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BEIJING—While China’s promotion of hospital deliveries in the past 20 years has significantly reduced maternal mortality, midwifery education and support have not received adequate investment, according to an opinion article published today by the Representative of UNFPA, the United Nations Population Fund.

A national survey by the Ministry of Health has found that eastern China has just 4.0 midwives per 100,000 people, with 2.8 and 3.3 for the central and western regions respectively. This amounts to about one twentieth of the midwifery coverage in Sweden and the United Kingdom, a tenth of Malaysia’s and one eighth of Cambodia’s.

UNFPA China and the Chinese Maternal and Child Health Association have launched a pilot programme in Hunan province advocating for improved resource allocation and formal inclusion of midwifery curriculum and certification in medical education systems. At the same time, the programme will promote natural delivery in selected hospitals by working with health providers and clients.

A shortage of qualified midwives and a lack of health education on natural delivery among mothers-to-be and their families have led to unnecessary obstetric interventions, particularly caesarean sections. According to a World Health Organization survey on maternal and perinatal health in nine Asian countries, published in The Lancet in 2010, almost half (46.2 per cent) of all babies born in China during the survey period were delivered by caesarean. One quarter of these operations – the highest proportion in the region – were undertaken for reasons not purely medical. Undertaking such procedures without medical justification exposes pregnant women and babies to much higher health risks and is an inefficient use of healthcare resources.

See op-ed by UNFPA Representative Arie Hoekman: