Labour pain dey run through Grace Mwale body as she hold her big belle, di contraction dey strong pass di one wey don pass.

Di 24-year-old Malawian woman wey dey expect pikin dey fear for her life and di pikin wey she carry, as time dey go and no maternity help dey show face.

Di nearest hospital dey far, ambulance no dey, and nobody sabi whether Grace go fit born di pikin normal.

Dis kain situation no be new thing for villages like their own, but e no dey easy for family to prepare for medical wahala.

Na there Esther Banda enter, one local midwife wey don get plenty years of experience and steady hand.

Esther guide Grace through di labour for di next few hours, dey talk soothing words, massage her back, and make sure say she dey drink water well well. When di pikin head finally show, Esther use her skill deliver di healthy baby boy.

Grace, wey don tire but dey happy, whisper her thank you.

"If no be for Esther, I no sabi wetin for happen," she tell TRT Afrika as she carry her new baby.

Dis kain scene dey happen every day for Africa, where midwives like Esther dey form di backbone of maternal healthcare, dey work for hard condition to make sure say women fit born safely.

Now, di World Health Organisation (WHO) dey call make dem expand midwifery care globally, as experts believe say e fit save millions of lives.

Tradition of trust

Skilled midwife dey build trust, dey give emotional support and dey empower women for di vulnerable time of their life.

Studies don show say women wey midwives dey care for dey more likely to get healthy vaginal births and dem dey happy with di care wey dem receive.

"Midwives no just dey catch pikin – we dey listen, we dey educate, and we dey stand for women," na wetin Fatoumata Diallo, one midwife for Senegal, talk. "For many villages, na we be di only healthcare provider wey mothers fit rely on."

Kenyan midwife Jane Wambui sabi wetin e mean to dey give pregnant woman assurance.

"When woman dey see di same midwife throughout her pregnancy, she go feel safe. She go sabi say person dey understand her fear and her body. Dat connection dey save life," Jane tell TRT Afrika.

Numbers tell a story

Maternal and newborn deaths still dey high, especially for low-income countries. WHO talk say if everybody fit get access to skilled midwives, over 60% of di deaths fit reduce, and dem fit save 4.3 million lives every year by 2035.

"To expand midwifery care na one of di most effective way to improve maternal and newborn health globally," na wetin Dr Anshu Banerjee, director for maternal, newborn, child and adolescent health for WHO, talk. "Dis approach dey improve results, dey maximise resources, and fit work for all countries."

Midwifery dey also help reduce di over-medicalisation of childbirth. Even though things like C-section dey help for some cases, e still get risk. Some countries get C-section rate wey pass 50%, wey dey higher than di 10-15% wey WHO recommend for medical necessity.

"Skilled midwives dey help women trust their body and ability; dem dey make sure say women get di emotional support wey dem need," na wetin Ulrika Rehnström Loi, one WHO midwifery expert, talk.

Building better systems

Midwives dey work for hard condition wey dey worse because of lack of funding, equipment, and di way dem no dey properly include dem for health system.

Many of dem dey work alone, without doctor backup when wahala happen.

Di new WHO guidance dey give practical tools to strengthen midwifery care through three main ways. Di first one na continuity of care, wey mean say di same midwife or small team of midwives go dey assist di pregnant woman from di time she carry belle, to di time she born, and recovery.

Another model na to create midwife-led childbirth centres wey go help women wey no get high risk to born safely without too much intervention.

Community-based approach dey also bring maternity care come villages through mobile units or local health centres, so even di remotest areas fit get help.

"Midwifery models no just dey smart; dem dey necessary," na wetin Anna Ugglas, CEO of di International Confederation of Midwives, talk. "Dem dey bring dignity to childbirth and dey ensure safety for mothers and babies everywhere."

As global healthcare leaders dey push for more midwifery care, di message clear say to support midwives na to save lives.

Back for her Malawian village, Esther dey continue her work with di quiet determination of person wey sabi say she dey make difference.

"Every mother deserve safe birth," she tell TRT Afrika. "And every midwife deserve di tools to make am happen."