Jolene Wescombe, Massey University

Jolene’s Research Topic: Ethiopian midwives as agents of change

“As a New Zealand midwife, I have always been intrigued by how midwives in development settings model practice that is respectful and woman-centred – or not. The challenges are enormous. Sub-Saharan Africa still accounts for 70% of all maternal deaths in 2020, and addressing disrespect and abuse in childbearing is an international priority.

Ethiopian midwifery has great potential to inform maternity care that brings real community change in development settings. Ethiopian midwives practice in incredibly challenging remote rural environments complicated by lack of infrastructure, resourcing and support. Also, cultural norms contribute to 46% of rural women still giving birth at home, unassisted by skilled birth attendants. Yet Ethiopia’s midwifery workface has made incredible strides in decreasing maternal mortality from 871 per 100,000 live births in 2000 to 267 per 100,000 live births in 2020.

Quite simply, an empowered midwife empowers women, and empowered women empower entire communities. Initial research findings reveal how empowering midwifery practice is locally enacted through familial-type relationships. These relationships were characterised as mother, mentor, sister, and brother, and emphasised the importance of male collaboration. These familial relationships included person-to-person role modelling as a powerful tool for empowerment: mentoring midwives in education and practice, midwives’ peer-to-peer role modelling, and mobilising women peer-to-peer within communities. Compassionate respectful care and “Mikirke”, meaning a two-way model of communication and sharing, creates a woman-centred care model essential to building trust and relationship between midwives and women. However, community trust in midwives is significantly damaged by unreliable supplies of contraceptive choices. This causes suspicion and misunderstanding. Lastly, further efforts are needed to enhance health professional and community understanding of how the broad scope of midwifery practice is essential to midwives’ functioning in empowerment.

I would like to thank DevNet, as this project field work was substantially assisted by a New Zealand Postgraduate Development Field Research Award. And most of all I would like to thank my incredibly supportive supervisors Dr Maria Borovnik, Professor Rochelle Stewart-Withers, and Associate Professor Gerard Prinsen.”

Jolene Wescombe, PhD student in Development Studies, Massey University.