Open Letter to H.E. Mr. President Sebastián Piñera of Chile
ICM Calls on President of Chile to intervene in decision to update Book V Health Code
H.E. Mr. Sebastián Piñera Echenique
President of the Republic of Chile
31 August 2021
Dear Mr. President,
Please receive our warm greetings from the International Confederation of Midwives (ICM) and its one million midwife members worldwide who are serving the needs of families around the world, including your beautiful country, Chile.
The International Confederation of Midwives (ICM) represents midwives, from over 123 countries globally. We work with our 140+ ICM Member Associations and collaborate with international organisations such as the World Health Organization (WHO) and the United Nations Fund Population Agency (UNFPA) to strengthen midwifery and support all women to have access to a midwife.
Chile has a 184-year history of education and midwifery practice. The commitment of the Chilean State to the development of women's and children's rights is well known internationally.
For this reason, Mr. President, I request your intervention in the recent decision to update Book V Health Code, which, if approved, will dramatically change the scope of the provision of midwifery services and hamper the rights of women to access to sexual and reproductive health-care services provided by midwives, including for family planning, information and education, and the integration of reproductive health into national strategies.
We respectfully would like to draw your attention to the following:
The ICM believes that midwives are pivotal in attaining improved health for women, and in achieving improved maternal and newborn health outcomes through the provision of competent, culturally sensitive, evidence-based midwifery and reproductive health care.
Midwives are proven to be the best choice to care for women, and their babies during pregnancy, birth and postnatally as well as from a health system and financing perspective. You can find detailed information of evidence in the State of the World Midwifery (SoWMy) 2021 report, which includes:
- SoWMy 2021 analysis indicates that fully educated and regulated midwives integrated within and supported by interdisciplinary teams and an enabling environment can deliver about 90% of essential sexual, reproductive, maternal, newborn, adolecscent health (SRMNAH) interventions across the life course, yet they account for less than 10% of the global SRMNAH workforce.
- There is now a large body of evidence which shows that investing in midwives facilitates positive birth experiences and safe and effective comprehensive abortion services, improves health outcomes, increases workforce supply, favours inclusive and equitable growth, facilitates economic stabilization, and can have a positive macroeconomic impact.
- Midwives are essential providers of primary health care and can play a major role in this area as well as other levels of the health system: in addition to maternity care, they provide a wide range of clinical interventions and contribute to broader health goals, such as addressing sexual and reproductive rights, promoting selfcare interventions and empowering women and adolescent girls.
- The findings of the report demonstrate the importance and effectiveness of midwives as core members of the sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) workforce. They have been instrumental in helping to drive tangible progress towards several goals and targets of the 2030 Agenda for Sustainable Development.
We at the International Confederation of Midwives, together with your dynamic and dedicated Colegio de Matronas y Matrones de Chile, ask you to intervene so that your decision to update the book, take into consideration the various recommendations of the Colegio.
By doing so, Mr President, we ask you to recognize the Chilean midwives as competent SRMNAH workers, who meet the ICM Definition and Scope of Practice of a midwife and the ICM’s Essential Competencies for Midwifery Practice, so that midwives may continue to contribute as fully as possible to the health, well-being and economy of Chile and help guarantee the provision of sexual and reproductive rights of women and adolescent girls.
I thank you for your contribution in ensuring that every woman, every child and every family receives the highest quality of care they need and deserve.
Franka Cadée María Florencia Francisconi
ICM President ICM Regional Representative Latin America