International Midwives Day
<p>The first International Day of the Midwife, on 5 May 1991, carried a slogan that now reads as both hopeful and unmet: “Towards safe birth for all by the year 2000.” The deadline came and went without the goal being reached, but the day endured, and its bluntly numerical ambition tells you something about the profession it honours. Midwifery deals in outcomes that can be counted, in lives saved or lost, and the day attached to it has never been content to be merely ceremonial.</p>
<p>The decision to create the observance was taken four years earlier, in 1987, at a congress of the International Confederation of Midwives in the Netherlands. The ICM, founded in 1919, had spent decades arguing that trained midwives were not an optional extra but a frontline defence against maternal and newborn death. Setting aside 5 May was a way of making that argument annually, in public, to governments that often funded everything in maternity care except the people present at the birth.</p>
<h2 id="where-the-day-comes-from">Where the day comes from</h2><div class="ad-unit ad-in-article" aria-label="Advertisement">
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<p>The word at the heart of all this is older than any organisation. “Midwife” comes from the Old English “mid wif”, meaning “with woman” — not a description of a medical procedure but of a stance, of simply being beside someone through one of the most consequential hours of her life. That etymology is worth dwelling on, because it captures what distinguishes midwifery from much of modern medicine: it is defined by presence as much as by intervention.</p>
<p>The ICM gave that ancient role an institutional voice. From its 1919 founding it worked to standardise training and to lift the status of a profession that, for much of history, had been practised by women without formal recognition and frequently with active suspicion. The 1987 decision to mark a day, and the 1991 launch, were steps in a long campaign to move midwives from the margins of the health system to its centre.</p>
<h2 id="a-history-of-being-underestimated">A history of being underestimated</h2>
<p>The history of midwifery is in large part a history of being pushed aside. In Europe, the rise of male physicians and the lying-in hospital from the seventeenth century onwards gradually displaced the village midwife, and the early-modern witch trials swept up many women whose only crime was attending births. The professional rehabilitation of midwifery in the twentieth century, which the ICM led, was a deliberate reversal of that long decline.</p>
<p>The evidence eventually became hard to ignore. A series of analyses published in The Lancet in 2014 concluded that midwife-led care, properly trained and integrated into health systems, could avert a very large share of maternal and newborn deaths. That body of research gave the day’s advocacy a firmer footing than mere sentiment: it allowed midwives and their associations to point to numbers when asking for investment, which is exactly what each 5 May is now used to do.</p>
<p>Individual figures stand out in that long rehabilitation. Florence Nightingale, though remembered chiefly as a reformer of nursing, helped establish the principles of sanitation and trained attendance that underpin safe childbirth. In the United States, Mary Breckinridge founded the Frontier Nursing Service in rural Kentucky in 1925, sending nurse-midwives on horseback into remote Appalachian valleys and producing maternal-survival figures that put the wider country to shame. Their work made a concrete case that the right person at the bedside, properly trained, changed outcomes more reliably than any amount of expensive equipment — the same argument the ICM was formalising at an international level.</p>
<h2 id="why-it-matters">Why it matters</h2><div class="ad-unit ad-in-article" aria-label="Advertisement">
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<p>Maternal death remains one of the starkest inequalities on the planet. A woman’s risk of dying in childbirth depends overwhelmingly on where she happens to give birth, and the single most effective remedy is the presence of a skilled birth attendant. Midwives are that remedy in most of the world, particularly in rural and low-income settings where a doctor or a hospital may be hours away.</p>
<p>The day matters because the people best placed to reduce those deaths are so often the least resourced. Midwives in many countries work long shifts with inadequate equipment and little recognition, and the profession struggles to recruit and retain enough of them. An annual occasion that names this gap, and pushes ministries to close it, is doing more than offering thanks. It is part of the mechanism by which a quiet, female-dominated profession makes its claim on public spending heard.</p>
<p>There is also the matter of what happens after the birth. Postnatal depression and, in its severest form, postpartum psychosis are leading contributors to maternal death in the weeks and months following delivery, and midwives are frequently the first to notice the warning signs. That places them on the front line of a mental-health crisis that overlaps with the concerns of observances such as <a href="/specialdate/world-suicide-prevention-day/">World Suicide Prevention Day</a>, and underlines that a midwife’s care does not end when the cord is cut.</p>
