International Day of the Midwife (5May2021)

This is God’s Mothering Spirit: watching us, tending us, keeping us safe, never leaving our side, whispering words of comfort and strength and hope that this, too, shall pass.

“Yet it was you who took me from the womb;
you kept me safe on my mother’s breast.
On you I was cast from my birth,
and since my mother bore me
you have been my God.”
(Ps 22:9-10)

“For you, O Lord, are my hope,
my trust, O Lord, from my youth.
Upon you I have leaned from my birth;
it was you who took me from my mother’s womb.
My praise is continually of you.”
(Ps 71: 5-6)

How beautiful to think of the midwives and doctors and nurses and doulas who attend to women and babies at birth as being God-like in their work.

And what a tender image of God as the wise and strong and loving woman who catches each of us upon our birth and places us into our parents’ arms.

(Source: Laura Kelly Fanucci)

Two of the most powerful Jewish leaders in Jewish history, both extremely faithful and righteous women, were the first recorded midwives, Shifra and Puah.

They practiced their trade during a time where the very existence of the Jewish people was hanging by a delicate thread. Pharaoh’s astrologers had predicted that a Jewish male would rise amongst the Hebrews and overtake his throne. In a paranoid attempt to curtail the Jewish birth rate, he ordered all Jewish men into backbreaking slave labor (Ibn Ezra). But when the Jews continued to multiply, Pharaoh, driven by evil and desperation, commanded Shifra and Puah to kill all newborn Jewish boys.

“The midwives, however, feared G‑d; so they did not do as the king of Egypt had spoken to them, but they enabled the boys to live.” (Exodus 1:17)

Pharaoh didn’t count on the midwives’ defiance or their faith in G‑d. Despite the danger of defying Pharaoh’s command, Shifra and Puah decided to continue their holy calling. With whole-hearted faith in the Creator, they swam against a very strong and dangerous political tide, fully knowing that disobedience of Pharaoh’s decree meant death for them. But their fear of G‑d far surpassed their fear of a human king.

They helped to nurture and sustain all the newborn babies
From then on, not only did Shifra and Puah help birth the Jewish women, but they helped to nurture and sustain all the newborn babies. Before each birth, they prayed to G‑d to assist the Jewish women to birth quickly and safely, and they prayed for the health and well-being of all the babies under their care. The Midrash states that Shifra and Puah actually became G‑d’s partners in creation, granting life to the Jewish children ( Shemot Rabba 1:19).

“G‑d bestowed goodness upon the midwives, and the people multiplied and became very strong. It was because the midwives feared God that He made houses for them.” (Exodus 1:20-21)

The “houses” G‑d made for Shifra and Puah were, in fact, dynasties born through them. Our sages explain that Shifra was a pseudonym for Jochebed, and Puah was another name for Miriam. The name “Shifra” comes from the Hebrew word meshaperet, which means “to beautify” and/or “to swaddle and clean” (i.e., a baby). Miriam was called Puah, from the Hebrew verb “Po’ah,” which means “cry, coo or groan” because of the way she soothed and cooed the crying newborn infants.

Jochebed was blessed to give birth not only to her daughter, Miriam, but also to Moses and Aaron. Through Jochebed (Shifra), a nation of priests was born. And Miriam (Puah) was blessed to mother the Royal dynasty, the “House of David.”

There is something about being present at a birth . . . about standing at the threshold between born and unborn that transforms a person. Perhaps it is because of their trade that Shifra and Puah developed such faith in their conviction. Perhaps it was because they witnessed the miracle of life unfold before their eyes that they found the strength to face the challenge to kill or be killed—and overcome it with power and grace.

