Fire in her belly

Midwives magazine: Issue 5 :: 2011

Frances Day-Stirk’s experience of growing up in Jamaica, and then working as a midwife for over 30 years in England is her personal motivation for taking up the mantel as the global voice of midwives. 

‘I guess, coming from a developing country and then living in the developed world, I can see both worlds and I think it’s given me a sensitivity and awareness to some of the cultural differences. I think that is what has really driven me,’ says the new president of the International Confederation of Midwives (ICM), who was sworn in at the triennial congress in Durban, South Africa, in June.

Frances, who is the RCM’s director of learning, research and practice development, has long had one foot in domestic midwifery policy and practice and the other in the international arena. ‘The pathways to becoming president of the ICM were laid out for me,’ she says.

She represents the RCM on several international forums, including the European Midwives Association and also sits on the committee of the European Forum of the Nursing and Midwifery Associations of the World Health Organization (WHO). She has been vice president of the ICM for the past three years. ‘So I have become very familiar with the language, politics and policies of international work, mostly in Europe and then latterly in a global perspective,’ she says.

This work is important, she says, as it is about recognising that a lot of what happens in Europe and globally has an impact on midwifery here in the UK. ‘It’s really important for UK midwives to have a voice in these arenas, so that we both know what’s going on and are able to influence and input into it,’ she says.

Frances says her main task in governing the ICM will be one of relationship building. Both in terms of maintaining the positive associations developed by her predecessors, and in seeking new in-country associations within the confederation’s four regions – the Americas, Africa, Asia-Pacific and Europe. ‘There are a whole host of stakeholder groups that the ICM has engaged with and needs to engage with, both from an advocacy perspective – in terms of civil society groups, for example – but also the big United Nations (UN) organisations and also our donors. It’s about bringing to all of those the difference that midwives can make to populations,’ she says.

She adds that while heavyweight global institutions such as the WHO and Unicef are acknowledging the importance of midwives’ role in maternal and newborn health, there are still countries where midwives do not exist or are unable to practise, or where a short-term approach is taken to midwifery education. It is in these areas where the ICM needs to develop its stronghold. ‘It is about providing them with a framework and the tools so they (midwives) get off on the right foot, making sure they are educated to the standards that the ICM has just launched, and it is regulated in a way that enables midwifery practice to be carried out to the benefit of women and their babies.’ 

Forging links with non-governmental organisations involved in training midwives will be a key area of the ICM’s ongoing work. ‘There is nothing universal about how a midwife is educated in Alaska or Afghanistan, and the ICM believes a woman should have access to competent midwives wherever she lives, so education and training programmes need to meet those standards. We have a big piece of work to do around awareness to make sure everybody knows that the standards exist and then see how we can work with them to make sure they are well delivered,’ explains Frances.

When she talks about the overarching objective of her three-year term – that is to steer the confederation in its part in reaching the UN Millennium Development Goal (MDG 5) on improving maternal health – the fire in her belly ignites.

She is exasperated that, of the eight MDGs to end poverty by 2015, this is the goal that has made the least progress. ‘Sixty million women worldwide give birth unattended. How do we break that? We need to cut the figure on women dying from childbirth and related illness and none of those things will happen unless governments commit to educating, training and regulating midwives and enable them to work within a good health system.’

However, she says the jeopardy posed by missing this goal also presents an unprecedented opening for midwives. ‘Maternal health is high on everybody’s agenda – at the UN, the G8, the G20, across the board, we need to capitalise on this opportunity leading up to 2015, so that is the reason for the big push at the moment,’ says Frances.

What midwives across the world need to be doing to seize this moment is to come together on local activities to raise awareness of the importance of midwifery. One example she suggests is getting involved in the activities of the White Ribbon Alliance – the international coalition of associations campaigning for safe motherhood. It is also important to work with civil society groups, ‘because often you don’t make much progress without working with women. It’s when women and midwives come together that the shifts happen,’ adds Frances.

Sharing and twinning – supporting another association in a different part of the world to assist in the development of their education and practice – is another way in which midwives can make a practical difference. This work will expand on existing programmes run by the ICM. ‘Twinning is likely to be part of the ICM’s strategy for regional development. We will be identifying where the needs are, working with those countries and looking for twinning partners,’ she says.

Asked what her message is likely to be for the next ICM congress – Prague 2014 – she predicts: ‘More than likely, one year to go (before the MDG deadline) we will have made huge strides but there is still a long way to go.’

On the journey, she says she is most looking forward to meeting midwives across the globe. ‘I love seeing where midwives have instituted something new, where the benefits can be seen by their population – that’s what I’m really looking forward to,’ says Frances.