Prenatal Care Without Hospitals: Midwives Trained Through Private Initiatives
The role of midwives in communities is of great importance, as they are regarded as wise women. Their training also helps minimize the risks faced by pregnant women who lack access to healthcare.
In rural and marginalized communities around the world, the arrival of a new life is an intimate event but one fraught with medical and logistical challenges due to the local context. In many of these places, the absence of hospital infrastructure, limited access to medical services, and distrust of health systems have led pregnant women to rely on an ancestral figure that has reemerged with renewed strength: the midwife.
But these are not the midwives of centuries past; this is a renewed figure. Private initiatives and NGOs committed to maternal and child health have trained thousands of midwives to ensure they are properly prepared.
Equipping these women with modern knowledge in prenatal health, emergency management, and postnatal care—alongside the ancestral wisdom passed down through generations—improves health outcomes in vulnerable territories where institutional medicine remains an inaccessible privilege.
A Reliable Alternative in Times of Need
The World Health Organization (WHO) has reported that more than 800 women die every day worldwide from pregnancy- and childbirth-related complications. The majority of these deaths occur in regions with limited access to healthcare, such as sub-Saharan Africa, South Asia, and rural areas of Latin America.
Lack of access to healthcare is one of the main causes. Whether due to distrust of the system or the inability of services to reach women in difficult terrains, many pregnant women go unattended by professionals during pregnancy and childbirth.
This reality has spurred the rise of private initiatives investing in intensive training programs for midwives. These programs combine ancestral practices with medical knowledge based on scientific evidence. One of the most impactful models is peer-to-peer training, in which experienced midwives are trained by healthcare professionals and then replicate the knowledge in their communities—an effective approach in areas where cultural or linguistic barriers hinder other solutions.
Modernizing the role of the midwife requires striking a balance between appropriate technology and respect for traditional practices—the blending of “both worlds.” This balance is necessary to build trust in the figure of the midwife within communities.
In many programs, for example, midwives are provided with sterile birthing kits, fetal stethoscopes, digital blood pressure monitors, and cell phones equipped with apps for recording clinical data and consulting basic protocols. At the same time, ancestral practices such as herbal massages, infusions, and emotional support techniques are also recognized and valued.
The results are already evident. In Huehuetenango, Guatemala, the Semillas de Vida Foundation reported a 40% reduction in severe childbirth complications after three years of working with trained midwives. In Uganda, a similar program led by the Safe Mothers, Safe Babies foundation achieved a 78% rate of pregnant women completing at least four prenatal check-ups—an unprecedented figure in the area.
Beyond clinical outcomes, working with trained midwives is also a step toward equity, as hospital births can often involve discrimination, obstetric violence, or cultural exclusion for indigenous and rural women.
By strengthening the role of community midwives, women regain autonomy over their bodies, and historically undervalued knowledge is reaffirmed.
The future of prenatal care in vulnerable territories likely does not lie in replacing midwives with hospitals, but rather in integrating them into a hybrid, resilient, and culturally contextualized healthcare model. Results in various regions have shown that when provided with training, tools, and respect, midwives can be a key force in reducing maternal and infant mortality.
This project marks an important step toward transforming access to basic healthcare, which remains far from universal. The Global Financing Facility reports that strengthening community health services, including midwife training, can reduce maternal and infant mortality by up to 60% when combined with efficient referral systems and basic tools.
These figures underscore the importance of implementing models that recognize the value of local knowledge, reduce exclusive dependence on hospitals, and prioritize community health.
Investing in trained midwives not only saves lives but also redefines access to healthcare as a universal right, regardless of postal code.