Although Liberia has been Ebola-free for over a year, the devastation the disease wreaked on the Liberian healthcare system persists. Liberian midwives are increasing in number, but they face many challenges.

Liberia was the center of an Ebola outbreak in 2014 that claimed the lives of roughly 180 healthcare workers. In the midst of the epidemic, maternal death rates rose, and they have been slow to decline.

Hannah Gibson, a trainee in a program designated to teach advanced obstetrics to midwives, recounted the panic that struck the Liberian healthcare system when patients suffering from Ebola first began to surface.

Many Liberian midwives abandoned their positions, leaving hospitals understaffed. Gibson and a few of her coworkers eventually quarantined themselves in their hospital, working around the clock to provide medical care for the women in the maternity unit.

Even before the Ebola outbreak, the number of obstetrician-gynecologists in Liberia was low. According to Liberian minister of health Bernice Dahn, today there may be fewer than five.

During the outbreak, Gibson became one of the first Liberian midwives to be trained by British NGO Maternal and Childhealth Advocacy International (MCAI). The NGO proposed teaching surgical procedures such as caesarean sections to midwives in order to bridge the gap in prenatal care in Liberia. The training empowers midwives to operate, resulting in more positive outcomes in semi-complicated childbirths.

Unfortunately, specialized midwifery like this is not accessible to all expecting mothers. There are currently only 400 trained midwives in the Liberian healthcare system, a number too small to meet the needs of over four million people, and the majority of midwives reside in urbanized sectors.

In Liberia, 44 percent of women give birth with no medical attendant because they live in rural areas where care is too far away to obtain. One in every 138 live births results in a mother’s death due to preventable complications requiring basic medical care.

The World Health Organization (WHO) is working with the Liberian Ministry of Health and Social Welfare to enhance Liberia’s six midwifery schools. But merely training midwives will not end the midwife crisis completely. Because midwifery in Liberia is a low-income profession with few opportunities to advance, retaining Liberian midwives is also a problem. Medical professionals trained in Liberia often take their credentials and move to countries that offer better salaries.

Fortunately, through a new Bachelor of Science midwifery program, midwives will be able to further their careers within the Liberian healthcare system, attending to peoples’ needs in understaffed locations. The Danish Midwives Association is giving program instructors current and advanced training in order to ensure the enterprise’s success.

– Amy Whitman

Photo: Flickr