On Mother’s Day, we celebrate life — pregnancy, motherhood, and the arrival of babies. But this celebration should also compel us to confront a difficult truth: every year, an estimated 260,000 women still die from complications related to pregnancy and birth, and millions more suffer birth injuries, infections, or disabilities that significantly affect their health and futures.

These outcomes are not inevitable. Women do not die or become harmed because maternal health challenges are unsolvable. They die because complications are not managed properly in time — and too often because those complications were not prevented in the first place.

This Mother’s Day, our message is clear: if we want to give mothers a truly meaningful gift, we must invest in midwives — and support them to prevent complications before they arise and manage them effectively when they do. Both survival and thriving of women depends on this.

Maternal health initiatives seem to focus more on managing complications as they arise. These efforts are, of course, essential. Emergency obstetric care saves lives. Caesarean sections, newborn resuscitation, and the prompt management of excessive bleeding are all critical and should always be available.

But many life-threatening complications are rooted earlier in pregnancy: untreated anemia, undetected hypertension, infections, poor nutrition, mental health challenges, lack of proper evidence-based information, and delays in seeking and receiving quality care. When these risks are not identified and addressed early, birth can become risky long before a woman reaches the time of birth.

Yet prevention still receives far less attention, funding, and recognition than emergency response. It does not lend itself to heroic narratives. It is quieter. Less visible. Harder to measure. Yet prevention must stand at the foundation of maternal healthcare. Delivered consistently and skillfully, it often determines whether a woman arrives at birth healthy or already in crisis. And this depends on skilled, well-supported midwives.

Think of maternal health care as a journey on a bumpy, uneven road. One strategy is to place a highly qualified emergency team at the end of the road, ready to treat those who arrive injured. That is intervention. Another strategy is to invest in reducing the bumps along the road and ensuring that those traveling it know how to navigate well. That is prevention.

If all attention and resources are concentrated on emergency response at the end of the road, the number of injured people remains unchanged. The system stays costly and traumatic — for patients and providers alike. But when we invest in safer roads and better navigation, while still maintaining emergency services for unavoidable incidents, fewer people get hurt. Long-term costs decline, trauma is reduced, and outcomes improve.

Maternity care works similarly. When prevention is neglected, health systems remain stuck in a perpetual state of emergency response. Yet when prevention is prioritized — through quality antenatal care, early risk detection, proper nutrition and supplementation, and skilled midwifery care — fewer women arrive at birth already in danger.

Midwives are the backbone of maternal healthcare in most parts of the world, also in low-resource settings where most maternal deaths occur. They are often the first — and sometimes only — point of contact for pregnant women.

Yet the world faces a shortage of almost one million midwives. Many of those currently practicing do so under immense pressure, with limited access to updated guidelines, continuous professional development, or practical tools that translate evidence into daily clinical decision-making.

This gap has consequences. Fewer than 13% of pregnant women are offered the World Health Organization’s recommended eight antenatal care contacts — each one is a missed opportunity to detect risk early, support a healthy pregnancy, and prevent complications from escalating.

Ensuring women receive quality care, therefore, means investing in those who care for them. Prevention is not an abstract ideal; it is a clinical skillset that must be built, maintained, and supported — just like emergency care skills.

This understanding underpins the partnership between Maternity Foundation and Gnosis by Lesaffre, which aims to improve maternal outcomes by strengthening midwives’ preventive capacity in low-resource settings.

A core focus of the partnership is the accelerated rollout of the newer antenatal care module within Maternity Foundation’s Safe Delivery App — an evidence-based job aid, training, and microlearning platform designed for midwives working in challenging conditions. The App is free, functions offline once downloaded, and has already reached more than 500,000 healthcare professionals across more than 70 low- and middle-income countries in combination with its accompanying training programme.

When the Safe Delivery App first launched a decade ago, its focus was on basic emergency obstetric and newborn care. Today, that focus has expanded to reflect a more holistic understanding of maternal health, incorporating modules on e.g., antenatal and postnatal care, perinatal mental health, and modern contraception — all critical elements of prevention.

The antenatal care module, in particular, supports midwives in delivering consistent, quality care throughout pregnancy, enabling early risk identification and timely action before complications become emergencies.

But tools alone are not enough. That is why this partnership also prioritizes expanding access to hands-on antenatal care training, supporting master trainers who can strengthen midwives’ preventive skills at scale. Investing in midwives’ knowledge and skills is one of the most cost-effective and transformative investments a health system can make.

This is not an argument against emergency care. Prevention and intervention are not competing priorities — they are mutually reinforcing. Early risk detection improves referral quality. Healthier pregnancies reduce emergency burden. Well-trained, well-supported midwives improve outcomes across the entire continuum of care, from pregnancy through birth and beyond.

On this Mother’s Day, we must broaden our definition of what it means to ensure a safe birth. It begins much earlier with prevention with prevention. It depends on midwives whose skills — both preventive and lifesaving — are valued, updated, and supported. And it requires sustained investment in everyday care that quietly prevents tragedy before it unfolds. Because safer births do not start in the delivery room, they start with healthy pregnancies — and with midwives equipped to both prevent and manage complications when it matters most.