Evidence Based Practice on Pediatric Health Promotion and Protection


Poor quality newborn and maternal care is a major concern across the continuum of care. It leads to high rates of maternal mortality, psychological morbidity, and acute and chronic illness among newborn and mothers. This aspect has resulted to the need for implementation of affordable, sustainable, and effective improvements in quality of care such as midwifery. Midwifery can improve care and outcomes by minimizing neonatal and maternal morbidity and mortality, promoting public and psychosocial health outcomes, reducing number of unnecessary interventions, and decreasing preterm birth and stillbirth (Renfrew et al., 2014).

Midwifery has significant contribution to the quality of care of infants and women and facilitating effectiveness of newborn and maternal care providers.

Midwifery and its Contributions to Maternal and Newborn Quality of Care

There exists an increasing consensus among public health professionals that midwifery care is a crucial component in promoting high-quality newborn and maternal services. Midwifery is defined as the practice of compassionate, knowledgeable, and skilled care for newborn infants, childbearing women, and families throughout the scope of care in pregnancy, pre-pregnancy, post-partum, birth and the period of early life. Souza, Gülmezoglu and Vogel et al. (2013) indicate that although there are other interventions that have proved to minimize mortality rate among the newborn and maternal, midwifery has been proved to be an evidence-based framework that enhances quality of care for maternal and newborn care. It consists of working in collaboration with women to improve their capabilities for self-care and that of their families, respect the individual opinions and situations, timely prevention and management complications, cultural, psychological, biological, and social reproduction process and early life, and consultation and referral to other more advanced services. Therefore, these aspects makes midwifery to be a more reliable intervention to improving maternal and newborn care.

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Some case studies offer opposing views and arguments against the implementation of the midwifery practice in nursing care. They suggest that putting more efforts on emergency and faculty based care can contribute significantly towards minimizing perinatal and maternal mortality. They argue that the scope of midwifery care can only be effective if it has a balancing effect but without it, it cannot work.  They reveal that the midwifery care practice strategy has in some cases led to fast increasing numbers of needless, costly, and possibly iatrogenic interventions as well as disparities in the delivery of care and outcomes (Black, Victora & Walker et al., 2013). Moreover, the case studies indicate that despite the implementation of the midwifery care in countries such as China and Brazil, they are among the nations in the world with prevalence of caesarean sections. Also, India records high number of mortality rate and disparities associated with poverty despite its current development in economy. The poor outcomes have been linked to scarcity of resources for prevention of mortality rate and care for maternal and newborn (Finlayson & Downe, 2013).

According to the writer’s opinion, midwifery is related with more effective utilization of resources that lead to improved outcomes. The writer suggest that improved outcomes can be achieved if essential measures are put in place such as the midwifery services being provided by well educated, licensed, trained, and regulated midwives. The International Labour Organization (ILO) defines a midwife as an individual who has finished the midwifery education programme successfully, demonstrates the qualifications to be licensed legally to practice midwifery, and exhibits competency in midwifery practice (Ryan, Revill, Devane and Normand, 2013). Information and education are crucial component in maternal and newborn care whereby it enables women to learn what they need to know and have comprehension of the services of the organization so that they can have access to them in a timely manner. Moreover, well trained and educated health care professionals demonstrate cultural competence and clinical knowledge and interpersonal skills who are able to provide personalized needs and care in a kind, empathic and respectful way thus eliminating inequalities in maternal care. Furthermore, midwifery practice can be enhanced through improved communication and good quality clinical care are a combination of factors required to provide the safety of newborn infants. Factors such as disrespectful care or low quality services have a negative impact on worldwide minimization of newborn and maternal morbidity and mortality. These factors makes it difficult for women to access healthcare services and meet their needs thereby contributing to high mortality and morbidity rate among mothers and newborns. Therefore, the writer believes midwifery is a new evidence-based framework that would contribute towards achievement of high-quality newborn and maternal care and enhanced maternal and neonatal outcomes.


It is evident that midwifery is an integral approach towards eliminating factors that contribute to poor maternal and neonatal outcomes. It comprises of supportive and preventive care that enhances the capabilities of women in offering self-care and across families. It focuses on improving the normal reproductive process, meeting individual needs, and promote respectful relationships, which facilitates accessibility of emergency treatment and management of complications that improves quality of care and outcomes. Hence, its implementation of midwifery as a quality framework across the community and facility settings and effective interdisciplinary teamwork would contribute significantly improving maternal and neonatal outcomes.