Prof Jacqueline Dunkley Bent Advocating Takes Courage

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 Midwives Need To Be Courageous

Advocating for women before during and after birth is the life’s work of Prof Jacqueline Dunkley Bent OBE Chief Midwife with ICM International Confederation of Midwives. She used to work for the NHS now she is working at a global level where the need is as great as ever. It takes takes courage to face those who hold the levers of power in society, politically and sometimes even within a family or a relationship. Women are at their most vulnerable when giving birth. While the ideal image we have of the pregnant mother is of the women surrounded by loving family or partner in a safe, high-tech hospital, for very many women around the world, this is far from the norm.  Over 287,000 women die worldwide in the period just before during or soon after delivery and that was from a 2020 statistic*. Many because they are in third world countries or war-torn places where standards of midwifery are not high up the agenda if they exist at all. Prof Dunkley Bents mission is to have the best medical and midwife care available to every woman. “This is why health systems, ministries, governments, decision makers, policy makers, strategists, people in power, must pay attention to how we can move the dial on on perinatal mortality, that’s stillbirth and death within the first 28 days of life, and how we can move the dial on maternal death so that all women have the same maternity outcomes and experiences as those who have the best.” These maternal deaths she believes are a violation of human rights and must be taken seriously. “We know that the majority of maternal deaths occur in low and middle income countries. Sub Saharan Africa alone accounts for approximately 70% of global maternal deaths, and the majority of those are avoidable.”

Violence During Pregnancy

Prof Dunkley Bent says violence during pregnancy is an issue world wide. “Between one in three or one in four women experience violence during pregnancy, and it certainly is exacerbated during pregnancy. Violence knows no boundaries during pregnancy. It exists in all cultures and crosses all socio economic groups and for that reason, it’s really important that when a woman engages with a midwife, that there is some private time away from the partner. The relationship may be perfect, but there may well be some situations where that is not the case, given the data on violence during pregnancy, and it’s for that reason why the midwife will be able to ask some searching questions, helpful questions, hopefully, about whether the woman feels safe.”

Leadership Means Using The Voice

“We believe that every midwife is a leader. They’re just at different parts of the health architecture. So a newly graduated midwife or a newly qualified midwife will have a voice and that would be that would have been supported by his or her undergraduate program. And then, of course, as one becomes more experienced as a midwife, experience teaches you much, but you should be competent from your education programme that prepared you to be a midwife in the first place.  With all of that, we see the voice is there, but it needs to be supported and nurtured,” Prof Dunkley Bent says.  “I do believe that we need a dose of courage sometimes, particularly when one is speaking to very senior leaders, leaders in the ministry, in governments and of course, those who hold power. The midwifery leader, the midwife voice is is pivotal in  environments like that, strategic goals are significant, communicating about the entire profession, speaking truth to power, and also talking about the very basic tenant of ‘if you educate, support your midwives, if they are in a regulated, licensed environment within an established health system, working within a scope of practice, in an interdisciplinary team,’ then they will have a voice because they’ll be supported there to have a voice, because they’ll be enabled to have a voice.”

Data Obscures The Human Experience

Speaking up to those in power, policy makers and decision makers worldwide and at national level Prof Dunkley Bent believes will have positive consequences for generations.   “Data obscures the human experience, every death has a ripple effect for individuals, the families, for babies who have never taken their first breath for arms that remain empty.” This is a core belief for Professor Dunkley-Bent that drives her on. “I have a personal ambition that all women have the same maternity outcomes and experiences as those who have the best and yet we have harmful gender norms and inequality that result in in a low prioritisation of the rights of women and girls.”

ICM is over 100 years old and represents 136 midwives associations in 117 countries worldwide.

SDG 3.1 is to reduce the global Maternal Mortality Ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030. The global MMR in 2020 was estimated at 223 maternal deaths per 100,000 live births, down from 227 in 2015  and from 339 in 2000. During the Millennium Development Goal era from 2000 to 2015, the global annual rate of reduction was 2.7%, but this fell to negligible levels during the first five years of the SDG era from 2016 to 2020.

*https://blogs.worldbank.org/en/opendata/progress-reducing-maternal-mortality-has-stagnated-and-we-are-not-track-achieve-sdg-target

Angela Mezzetti
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