PURPOSE:
Lesotho continues to grapple with alarmingly high maternal and neonatal mortality rates, currently estimated at 530 maternal deaths per 100,000 live births and 33 neonatal deaths per 1,000 live births (WHO, 2023). In a largely rural and mountainous country with limited access to health facilities, skilled midwifery stands as a vital pillar in the fight against preventable deaths. This presentation explores the midwifery practice in Lesotho through the lens of rural outreach, evidence-based intrapartum care, and culturally sensitive interventions.

DISCUSSION:
Drawing from the experience of frontline midwives stationed in primary health center and communities, we highlight critical midwifery practices such as timely identification and referral of high-risk pregnancies, use of the partograph, active management of the third stage of labor (AMTSL), postnatal home visits, and community health education. These efforts have led to a noticeable increase in facility-based deliveries and antenatal attendance, contributing to improved maternal and new-born outcomes.

EVIDENCE WHERE RELEVANT:
Lessons learned include the need for policy-level recognition of midwives as autonomous professionals, investment in midwifery education and rural deployment, and the power of community trust in enhancing care-seeking behavior. Strengthening midwifery is not only essential for achieving Sustainable Development Goal 3 which aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030 (United Nations, 2024) but is a human rights imperative.

KEY MESSAGE:
The relevance of this experience to midwifery lies in its demonstration of how midwife-led models of care can effectively reduce mortality, even in low-resource contexts. It emphases the importance of continuous professional development, supportive supervision, and integration of midwives into broader health systems planning. Climate change 3