One investment unlocks four impacts:
economic growth, health equity, gender equality, and climate resilience.

In the face of growing polycrises—including geopolitical instability, economic disruption, and climate change—urgent, high-impact solutions are needed. Midwives stand out as one of the most strategic and cost-effective investments to address these crises, accelerate progress on the SDGs, and secure a healthier, more equitable, and resilient future.
‍This brief sets out the evidence of the impact midwives unlock on:

Six actions to unlock impact

Scaling up the midwifery workforce and embedding woman-centred midwifery models of care in health systems offers a high-impact, cross-sectoral solution to today’s most pressing challenges.
The evidence is clear; the time to act is NOW:  

1. Invest in midwives as a strategic, high-impact solution
2. Integrate midwives into health policy, leadership, and systems
3. Institutionalise woman-centred midwifery models of care
4. Strengthen midwifery education, workforce, and regulation
5. Fund advocacy, innovation, and women-led movements
6. Mobilise public support and accountability for midwifery and women’s health

Key statistics:

• Global burden (annual):~300k maternal deaths, ~2M neonatal deaths, ~2M stillbirths; 200M women with unmet need for contraception.
• Up to 16× ROI: Midwifery models of care deliver the highest return in global health—up to sixteen dollars back per dollar invested.
• Universal midwifery care could save 4.3M lives annually; a 10% scale-up saves 1.3M by 2035.
• Midwives can deliver ~90% of essential sexual, reproductive, maternal, newborn and adolescent health services across the continuum of care.
• Country proof – Lao PDR: By 2030, +95% coverage + full contraception = US$768M benefits; 377,602 unintended pregnancies, 254 maternal and 6,689 newborn deaths, and 2,228 stillbirths averted.
• Country proof – Morocco: 2021–2023 investment yielded >US$10B in benefits for US$638M in costs.
• Country proof-- USA : Shifting all low-risk births to midwife care saves ~US$340M/year via fewer unnecessary C-sections and interventions.
• Women are 70% of the health workforce yet earn ~24% less and hold <20% of leadership roles. Midwifery is ~93% female.
• 61% of maternal deaths occur where only ~25% of live births happen—humanitarian settings.
• By 2030, climate-related displacement could block 14M women from contraception, causing 6.2M unintended pregnancies and 2.1M unsafe abortions.

Acknowledgements

Special thanks to our partner on this project, Global Health Visions. This evidence brief is the result of the work of many experts and collaborators who generously contributed their time and expertise to ensure it is comprehensive and practical. We thank American University of Beirut – Women’s Institute for Sexual Health; Center for Reproductive Rights; Data2X; Direct Relief; Engender Health; Forum for Women Development and Research (WRA Pakistan); FP2030; Gates Foundation; Guttmacher Institute; International Rescue Committee; Likhaan Center for Women’s Health; Lund University; Médecins Sans Frontières; PMNCH; Women Deliver; and UNFPA.