of midwives' professional development.

In addition, the use of mobile units and telemedicine to enhance maternal care, particularly in crisis situations, was another significant theme. The creation of mobile units for maternal care in remote areas during crises and the use of telemedicine to provide virtual consultations during emergencies were explored. Recommendations focused on developing mobile midwifery units for maternal care in remote or isolated areas, expanding the use of telemedicine to ensure continued maternal care when physical access is limited, and ensuring that mobile units are equipped with all essential maternal and neonatal care services.

Psychosocial and mental health support for pregnant women during crises was recognized as a crucial component of care. Discussions addressed the psychological distress experienced by pregnant women in crisis situations and the importance of integrating mental health support into crisis plans. Recommendations emphasized the need to integrate mental health support as a core component of maternity crisis plans, provide training for healthcare professionals, including midwives, on providing psychosocial support during emergencies, and ensure that counseling services are readily available for women affected by crises.

Furthermore, the importance of community involvement and women’s feedback in shaping effective crisis preparedness was also highlighted. Discussions focused on incorporating the perspectives of women and the broader community in crisis preparedness efforts and addressing the specific needs of women during crises. Recommendations included conducting community surveys to gather feedback from women about their experiences during previous crises, actively involving women’s voices in planning processes, and partnering with community organizations to educate and prepare women for potential crises.

Additionally, the value of collaboration with international organizations to enhance maternal crisis management was another key theme. Participants discussed the importance of learning from other countries’ best practices in maternity crisis management and the role of UN agencies in supporting preparedness plans. Recommendations focused on collaborating with UN agencies and international organizations to review and improve crisis preparedness plans, learning from countries with effective maternity crisis plans, and seeking technical support from global experts in maternity care during crises.

Finally, the event addressed the critical issue of prenatal midwifery training and education. The current shortage of prenatal midwifery trainers and the need for additional trainers and expanded prenatal education programs were discussed. Recommendations included increasing the number of trained prenatal midwifery educators by offering certification programs for midwives to become qualified prenatal trainers, implementing a train-the-trainer model to expand the reach of education, and expanding virtual prenatal education options to reach a larger population, particularly in remote areas.

The panel discussion effectively centered on the vital role of midwives in ensuring effective maternity care during crisis situations. Key topics included the challenges midwives face, notably shortages and the lack of professional recognition, and the urgent need for a more coordinated and integrated approach to maternity crisis preparedness. The discussions also emphasized the importance of fully integrating midwives into national crisis management committees, thereby ensuring that their critical role in maternal care is both recognized and adequately supported during emergencies. Proposed solutions encompassed specialized training initiatives, robust mental health support systems, and the strategic use of telemedicine and mobile units to enhance access to care, especially in remote areas. Furthermore, the event acknowledged community engagement and incorporating feedback from women as essential components for effective planning and response strategies.

Recommendations

The event culminated in a set of comprehensive recommendations designed to strengthen maternity healthcare systems:

• A primary recommendation was to create a Coalition of Midwives to formally advocate for the recognition of midwifery as a distinct profession, complete with dedicated licensing and specialized incentives that reflect the critical nature of their work.
• Integrating midwifery into national crisis management plans was identified as crucial, emphasizing the need for midwives and obstetricians to have representation in national emergency committees to ensure that maternity care is prioritized during all emergency situations.
• The development of comprehensive crisis preparedness plans was strongly recommended, with a specific focus on including maternity services and midwifery support at every level, from national and regional to individual facility and village levels, to create a robust and responsive system.
• The implementation of specialized training programs for midwives was deemed essential, with a focus on crisis management, providing psychosocial support, and delivering maternal care during emergencies. Collaboration with international agencies was encouraged to enhance the quality and effectiveness of these training programs.
• Establishing mobile midwifery units and expanding the use of telemedicine were proposed as innovative solutions to ensure access to remote maternal care during crises, thereby extending the reach of essential services.
• Integrating mental health and psychosocial support into maternity care plans was considered vital, advocating for training healthcare professionals to effectively address the psychological needs of pregnant women during emergencies and provide necessary support.
• Engaging the community and actively including women’s perspectives in the planning process for maternity crisis preparedness was recommended, utilizing methods such as conducting surveys and incorporating feedback to ensure that services are both relevant and responsive.
• Collaboration with international organizations and UN agencies was strongly encouraged to enhance maternal crisis preparedness by incorporating global best practices into national plans, leveraging expertise and resources to improve outcomes.

To further enhance maternal care and optimize the role of midwives, a comprehensive assessment of the existing midwifery program will be undertaken jointly by UNFPA and the Ministry of Health. This collaborative effort will rigorously assess the program's coverage, the quality of care provided, and the distribution of the midwifery workforce across the country, identifying key gaps and developing evidence-based recommendations to improve midwifery-led maternal care, particularly in underserved areas, ensuring adherence to minimal international standards, while simultaneously supporting the development of community-based maternal care services, with midwifery established as a central and indispensable pillar.

Finally, increasing the number of trained prenatal midwifery educators was recommended, suggesting the implementation of certification programs for midwives to become qualified prenatal trainers, the adoption of a train-the-trainer model to expand educational reach, and the creation of virtual prenatal education options to improve accessibility, especially in remote areas.

The International Day for the Midwife event, "Midwife in Every Crisis," successfully facilitated a vital discussion on the critical role of midwives in ensuring maternal care during crisis situations. The insights shared by the panelists clearly underscored the urgent need for improved governance, enhanced training, and robust crisis preparedness to guarantee that maternity care remains a priority during all types of crises, both natural and non-natural. The recommendations articulated in this report represent a collective vision for strengthening the maternity healthcare system in Oman. This vision encompasses the professional recognition and empowerment of midwives, the seamless integration of midwifery services into national crisis management plans, and the provision of comprehensive care that includes mental health and psychosocial support. The adoption of innovative approaches, such as mobile units, telemedicine, and active community involvement, is deemed essential to improve access to care and ensure that women receive the highest possible standard of support during crises. Ultimately, the continued and strengthened collaboration between midwives, obstetricians, policymakers, and international partners will be instrumental in achieving these critical goals and significantly advancing maternal health outcomes throughout Oman.