<p>The shortage that the day repeatedly names is not a vague grievance but a measurable one. The World Health Organization has estimated a global deficit of nearly a million midwives, a gap concentrated in exactly the regions where maternal death is highest. Closing it is among the most cost-effective interventions in all of public health, since a single trained midwife can attend hundreds of births over a career. An annual occasion that keeps that figure in front of finance ministries is doing the unglamorous work of turning a moral case into a budget line.</p>
<h2 id="how-it-is-celebrated">How it is celebrated</h2>
<p>On 5 May, hospitals and birthing centres hold ceremonies to thank their staff, and professional bodies such as the Royal College of Midwives in the UK organise conferences and continuing-education sessions. In many countries the day takes a more assertive form: marches and rallies that demand better pay, safer staffing ratios and proper funding. Social-media campaigns invite parents to post photographs of the midwives who saw them through, turning private gratitude into a visible public record.</p>
<p>Student midwives are often welcomed into the profession on this day with ceremonies that mark the handing on of knowledge from one generation to the next. Awards for outstanding practitioners are common, and gatherings frequently end, as such gatherings do everywhere, with shared food — the celebratory desserts and indulgences of an <a href="/specialdate/us-national-spumoni-day/">ice-cream day</a> would not be out of place at a staff-room thank-you. The communal meal is a small thing, but it reflects a profession built on continuity, mentorship and trust.</p>
<p>The week itself has steadily expanded around the date. The ICM promotes a Year of the Midwife or longer campaign periods in some years, and 2020 was designated by the World Health Organization as the International Year of the Nurse and the Midwife, deliberately timed to coincide with the two-hundredth anniversary of the birth of Florence Nightingale. That designation pushed midwifery into a rare moment of global political attention, only for the year to be overtaken by the COVID-19 pandemic — a turn of events that, grimly, demonstrated exactly how essential frontline maternity staff are when a health system is under strain and how easily their needs can be crowded out by a crisis.</p>
<h2 id="variations-across-borders">Variations across borders</h2>
<p>The day reads differently depending on the state of midwifery locally. In the Netherlands, where home birth attended by an independent midwife remains common and respected, 5 May celebrates an established and confident profession. In parts of sub-Saharan Africa and South Asia, where shortages are acute, the day is used to lobby hard for training places and rural deployment. In the United States, where the place of midwives within a physician-dominated system has long been contested, the occasion doubles as advocacy for the profession’s wider acceptance.</p>
<h2 id="symbols-and-traditions">Symbols and traditions</h2>
<p>Candlelight features in many ceremonies, the lit lamp echoing the older imagery of nursing and night-time vigil. The colours and emblems of the ICM appear on banners and ribbons. Handmade tokens of appreciation, passed from new parents to the midwives who helped them, are a recurring tradition, fitting for a role defined by the personal rather than the institutional.</p>
<h2 id="fun-facts">Fun facts</h2>
<ul>
<li>The day’s very first theme in 1991 set a deadline — safe birth for all by the year 2000 — that the world failed to meet, yet the observance outlasted the missed target.</li>
<li>The decision to create the day was made in 1987, but the first celebration did not take place until 1991, a four-year gap between resolution and reality.</li>
<li>“Midwife” means “with woman”, describing companionship rather than any clinical act.</li>
<li>A landmark 2014 series in The Lancet found that well-trained, properly integrated midwifery could prevent a large proportion of maternal and newborn deaths, giving the day’s advocacy a hard evidence base.</li>
<li>The ICM, which created the day, was founded in 1919 and is one of the oldest international health professional bodies still active.</li>
</ul>
<h2 id="a-closing-reflection">A closing reflection</h2>
<p>There is a particular kind of work that is most visible by its absence — noticed only when it goes wrong, taken for granted when it goes right. Midwifery sits squarely in that category, which may be why it needs a day at all. The slogan of 1991 promised safe birth for everyone by the turn of the millennium and did not deliver it; a quarter-century on, the gap between where a woman gives birth and whether she survives it remains scandalously wide. The honest tribute on 5 May is not just to thank midwives, but to keep asking why so much of the world still cannot give every mother the one thing the day was founded to demand.</p>
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