Midwives have a key role to play in saving the lives of millions of women and babies worldwide, yet the benefits of midwifery ‘are far from being realised on a global scale', experts have insisted.

They conducted the most wide-reaching examination of midwifery ever undertaken, which highlighted the major positive impact on women and babies if effective, high-quality midwifery is available to them.

Aside from potentially saving lives, midwives can also improve the ongoing health and wellbeing of those in their care.

However, many people's needs across the world ‘are still not being met, despite long-standing recognition that women and their babies need access to healthcare which provides more than just emergency interventions for acute medical problems', commented Prof Mary Renfrew of Dundee University in Scotland, one of the authors of the review.

"Although midwifery is already widely acknowledged as making a vital and cost-effective contribution to high-quality maternal and newborn care in many countries, its potential social, economic and health benefits are far from being realised on a global scale," she insisted.

Each year, almost 300,000 women are estimated to die during pregnancy, childbirth or soon after birth. Up to six million women have stillbirths and up to nine million infants die in their first month of life. However, millions more also suffer long-term health, emotional and financial problems because they did not receive proper healthcare before, during or after pregnancy.

As expected, most maternal and child deaths occur in low and middle-income countries, as a result of lack of access to adequate midwifery services. However, high-income countries are not without their problems.

According to the experts, the over-medicalisation of pregnancy can also have long-term effects on the health and wellbeing of mothers and their babies. An example of this is the routine use of unnecessary interventions, such as caesarean sections and episiotomies.

"Both underuse and overuse of medical interventions in pregnancy contribute to short- and long-term illness for an estimated 20 million childbearing women. This not only effects their health and wellbeing, but may also result in their needing to pay for ongoing healthcare costs, and on the ability of their families to escape poverty," noted another of the review's authors, Prof Caroline Homer, of the University of Technology in Sydney, Australia.

The experts acknowledge that while the level and type of risk differs depending on what country you are living in, ‘the need to implement effective, sustainable, and affordable improvements in the quality of care is common to all, and midwifery is pivotal to this approach'.

"However, it is important to understand that to be most effective, a midwife must have access to a functioning healthcare service, and for her work to be respected, and integrated with other healthcare professionals," they added.

The review was undertaken by an international group of doctors, midwives, policy makers, academics and advocates for women and children. It is published in the medical journal, The Lancet.

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