For Beng Seanmeung, it is a sight she will never forget, and it was her epiphany.

I remember seeing a neighbour giving birth, losing a lot of blood and being rushed to the hospital. It was on this day that I decided,” said Beng, reflecting back on this day when aged just 17 years old and about to graduate from secondary school.

Beng’s life-changing decision was to become a midwife and a champion of maternal and newborn health for ethnic minority mothers and children.

At that time, there were very few midwives around here. In many of these ethnic-dominated rural villages, there still aren't enough of us, but we can’t give up. Lives depend on us,” said Beng, now aged 22 years, from her home in southern Saravan province – known for its natural beauty and rich diversity of ethnic minority communities as well as being one of the nation’s poorest regions.

Notable progress has been made towards protecting the lives of mothers in Lao PDR during pregnancy and childbirth across the past two decades. Between 2000 and 2023, the country’s maternal mortality rate fell by 82% – one of the largest percentage reductions in the world – from 609 maternal deaths per 100,000 live births in 2000 to 112 maternal deaths per 100,000 live births in 2023. This is one of the largest percentage reductions in the world, far surpassing the global trend, where the estimated MMR in 2023 was 197 maternal deaths per 100,000 live births, a 40.0% reduction from 328 in 2000 over the same period^[1]. As a result, Laos is well-positioned to meet the Sustainable Development Goal target of 70 maternal deaths per 100,000 live births by 2030. Similarly, downward trends in both neonatal and infant mortality have been witnessed to sit at 12 and 25 deaths per 1,000 live births, respectively, in 2023 compared to 32 and 68 deaths per 1,000 live births, respectively, in 2012.

Despite these steps forward, rates of maternal, neonatal and infant mortality remain an acute challenge in this land-locked South East Asian nation—particularly among ethnic communities living in remote, mountainous areas.

Aware of these challenges and proud of her Ka Tang ethnicity, Beng chose to enter the UNFPA-supported midwifery course straight from high school.

I knew right from the start of training this was the right path for me. At first, I was worried, but my teacher guided and supported me. I wasn’t afraid—I just wanted to learn. Because I love this work, I wasn’t scared to practice” said Beng.

Aware of the critical need to boost the intake of professionally trained midwives – especially with ethnic minority backgrounds, UNFPA in partnership with the Ministry of Health is working to ensure more young people follow in Beng’s footsteps. Aligned with UNFPA’ Midwifery Strategy and the national goal of ensuring at least one midwife in every primary healthcare center, the agency is advocating for the recruitment and deployment of midwives who reflect the country’s rich ethnic and cultural diversity. To this end, UNFPA offers scholarships to students from remote and underserved communities, enabling them to return home equipped to serve their people. Beng is part of this journey, one of a new generation of midwives transforming maternal health from within the very communities that need them most.

But, it hasn’t always been an easy road forward. Despite Lao PDR’s proud 100-year journey in developing its midwifery education, with the first diploma introduced in 1924, midwifery training was discontinued for 23 years until 2010 due to lack of funding. By 2008, just 100 midwives remained in the country, resulting in the highest maternal mortality ratio in the region.

To prevent these avoidable tragedies, UNFPA and the Government of Lao PDR joined forces to revive the national midwifery programme in 2010. Since the launch of the Skilled Birth Attendance Development Plan in 2008, over 3,000 midwives have been trained to deliver culturally sensitive and accessible care for pregnancy, childbirth, and postnatal services across the country.

By the end of 2024, 93 ethnic midwives graduated thanks to UNFPA’s scholarships and technical assistance, many of whom—like Beng—come from remote and hard to reach areas. These efforts are significantly contributing to the growing presence of trained midwives in previously underserved areas.

Graduating in 2023, Beng knows she is in a unique position to challenge cultural taboos and centuries-old traditions to realize transformational maternal and newborn health outcomes for ethnic minority communities.

Speaking local ethnic languages helps me connect—but challenges remain. Traditional beliefs are deeply rooted, and many elders do not understand modern healthcare practices. They apply traditional medicine, which often causes infection. We advise against it, but not everyone listens,” said Beng.

