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Supporting Healthy Mothers

Issues & Solutions

Pregnancy is often a time of joy and anticipation, but in low- and middle-income countries, it can be a life-threatening condition. Most of the risks for pregnant women are related to poverty, poor nutrition, a high burden of infectious disease, limited access to care, and a lack of understanding about when to seek care.

In Brief

Direct Relief’s humanitarian health efforts place particular emphasis on protecting women and babies in fragile settings.


Direct Relief supports health organizations in countries around the world who provide critically needed maternal and neonatal health services during the full spectrum of pregnancy, childbirth, and postpartum care.


Women’s Health

Midwife Kit

Direct Relief’s Midwife Kit contains 59 essential tools midwives need to facilitate safe births.

Fistula Repair Module

A standardized pack of high-quality medicines and surgical supplies necessary for fistula repair surgery and post-operative care.

Reproductive Health

Direct Relief and leading healthcare companies are partnering to provide women across the U.S. with no-cost birth control.

Five Ways Direct Relief Helps Moms Thrive

Direct Relief protects women through the critical periods of pregnancy, childbirth, and postpartum. This support includes ensuring more trained midwives are properly equipped, supporting healthy pregnancies with prenatal vitamins, expanding emergency obstetric care in areas of crisis, and supporting life-restoring surgeries for women who suffer the debilitating effects of obstetric fistula—a birth-related injury that affects women in low- and middle-income countries almost exclusively.

1. Equipping Midwives

The best way to keep mothers safe is to make sure every birth is accompanied by a trained and equipped professional. Midwives are the first line of assistance, providing high-quality care during routine deliveries, managing basic complications, and recognizing when to refer a mother to emergency obstetric care. But they can only do their work if they have the right tools.

To equip midwives with the resources they need to provide life-saving antenatal, delivery, and postpartum care, Direct Relief developed its midwife kit, which the International Confederation of Midwives has endorsed as a standard for midwives trained to ICM’s competency standards.

Since 2012, Direct Relief has delivered over 4,500 midwife and replenishment kits to midwives in low-resource settings, facilitating an estimated 225,000 deliveries.

2. Supporting Healthy Pregnancies

Pregnant women and developing babies are particularly vulnerable to micronutrient deficiencies, which increase the risk of dying during childbirth or of giving birth to a baby that is preterm, underweight, or impaired. Direct Relief addresses this issue by distributing prenatal vitamins to partner facilities and organizations around the world.

Direct Relief disseminates prenatal vitamins worldwide. In recent years, Direct Relief has partnered with Kirk Humanitarian, a nonprofit organization dedicated to reducing global inequity by driving a global effort to ensure multiple micronutrient supplements, or MMS, reach women at risk of undernutrition during pregnancy.

Since 2018, Direct Relief has distributed over 4.2 million bottles of Kirk Humanitarian prenatal vitamins to 70 countries. MMS, which contains 15 essential micronutrients, is a standard component of antenatal care in high-income countries, but women in low- and middle-income countries often do not have access. In partnering with Kirk Humanitarian, Direct Relief is working to change that.

3. Fighting Fistula, Restoring Dignity

Obstetric fistula is a hole in the birth canal caused by prolonged and obstructed labor. If untreated, a woman with obstetric fistula will experience constant and uncontrollable leakage of urine and/or feces. Many women with fistula suffer humiliation, isolation, and stigma as a result of the smell and constant leakage. In most cases of obstructed labor in which a fistula develops, the baby is stillborn.

According to the United Nations Population Fund, there are half a million women and girls living with fistula, with new cases developing every year in low to middle income countries.

Direct Relief, in collaboration with the United Nations Population Fund, developed the Global Fistula Hub — the first-ever worldwide map of treatment for this devastating childbirth injury — to help better understand the current fistula treatment capacity, more effectively target scarce resources to where they are needed most, and identify where gaps in service may exist. In 2020, the platform was re-imagined beyond just the fistula treatment map to include an ArcGIS framework offering an open data hub, data visualizations and analytics.

Since 2003, Direct Relief has maintained its commitment to expanding the understanding and quality of obstetric fistula repair services for women affected by this devastating and debilitating health issue in low-resource communities around the world. Direct Relief has established partnerships with facilities performing fistula repair surgeries according to best practices and provided a reliable supply of the materials needed to conduct these life-restoring procedures. In May 2016, the International Federation of Gynecology and Obstetrics (FIGO) officially endorsed the Obstetric Fistula Repair Module developed by Direct Relief to ensure that surgeons and other healthcare professionals are provided with high-quality, standardized, items necessary to perform fistula repair surgeries.

4. Emergency Obstetric Care

When complications occur, emergency obstetric care such as a cesarean section may become necessary. During natural disasters or other humanitarian emergencies, these life-saving services may be cut-off due to damage to health facilities or medical equipment. In areas affected by disaster and humanitarian crisis, Direct Relief provides funding to restore and increase access to emergency obstetric services by building or outfitting suitable health facilities with the equipment they need to provide quality care. This includes the provision of fetal monitors, oxygen concentrators, birthing beds, ultrasound machines, anesthetic machines, and more.

In recent years, Direct Relief has provided grant funding in response to natural disasters to increase emergency obstetric services in the Philippines, Nepal, Indonesia, and Haiti.

5. Expanding Access to Family Planning

The ability to delay and space childbearing is crucial to women’s social and economic advancement, yet the evidence suggests that the most disadvantaged women in the U.S. do not fully share in these benefits. Forty-five percent of all pregnancies in the US are unintended and occur at a higher proportion in young, poor, and minority women. Unintended pregnancies are also often associated with negative outcomes such as premature birth, maternal depression, and other lifelong health, economic and societal difficulties. Supplying health professionals with high quality contraception to allow their most disadvantaged patients to choose if and when to become pregnant, has the ability to transform lives.

Direct Relief offers IUDs at no cost to health facilities providing family planning services to uninsured patients in need through the IUD Access Partnership, an institutional patient assistance program in collaboration Medicines360, and through the safety-net support program in collaboration with Bayer.