Midwife with MSF: Care at every step

05 May 2020

The work of our midwives, ensuring high quality care and continuity of care, is too often unsung. On International Day of the Midwife 2020, we recognise their pivotal role.

Midwives work in Médecins Sans Frontières’ highest level hospitals, and our most basic health centres. They play a critical role in health promotion, disease prevention and patient education.

They are often the first point of care in their communities, as confidants and as clinicians. They are a constant presence at the bedside of people who need ongoing medical care. They are a trusted companion in childbirth, and a trusted comfort in death.


Australian midwife Kate Edmonds attends to a woman and her newborn baby in the Kutupalong hospital, Cox’s Bazar, Bangladesh. © Kate Geraghty/MSF

Kate Edmonds is an Australian midwife with a background in sexual violence care who worked in rural and remote Australia before joining MSF. She has worked in Peshawar Women’s Hospital in Pakistan, in the ‘hospital on the hill’ in Kutupalong, Bangladesh, and most recently in the world’s second largest refugee camp in Uganda.

“What is exciting for me is that sexual and reproductive healthcare for women in Médecins Sans Frontières’ projects is led by midwives. A lot of the decision-making is on us. But it is important that those decisions be made within a patient-centred approach.
That’s part of the training I provide in our projects and for me, it’s really about role modelling. It starts with how we treat a woman when she first walks in. We do not stand over the chair and talk to her, we pull a chair up and we have a discussion.
Even in Australia our system is not there yet, but for the midwives in Pakistan and in Bangladesh, it was a whole new way of operating. I concentrated a lot on that first moment with the woman. We didn’t talk about what we’re going to do; instead, we listened to her story, her history, made observations about what we saw, and planned with her how we could make a difference for her for her current delivery, or her next.

“I feel a profound solidarity working with nurses and midwives in different countries and understanding where they have come from themselves.” 

It was amazing for me to see how midwives with limited experience could understand that a woman-centred approach makes a big difference. They were so very thirsty to learn, to have information and training.

In Uganda I was no longer in a maternity unit. I was training up midwives to be able to provide care for women, and men, who had been sexually violated as they fled from South Sudan, or after they arrived. To sit and listen to how the midwives elicited information from the women and men about their experiences was extraordinary. They had undergone training with MSF, but their approach seemed innate.

I feel a profound solidarity working with nurses and midwives in different countries and understanding where they have come from themselves.

Compared to how easy it was for me to choose to be a midwife, many of them have had to convince their families and their community that this is what they really want to do. They have had to find the money to pay for their education, which may have meant working at the same time as studying. I am in awe of their struggle.”