‘Midwives making a difference’ is the theme of the 31st ICM Congress. White Ribbon Alliance asked ten leading midwife advocates for their top tips.

By Brigid McConville

1. TAKE RESPONSIBILITY: Suzanne Stalls, Senior Technical Advisor, JHPIEGO

“After many years as a midwife I’ve learned that it’s imperative for those in a problematic situation to understand what each person’s responsibility is in creating that problem. We have the capability as humans to co-create extraordinary things, but we fail if we don’t take responsibility for our own part.

Midwives must also avoid navel gazing. We sit in a context of a much larger health system. I once set up a midwifery practice with an obstetrician who wanted to work with midwives. I was always going on and on about how we midwives must think about women until s/he got exasperated and said ‘what do you imagine I think about when I get up in the morning?’”

2. NEVER GIVE UP: Rose Mlay, National Coordinator of WRA Tanzania

“Never take for granted that politicians and policy makers are knowledgeable about what we are advocating for. They need information, but make it simple and precise. Leave them with written materials. Work with the government even though you are pushing them for change. Involve citizens without endangering them in any way (as there can be repercussions). Above all, never give up!”

3. GET THE SUPPORT OF WOMEN: Petra ten Hoop-Bender, Technical Adviser Sexual and Reproductive Health and Rights, UNFPA Office of Geneva.

“Personal connections work every time; sometimes that’s just having a cup of coffee with colleagues. You also need people who are willing to go out on a limb. Plus, you need good evidence — which we now have from State of the World’s Midwifery and the Lancet Series on Midwifery, while the work on Quality Care has established the philosophy and values of midwifery; we have momentum.

“But we can’t do any of this without the support of women. It makes no sense to fight for midwifery if women don’t want it. Women need to know that midwifery exists, and to demand it. Midwives need to build their grassroots base.”

4. BE ONE TEAM, WITH ONE VOICE: Andre Nyamabaji, Rwanda Association of Midwives

“Midwife advocates need many skills including leadership skills, political and diplomatic skills, linguistic skills, negotiation and communication skills. Midwife advocates need to be smart and organized, to have good presentation skills physically, psychologically and socially and to have a spirit of creativity, innovation, partnership and team working. Meanwhile all midwives need to join their Midwifery Associations in order to harmonize their efforts, talents, knowledge and skills. Midwives need to work as one team with one voice.”

5. COLLABORATE: Felicity Mapuvire Ukoko, Head of Midwifery Programmes WBFA

“Midwives must be assertive and communicate effectively on behalf of our colleagues, childbearing women and their families. We must continue to have the passion, highlight the good work done and equally raise awareness about the challenges we face in our day to day practice. We must stand for what we believe in and understand our rights. We cannot do it alone! We need to develop relationships with key potential partners; collaboration is key.

Today we have new social media platforms which we did not have 20 years ago, so let’s utilise these platforms effectively, raise awareness and interact using Twitter, Facebook, Instagram, WhatsApp and so on. Speak up midwives, let our voices be heard!”

6. BE CONVINCING: Nester T. Moyo, Senior Midwifery Advisor, International Confederation of Midwives (ICM)

“Midwife advocates need to be well informed about maternal and newborn health issues in the world, in their country and in their region. We need convincing facts and information. We need support from colleagues working in different areas of midwifery to buttress our arguments with on-the-ground examples so that we can give a face and a name to what we are advocating for — real women with real families.”

7. USE EVIDENCE, STAY POSITIVE: Professor Mary Renfrew, University of Dundee, Scotland.

“Creating change needs a combination of collaboration, cooperation, the strong voices of women and families, the use of evidence, being politically astute and skilled in the use of media. It’s not easy. People don’t always agree with each other or work together as you might hope. I was part of the campaign to legalise midwifery in Canada and we had to learn political and advocacy skills to debate with senior doctors and nurses, with politicians and the media. We had to develop consistent messages so that no matter which of us was on the television that evening, people heard the same arguments. We learned to use evidence to inform our debates, no matter how emotional and angry we might have felt.

8. BE STRATEGIC: Rima Jolivet, Maternal Health Task Force

“Midwifery advocacy in my experience often suffers from failure to identify a problem that is concrete enough, either taking an approach that is too broad or too complex, or embarking on a strategy that is not targeted or tailored enough to the audience or change agent but rather remaining largely self-referential. Multiple small, effective campaigns are better than one great idea that doesn’t get off the ground or hit its mark.


“To progress as midwives we want to be as educated and as skilled as we can be, and to go beyond what’s expected of us. We must have the ability to speak out. We should be confident in our competencies and comfortable working with people in power, with the confidence of ‘I know what I’m doing’! We need to reach outside ourselves to be advocates and communicators. We need to work with others on how to do the advocacy to bring out the voices of women, to express our common goals, to achieve a motivated and caring workforce.

In those who are successful as midwifery leaders you can see their commitment to women. When we stay focussed on women and babies and not on ourselves, we get so much further.”

10. BE BOLD, SPEAK WITHOUT FEAR: Lennie Kamwendo, White Ribbon Alliance Malawi

“In my experience, the greatest barrier is ourselves. We do not speak with one voice; we lack the boldness required to be advocates for ourselves and perhaps we also lack knowledge of advocacy. We must start with the desire and interest to make things change and make a difference. Unfortunately many midwives lack the necessary empowerment to speak out or engage policy makers on issues that affect them. And so we must be bold and speak out without fear. We midwives need to support each by being united in speech and actions. Additionally, we need to love and be bonded to our profession.”