In Senegal, midwives are key to improving the health of mothers and newborns. However, they face a big legal problem. The rules that govern their work are based on a law from 1966, which is no longer suitable for today's healthcare system. This 1966 law was created when midwives were seen as helpers to doctors, working under their control.
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Over time, midwives have taken on more responsibilities, like checking pregnancies, delivering babies, providing care after birth, helping with family planning, and supporting sexual and reproductive health.
But even though their work has grown, the law hasn't changed. As a result, there is a legal confusion that causes serious issues, according to Bigue Ba Mbodj, leader of the National Association of State Midwives of Senegal (ANSFES).
When asked about the legality of midwives' work, lawyer Aïssatou Kanté Faye, a member of the Association of Senegalese Women Lawyers (AIS), said that midwives are in a risky legal situation.
She explained that as long as the 1966 law isn't changed, midwives are in legal trouble. Their medical work, although important for the health system, might be considered illegal under the current law.
Without a clear legal definition of their skills and role, midwives could be seen as practicing medicine without proper authorization.
This is not just a theoretical problem—it's a real issue. If the law is strictly followed, anyone doing medical work without proper permission could face criminal charges. While such cases are rare, the risk exists, and midwives are always in a legal uncertain position. A legal expert warns that this could even lead to midwives being forced to stop working because they are breaking the law.
The idea of creating a national midwives' order is often suggested as a solution, but it faces a big problem: the lack of clear legal status for midwives.
Aïssatou Kanté Faye says that without changing the 1966 law first, a midwives' order can't be official. As long as their role isn't clearly defined, their work won't be recognized by the government.
Beyond the legal issue, this situation is a public health challenge.
Midwives are vital in reducing deaths among mothers and babies, especially in rural areas where they are often the only healthcare workers available.
Training, hiring, and assigning midwives while letting them work in a legal gray area is a contradiction that many people are now calling for change.
Both legal experts and healthcare workers agree that the only way forward is to reform the 1966 law. This would help recognize the midwifery profession, clearly define what midwives can do, make their work legally safe, and create the basis for a recognized midwives' order. Without this reform, midwives will keep working in legal insecurity, which is not acceptable given the important role they play in the Senegalese healthcare system.