Shifra and Puah never entertained the idea of fighting G‑d’s will. Instead, they fought for G‑d’s will. And they won. This strength has been handed down all the way from our ancestral midwives to the modern midwives of today. May G‑d bless them to continue in the paths of Shifra and Puah—fearing G‑d, not man—and through their faith in the G‑dliness of birth bless them to be God’s partners in creation.
(Source: Sarah Zadok)

Consider for a moment the courage required for such action. Consider the depth of faith necessary to move one to such defiance. The midwives’ trust and confidence in the Almighty is such that nothing else matters and scripture tells us they are rewarded.
How are you called to be a compassionate partner in the birth of new life?
Where in your life are you called to be courageous for the sake of justice?
How might you better accompany those who, like the Israelites, are oppressed?

Some facts
It is approximated that for every 100,000 births in Asia and the Pacific 150 women die from complications related to pregnancy which can be prevented if proper investment in midwives is prioritised.

Stark disparities exist within the region — for every 100,000 births 220 women die in South Asia and 150 in South-East Asia, compared to 37 in East Asia.

While midwives could provide up to 90% of essential sexual, reproductive, maternal, newborn, and adolescent health care across the lifespan, there is a need-based shortage of 900,000 midwives globally.

Midwives are fundamental in ending preventable deaths during and after childbirth and achieving Sustainable Development Goal (SDG) 3.1 – which aims to reduce global deaths due to complications from pregnacy and childbirths ratio to less than 70 per 100,000 live births by 2030.

This year’s IDM theme: “Follow the data: Invest in Midwives”, will concide with the launch of the State of the World’s Midwifery (SoWMy) Report 2021 co-led by United Nations Funds on Populations (UNFPA), World Health Organization (WHO), and International Confederation of Midwives (ICM).

According to a recent study by UNFPA, WHO, and ICM, investing in midwives is a cost-effective way of improving health outcomes.

Modest increase of 10% in midwife-delivered interventions every five years could save 22% maternal deaths, 23% newborn deaths and 14% stillbirths and save 1.3 million lives per year by 2035.

Likewise, increasing coverage of midwife-delivered interventions by 25% every five years could avert 2.2 million deaths per year while universal (95%) coverage could save up to 4.3 million deaths per year.

With a global shortage of 900,000 midwives and the world facing the continued challenges of a global pandemic, midwives remain critical. Covid-19 has dramatically affected all aspects of health systems, notably in relation to maternal, sexual and reproductive, and adolescent healthcare. Disruption to service provision in these areas has increased the risks relating to health outcomes, as well as increasing unplanned pregnancies, sexually transmitted infections, unsafe terminations and increased health risks for mothers, newborns and adolescents.

Midwives can deliver care for women, children and adolescents outside of health facilities in the communities where they live, which is particularly important amid the pandemic as it has alleviated pressure on medical services. Further to this, home births protect women and families from exposure to Covid-19 inside health facilities. Critical to the Covid response in healthcare facilities, we must refrain from deploying midwives from midwifery to nursing services to provide care to general patients with Covid-19 as this takes them away from their essential role working in partnership with women and further contributes to the global midwifery shortage.

Gender transformative policies are needed to challenge the underlying causes of gender inequality, with consistent global leadership required to end gender discrimination within the health sector. Comprehensive international research and SoWMy 2021 show that women comprise more than 70 per cent of the health workforce. Gender inequality affects the status of midwives, most of whom are women (93 per cent globally), as well as their recruitment, mobility, career development, pay rates and self-care.

This is evidenced by a lack of investment in training and the professionalisation of midwifery practice. Investing in midwives has the power to accelerate the human rights agenda. In fact, this investment would be one of the most cost-effective strategies – to achieving full sexual and reproductive health coverage and reproductive freedom for women and all who give birth.
(Source: Carla Donson, manager of Women’s Network Whanganui, NZ)

About admin

Rev Sandy Boyce is a Uniting Church in Australia Minister (Deacon) in placement at Pilgrim Uniting Church, in Adelaide CBD (12 Flinders St). This blog is mainly to resource worship planners for our services, but of course may be useful for others. We have some great writers of music, words for hymns and liturgy at Pilgrim, so this blog also includes their words.
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