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Spain’s Midwives: The Struggle for Visibility and Recognition

Lack of personnel, poor working conditions and unqualified practices are the main challenges facing Spanish midwives, who are fighting for better recognition and visibility.

With just 6.1 professionals for every 10,000 patients, their situation is one of the most precarious in the European Union, where the average is 9.1, according to the Madrid Association of Midwives (AMM).

To mark the International Day of the Midwife that will be observed on Friday, Spanish midwives are denouncing the inability and lack of political will of Spain’s regional governments which have been “irresponsible and indifferent” to their claims, María Ángeles Rodríguez Rozalén, head of Institutional Relations at the Spanish Association of Midwives (AEM), tells Efe.

“The profession has paid a high price throughout history for having an absolute majority of women and also a small collective that, somehow, becomes invisible to those who represent us and are supposed to defend us,” she adds.

In the Community of Madrid, which along with Andalusia has the lowest average of midwives in the country, these professionals complain of a lack of training and personnel, saying it is impossible for them to be present in key areas where they are needed and, in most cases, have been replaced by nurses.

“What we demand is to perform the skills for which we have been trained. In hospitals, we want to occupy the floors where puerperal women are, where there are women admitted for pathological pregnancies,” says Cristina González, president of the AMM.

The problem also affects their remuneration within the public health system, where midwives only represent 5.1% of the total of nursing professionals working in primary care – 1,945 out of 38,016. Rodríguez Rozalén acknowledges that some midwives are, in fact, working as nurses because labor conditions “are shameful”.

According to data provided by the AEM and AMM, there is only one professional for every 13,000 patients in Spanish Primary Care, which makes it impossible to attend every woman for the time they require and leads to ever-longer waiting lists. It is estimated that some 3,000 professionals would be needed to alleviate the situation. In Madrid alone, some 1,417 are required to ease the burden.

But, contrary to popular belief, the problem is not a lack of midwives – it is a lack of opportunity.

“In Madrid there are hundreds of unemployed midwives waiting for their phones to ring to start working, but there are no jobs created for them,” González says.

With an average of 12.5 midwives every 1,000 births – compared to the 25.9 every 1,000 births in the European Union – Spain is currently the third last country in the bloc regarding midwife rates.

Several factors could explain these numbers in a country that, paradoxically, boasts about the quality of its public health system. One is the fact that many women don’t ask for these services because they are unaware of them.

“We are working hard to separate the figure of the midwife from pregnancy, childbirth and puerperium so that we are seen as what we really are: experts in women’s sexual and reproductive health who therefore should carry out affective-sexual education within the community and schools,” González explains.

However, things seem to be changing thanks to the new healthcare paradigm that puts women at the center of decision-making, according to Marta Rodríguez, a midwife who, together with two colleagues, launched the project Blomma from the private sector “to fill a gap and focus on the care that midwives can offer women during their sexual and reproductive life”.

“Our aim is to accompany women beyond maternity: during menarche, menopause… stages that are often invisible,” Rodríguez says.

Midwives in the public health system, meanwhile, continue their fight to close that gap.

“Women’s health sustains the world and must be nurtured by providing all kinds of resources to those policies aimed at it,” Rodríguez Rozalén concludes.

Source : La Prensa Latina