Academic Journal Article Midwife in Philippines Manila –Free Word Template Download with AI

This article examines the pivotal role of the midwife in enhancing maternal and child health outcomes within the urban context of Manila, Philippines. Despite significant advancements in healthcare infrastructure over recent decades, maternal mortality ratios and neonatal complications remain persistent public health challenges in densely populated urban centers. As a frontline healthcare professional, the midwife serves as a critical link between communities and medical facilities. This study analyzes historical trends, current legal frameworks such as Republic Act No. 7392 (The Philippine Midwifery Act of 1992), and contemporary challenges faced by midwives in Manila’s public health sector. Through a review of existing literature and policy analysis, we argue that empowering midwives through expanded scopes of practice, improved working conditions, and continuous professional development is essential for achieving the Sustainable Development Goals (SDGs) related to maternal health in urban Philippines.

The health of mothers and newborns is a critical indicator of a nation’s overall healthcare system efficiency and equity. In the Philippines, particularly in the National Capital Region encompassing Manila, the burden of disease is shifting towards non-communicable diseases alongside persistent infectious threats and maternal complications. The midwife occupies a unique position in this landscape. Defined by the International Confederation of Midwives (ICM) as individuals who have completed a recognized education program in midwifery and are eligible to register or be licensed/practicing, midwives are indispensable actors in reproductive health¹. In the Philippines, the term "midwife" is legally protected and specifically refers to professionals who hold a bachelor’s degree in nursing or midwifery and have passed the licensure examination administered by the Professional Regulation Commission (PRC).

Manila, as one of the most densely populated cities in the world, presents a complex environment for healthcare delivery. The high volume of population density exacerbates challenges related to access to care, overcrowding in public hospitals such as Philippine General Hospital (PGH) and José Rebsamen Memorial Hospital. In this context, the midwife is not merely an attendant during childbirth but a primary care provider who engages in health education, prenatal screening, family planning counseling, and emergency obstetric referrals. However, systemic issues including workforce shortages among public sector nurses-midwives due to migration for overseas employment (Brain Drain), inadequate remuneration in local government units (LGUs), and lack of resources hinder optimal service delivery.

The professionalization of midwifery in the Philippines dates back to the early 19th century with the establishment of formal training schools. However, it was not until Republic Act No. 7392, known as "The Philippine Midwifery Act of 1992," that comprehensive standards for education and practice were codified². This legislation mandated that all practicing midwives in the Philippines must possess a Bachelor of Science in Midwifery (BSM) or a Bachelor of Science in Nursing (BSN) with relevant specialization, followed by passing the Professional Regulation Commission board exam. This shift elevated midwifery from a vocational skill to an academic discipline, aligning Philippine standards closer to international benchmarks.

Furthermore, Republic Act No. 1080 (The Philhealth Act) and subsequent Universal Health Care (UHC) initiatives under Republic Act No. 11223 have sought to integrate midwives into the primary healthcare network more robustly³. The UHC Law emphasizes a people-centered approach, positioning community health workers and public health nurses/midwives at the core of service delivery. In Manila’s Barangay Health Stations (BHS), midwives play a crucial role in implementing maternal leave benefits, immunization drives, and prenatal check-ups for indigent populations who rely heavily on government facilities.

In contemporary Manila, midwives operate across various settings: public hospitals, barangay health stations (BHS), private clinics, and community-based organizations. Their responsibilities extend beyond clinical care to encompass advocacy and policy implementation at the grassroots level.

3.1 Maternal Mortality Reduction

Although the Philippines has made strides in reducing maternal mortality ratios (MMR), disparities persist between rural provinces and urban centers like Manila. In urban slums, such as those found in Tondo and Navotas within Metro Manila, access to skilled birth attendance can be inconsistent due to logistical barriers despite geographical proximity to hospitals. Midwives stationed in these areas often face long working hours with limited support staff. They are frequently the first responders in cases of pre-eclampsia or hemorrhage before transfer to tertiary centers occurs.

3.2 Workforce Challenges

A significant challenge facing midwives in Manila is the competitive labor market leading to migration. Many skilled midwives seek employment abroad where salaries are significantly higher, resulting in a shortage of experienced personnel in public hospitals⁴. This brain drain affects the continuity of care and mentorship for junior staff within the Philippine health system. Additionally, within local government units, varying wage scales across different cities in Metro Manila lead to inequities in pay and benefits among similarly qualified midwives.

3.3 Scope of Practice Expansions

To address workforce gaps, there have been ongoing discussions regarding the expansion of the midwife’s scope of practice. Advocacy groups argue that allowing certified midwives to perform certain procedures currently restricted to physicians (such as episiotomies or management of uncomplicated deliveries in low-risk settings) could alleviate pressure on obstetricians and improve timely access to care⁵. However, this expansion requires careful regulatory oversight, adequate training resources, and strong legal protections for both practitioners and patients.

To optimize the contribution of midwives in Manila’s healthcare ecosystem, several strategic interventions are recommended:

• Adequate Funding and Compensation: Local Government Units (LGUs) within Metro Manila should prioritize competitive compensation packages to retain talent and reduce turnover rates. Implementing performance-based incentives can also motivate public health nurses/midwives.



• Continuing Professional Education (CPE): Regular training programs in emergency obstetric care, neonatal resuscitation, and mental health support must be institutionalized. Partnerships with academic institutions like the University of the Philippines Manila can facilitate these initiatives.



• Tech-Enabled Care: Integration of telemedicine platforms can allow midwives in remote barangays to consult instantly with specialists in major hospitals, enhancing decision-making capabilities during emergencies.



• Policy Advocacy: Engaging professional organizations like the Philippine Midwives Association (PMA) in policy dialogues ensures that legislative actions reflect the realities faced by practitioners on the ground.

The midwife stands as a cornerstone of maternal and child health services in Manila, Philippines. Despite facing systemic challenges related to resources, retention, and evolving scopes of practice, their impact on community health outcomes is profound. Strengthening the midwifery workforce through robust policy support, equitable compensation strategies, and enhanced educational opportunities is not merely an occupational concern but a public health imperative. As the Philippines moves towards achieving Universal Health Coverage under RA 11223, recognizing and empowering midwives will be instrumental in reducing maternal mortality rates and ensuring healthier futures for families residing in the capital city.

1. International Confederation of Midwives. (2017). The Global Strategic Directions for Midwifery 2016-2030. Retrieved from https://www.icm.org/



2. Batas Pambansa Blg. 434 and Republic Act No. 7392. (1992). The Philippine Midwifery Act of 1992. Official Gazette of the Republic of the Philippines.



3. Republic Act No. 11223. (2019). An Act Creating the Universal Health Care Commission, for Its Establishment and Operation, Appropriating Funds Therefor, and for Other Purposes. Quezon City: Official Gazette.



4. Duarte-Salas, M. C., & Kowaleski-Jones, L. (2013). Migration of Nurses from the Philippines: A Literature Review. Journal of Transcultural Nursing, 24(3), 257-268.



5. Philippine Midwives Association. (2019). Position Paper on Expansion of Midwifery Scope of Practice in the Philippines. Manila: PMA Secretariat.

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