By Dr. Luay Shabaneh
UNFPA Representative in Pakistan

Islamabad, May 4 2025; On the International Day of the Midwife on May 5, we are reminded of a profound truth. Midwives are the guardians of life at its most critical moments, ensuring the safety of mothers, newborns and families, and supporting health and wellbeing far beyond birth. Across Pakistan, particularly in rural and underserved communities, they are often the first and most trusted point of care, standing beside women during pregnancy, childbirth and the postnatal period, providing skilled care, preventing complications, identifying risks early and ensuring timely referrals. Their presence transforms childbirth from a moment of risk into a moment of safety, dignity and hope.

Yet the reality and state of midwives is worrying. Pakistan accounts for approximately four percent of global maternal deaths. Nearly 100 women die for every 100,000 live births, most from preventable causes. At the same time, the country faces a shortage of nearly 82,000 midwives and has only 2.2 midwives per 10,000 people, half the global average. These are not just statistics, they represent lives lost, families changed forever and a gap that must and can be closed.

Midwives offer one of the most effective and proven solutions to this challenge. When properly educated, supported and integrated into the health system, they can deliver most essential maternal and newborn health services, reduce preventable deaths, improve health outcomes and strengthen primary health care. Investing in midwives is also a smart economic choice. It reduces costly emergency care, lowers pressure on hospitals, improves workforce productivity and strengthens families and communities, delivering long term returns in both human and economic development.

However, midwives in Pakistan are too often expected to carry this responsibility without adequate support, including essential equipment, medicines, supervision, safe working conditions and fair compensation.

Pakistan now has an opportunity to act by expanding midwifery education, scaling up the B.S. Midwifery Programme, strengthening training standards and ensuring recruitment and deployment where they are most needed. Midwives must be fully integrated into the health system with clear career pathways, professional recognition and leadership opportunities. Midwives must be paid fairly, protected legally and prioritized in health sector planning and budgets. Access to skilled midwifery care is a fundamental right. No woman should lose her life while giving life.

UNFPA remains firmly committed to supporting Pakistan in strengthening midwifery education, workforce development and health systems. UNFPA will continue to work in close partnership with the Government and all stakeholders to advance this agenda.

The path forward is clear, the evidence is strong and the returns are undeniable. The question is not whether we can afford to invest in midwives, but whether we can afford not to. Let us stand with our midwives by protecting them, valuing their contribution and enabling them to reach their full potential, investing not only in health, but in the dignity, prosperity and future of Pakistan.