Over a million mothers and newborn babies are dying each year from easily prevented birth complications because of a chronic shortage of midwives across much of the developing world, a new report from Save the Children said on Friday.
In the world's least developed countries over half of mothers give birth without any trained help — compared with only one percent in Britain — and some 2 million women face one of the most frightening days in their life entirely alone.
Some 1,000 mothers and 2,000 newborns die every day as a result. Another 350,000 trained professionals are needed to save their lives, the "Missing Midwives" report said.
"It doesn't have to be complicated: someone who knows how to dry a baby properly and rub its back to help it breathe can make the difference between life and death," said Save the Children Chief Executive Justin Forsyth.
"No mother should face giving birth without help."
Of the 8 million children who die each year before the age of five, one in 10 do not even see the end of their first day.
But midwives trained in just eight procedures, including keeping newborns warm and fed, could immediately cut newborn deaths by more than a third in the 68 countries with the worst neonatal mortality rates, the report said.
History suggests these deaths can be avoided. British Prime Minister David Cameron has highlighted how the introduction of a British national midwifery program in the 1930s cut maternal deaths 80 percent over 15 years.
Some developing countries are now fighting for or have won support to roll out similar programs.
In Afghanistan, which has some of the highest risks to both mothers and children, the number of rural births attended by trained professionals rose from 6 percent to 19 percent between 2003 and 2006, Save the Children said.
Around 2,400 midwives have joined the workforce and 300 or 400 more graduate each year —although at this rate it will still take time to reach the World Health Organization's recommended rate of one midwife for every 175 pregnant women.
But the report also warned that resolving the shortage will require more than just cash for colleges and training schools.
Working as a midwife is not a very attractive profession in many areas. Despite demand for their services, midwives in the developing world are often poorly paid and over-worked, or have to work in remote or even dangerous places.
And rich countries often attract healthcare workers from poorer nations — whether through active recruitment or not leaving the neediest women short of midwives.
"We are calling on rich and poor country governments to put health workers at the heart of their plans," Forsyth said, seeking strong financial and political support for training and funding more midwives for developing nations.
"Without it, mums and babies will continue to die needlessly every day."