Midwives on the Front Line: Bringing Safe Birth for Women in Myanmar

MAGWAY, Myanmar — When Ei first visited the midwife, she was only two months pregnant. Like many women in Myanmar today, she was carrying more than a child. She was carrying uncertainty — about her health, the cost of care, and whether she would be able to reach a hospital safely when the time came to give birth.

When she learned about a local midwife at a clinic in Magway, that uncertainty began to ease.

“I have been receiving antenatal care from Sayarma (the local midwife) since I was two months pregnant,” she said. “I also received a clean delivery kit. With her support and referral, I was able to give birth at the hospital. Both my baby and I were safe.”

For Ei, the support did not end at childbirth. The clinic also helped cover the costs of going to hospital — a critical lifeline at a time when many families are struggling with rising costs, displacement and shrinking access to essential services.

“At a time when many families are facing economic hardship, this support was extremely helpful for me,” she said. “Because of the support from this clinic, I was able to save some costs and, most importantly, I felt safe and reassured.”

Her story reflects a wider reality across Myanmar. In a country facing a protracted humanitarian crisis, women and girls are among those most affected by conflict, displacement, economic hardship and the continuing impacts of natural disasters like the March 2025 earthquake. Access to sexual and reproductive health services remains severely constrained by insecurity of health workers, attacks on health facilities, shortages of essential medicines, transportation barriers and protection risks. Myanmar has the highest maternal mortality in South-East Asia, while an estimated 2.4 million women and girls of reproductive age require basic health care services. UNFPA estimates that over 400,000 pregnancies will require life-saving maternal and newborn care in 2026.

In these conditions, midwives are not only health workers. They are often the first person a pregnant woman trusts, the first to identify danger signs, the first to arrange a referral, and the first to reassure a mother that she is not alone.

“This support is as important as life itself”

For Ohnmar Lwin, who is nine months pregnant, the presence of a midwife in the community gives women confidence at one of the most critical moments in their lives.

“Having this clinic and the midwife here gives hope to pregnant women like us,” she said. “The clinic has provided us with essential support for pregnancy, including vaccinations, supplements, important health information and everything we need to know.”

In emergencies, safe childbirth begins long before labour. It begins with antenatal check-ups, nutrition support, accurate information, birth preparedness, early identification of complications and a referral plan when emergency care is needed.

For women affected by conflict, these services can be lifesaving.

“For people affected by conflict, this kind of support is as important as life itself,” Ohnmar Lwin said.

This year’s International Day of the Midwife, marked globally on 5 May under the theme “One Million More Midwives,” calls attention to the urgent need to invest in midwives as a foundation of stronger, more resilient health systems. Globally, midwives can deliver 90 per cent of essential sexual and reproductive health services, yet the world is short of at least one million midwives. Universal coverage of midwife-led care by 2035 could prevent 67 per cent of maternal deaths, 64 per cent of newborn deaths and 65 per cent of stillbirths, saving millions of lives annually.

In Myanmar, this global call has a deeply local meaning: every trained, supported and protected midwife can mean the difference between fear and safety, delay and timely care, risk and survival.

A referral that saved two lives

For May Moe, a displaced woman from Lashio and mother of a 42-day-old infant, the support of a midwife became critical when complications arose during pregnancy.

“I am a woman displaced from Lashio, Northern Shan State,” she said. “Being in an unfamiliar place while pregnant made me very worried about my baby.”

Far from home, surrounded by uncertainty, she was able to access care through the support of a midwife. During check-ups, the midwife identified that the baby was not in the correct position. May Moe was referred to the hospital, where her baby was delivered through a surgical operation. “It was through the midwife’s support and care that I found out this was an emergency situation,” she said. “If I had not known, both my baby and I could have been at serious risk.”

Her experience highlights the often unseen value of midwifery: careful monitoring, timely referral, technical knowledge of when a pregnancy is no longer routine, and the ability to connect a woman with emergency obstetric care before it is too late.

Across the country, UNFPA supports local partners to provide life-saving sexual and reproductive health services in some of the most insecure and underserved settings. This included support for safe deliveries, referral of pregnant women for emergency obstetric care, and distribution of clean delivery kits. In 2025, UNFPA-supported mobile clinics and static facilities reached over 120,000 people in conflict-affected and hard-to-reach areas, with sexual and reproductive health services.

Behind each number is a woman like May Moe — a woman who needed care in time, and a midwife who helped her reach it.

The midwife as caregiver, protector and guide

Daw Khin Hla Win, 70, has worked as a midwife for 33 years. After more than three decades of service, her motivation remains simple: to support pregnant women who have limited access to care.

“I want to help pregnant women in hard-to-reach and difficult areas,” she said.

She has seen how the crisis has deepened the needs of women and families.

“At this time, displaced people, especially pregnant women, need particular support,” she said. “Many do not have enough money even to buy the supplements they need.”

The challenges are not only faced by pregnant women. Midwives and health workers are also working under severe constraints, including shortages of medicines and supplies, insecurity, and difficulty travelling during emergencies.

“At night, when we are called to assist with childbirth, there are also security-related barriers and difficulties in travelling during emergencies,” Daw Khin Hla Win said.

Still, midwives continue to serve. They provide antenatal care, help women prepare for birth, distribute clean delivery kits, counsel couples on family planning, identify complications, support referrals and follow up with mothers after childbirth.

In many communities, midwives also play a vital protection role. As trusted frontline health workers, they are often among the first to notice when a woman or girl may be facing violence, distress or heightened protection risks — and can help connect her safely and confidentially to available gender-based violence response services, psychosocial support and referral pathways.

For Ei, postnatal care included information on voluntary family planning.

“After I gave birth, the midwife also explained family planning methods to me,” she said. “I chose to use Depo, one of the available contraceptive methods.”

Family planning is not only about preventing unintended pregnancy. It is about giving women and couples the power to make informed decisions about their bodies, their families and their futures — even in the most difficult circumstances.

Investing in midwives means investing in survival of women in the communities

The need for sustained funding is urgent. UNFPA Myanmar is seeking USD 15.8 million in 2026 to safeguard and expand life-saving sexual and reproductive health services. This includes a proposed USD 500,000 investment to sustain and strengthen the midwifery workforce, directly supporting frontline midwives and improving the quality and continuity of maternal and newborn care.

For communities, this investment is not abstract. It means a pregnant woman can receive a routine medical check-up. A midwife can carry the supplies she needs to save lives. A mother with complications can be referred to the hospital in time. A baby can be delivered safely. A displaced woman can feel less alone. A woman facing violence or distress can be connected to confidential care and protection.

Daw Khin Hla Win describes childbirth through a Myanmar proverb: “For men, crossing the river by raft; for women, giving birth.” The meaning, she said, is that childbirth is one of the most dangerous moments in a woman’s life. “Whatever the situation, women must be able to access basic health care,” she said. “For the community, midwives are close caregivers and protectors.”

Commemorating this International Day of the Midwife, UNFPA honours the midwives of Myanmar who continue to stand beside women and girls — in clinics, communities, displacement sites and hard-to-reach areas. Their work is quiet, skilled and often carried out under difficult conditions. But its impact is profound.

Because when a midwife is present, a woman is not alone.

And when midwives are supported, protected and empowered, more women and newborns survive — with dignity, safety and hope.

*This story was originally published on the UNFPA Myanmar website.