There is also a deep reluctance to give birth at health centres as families fear upsetting spiritual beliefs, and persistence of “Yu Kam” — a traditional custom for postpartum mothers to lay on a wooden bed with extreme heat underneath. The practice restricts mothers’ diets and promotes excessive consumption of hot water, which can potentially harm both the mother and the baby.

To counter these beliefs, Beng travels through the green, winding roads of Tumlan district in a pink shirt – the signature uniform of midwives in Lao PDR that led to their nickname ‘the heroes in pink’ –on her brown motorcycle loaded with her equipment to deliver education on maternal and child nutrition, and health during pregnancy and post-childbirth from village to village. She also collects health data on behalf of the local Maternal and Child Vaccination Promotion Unit, supports pregnant women through counseling, and even helps care for patients at the local hospital.

Every day is a challenge, though. With just five midwives to cover the broad district, the workload is unrelenting, the pay is modest and reaching some villages—especially during the rainy season—is difficult due to poor roads.

When things get tough, I think of my training and my mentors,” said Beng, gently caressing her abdomen. Expecting her first child, she continues to dedicate herself wholeheartedly to supporting other mothers-to-be in need.

Ethnic midwives foster trust and improve communication by sharing linguistic and cultural backgrounds with the women they serve. This shared understanding enhances the delivery of health information, early detection of complications, and informed choices regarding childbirth. Engaging communities through midwifery models of care, particularly with ethnic midwives in the Lao context, is a key element of successful global midwifery accelerators.

Dr. Lodchana Nanpasit, one such mentor and a tutor of Beng at the School of Health Sciences in Savannakhet province, has also seen first-hand how ethnic minority midwives can be change-makers and break the cycle of poor health outcomes.

Before receiving formal education, many students held traditional beliefs passed down from their parents—for example, that women should avoid eating after giving birth. Through their training, they gained a deeper understanding of health and nutrition and returned home to share this knowledge and accurate information on pregnancy, childbirth, and postpartum care, gradually replacing unsafe practices with healthier ones,” said Dr. Nanpasit.

The 45-year-old is proud to witness how Beng and other ethnic midwives are shifting cultural norms around childbirth.

In the past, people only recognized doctors as healthcare providers. Today, midwives are seen as essential figures, supporting women throughout their reproductive years and responding to emergencies. Many are mothers themselves or are driven by a strong passion for women’s health. Because they come from the communities they serve, they are trusted and effective in communicating sensitive health information,” said Dr. Nanpasit, who originally trained as a midwife in Thailand.

To build on this progress, the Lao PDR Midwifery Action Plan 2025–2035—a recent collaboration between the Ministry of Health and UNFPA—outlines a long-term vision for strengthening the profession. Built on five pillars—Education, Enabling Environment, Regulation, Workforce Development, and Community Engagement—the plan acknowledges the urgent need for more midwives, especially from ethnic backgrounds, to deliver culturally sensitive care in underserved areas.

Symbolizing the rebirth of the midwifery profession in Lao PDR, three colleges in 2023 became the first in the Asia-Pacific region to receive international accreditation from the International Confederation of Midwives with UNFPA support.

But, there is much work to be done if Lao PDR is to realize its goal of ensuring no one is left behind in receiving maternal and newborn healthcare – no matter their location or ethnicity.

Looking ahead, Dr. Nanpasit said all stakeholders need to double down and ensure all graduates like Beng continue to receive training to develop advanced skills to manage complications, interpret diagnostic tests and build confidence to better serve women in health centres, hospitals and the field.

But, midwifery is not just about clinical skills—it’s about trust, empathy, and a deep commitment to community health. With the right support and training, midwives—especially those from ethnic groups—are making a powerful impact in improving health outcomes across Lao PDR,” she said.

Beng agrees: “I’m proud that I studied midwifery. One day, I’ll also become a mother, and I want to help others stay healthy too.”

Beng’s midwifery journey is far from over. Her Continuing Professional Development (CPD) will persist throughout her career. She is set to receive CPD training, which will include Basic Emergency Obstetric and Newborn Care, with support from UNFPA.